From Increased Exercise to Reductions in Emotional Eating and Weight/Waist Circumference: Refining Theory-Driven Psychosocial Targets for Treating Obesity

Abstract

Overwhelmingly poor results beyond the short term suggest advances in treating obesity through behavioral means are required. Research on psychosocial intervention targets is particularly important. Because of possible widespread impacts crossing socioeconomic and racial/ethnic lines, methods that can effectively be disseminated in a large-scale and economical manner are also needed. This research assessed women participating in community-administered obesity treatments with similar curricula that were either manual-based ( n = 39) or in-person-based ( n = 44). Along with conclusions that emotional eating is relevant, especially in women, the paradigms of social cognitive theory, self-regulation theory, the mood-behavior-model, and coaction theory guided analyses of psychosocial predictors of weight/body composition changes. Both treatment formats were associated with significant improvements in exercise, mood disturbance, self-regulation of exercise and eating, emotional eating, weight, and waist circumference, with significantly greater improvements associated with the in-person format. Tests of model-fitting indicated that baseline–Time 2 change terms were the better predictor of the subsequent variable in planned regression models, except the self-regulation factors where Month 3 scores were strongest. Increased exercise predicted a reduction in mood disturbance. The path from mood→self-regulation of exercise→self-regulation of eating→emotional eating was significant, along with the direct path from (exercise-associated) changes in mood→emotional eating. Emotional eating reduction significantly predicted reduced weight and waist circumference over 6 and 12 months. The relation between mood and self-regulation supported the mood-behavior-model, whereas the prediction of self-regulation of eating by exercise-related self-regulation affirmed coaction theory. Findings may be used to inform further research and applications targeting psychosocial changes within behavioral obesity treatments.