Abstract
BackgroundA greater understanding of the mechanisms of action of weight-management interventions is needed to inform the design of effective interventions.PurposeTo investigate whether dietary restraint, habit strength, or diet self-regulation mediated the impact of a behavioral weight-management intervention on weight loss and weight loss maintenance.MethodsLatent growth curve analysis (LGCA) was conducted on trial data in which adults (N = 1,267) with a body mass index (BMI) ≥28 kg/m2 were randomized to either a brief intervention (booklet on losing weight), a 12 week weight-management program or the same program for 52 weeks. LGCA estimated the trajectory of the variables over four time points (baseline and 3, 12 and 24 months) to assess whether potential mechanisms of action mediated the impact of the weight-management program on BMI.ResultsParticipants randomized to the 12 and 52 week programs had a significantly greater decrease in BMI than the brief intervention. This direct effect became nonsignificant when dietary restraint, habit strength, and autonomous diet self-regulation were controlled for. The total indirect effect was significant for both the 12 (estimate = −1.33, standard error [SE] = 0.41, p = .001) and 52 week (estimate = −2.13, SE = 0.52, p < .001) program. Only the individual indirect effect for dietary restraint was significant for the 12 week intervention, whereas all three indirect effects were significant for the 52 week intervention.ConclusionsBehavior change techniques that target dietary restraint, habit strength, and autonomous diet self-regulation should be considered when designing weight loss and weight loss maintenance interventions. Longer interventions may need to target both deliberative and automatic control processes to support successful weight management.
Highlights
Two thirds of adults in the UK and USA are classed as being overweight or obese based on their body mass index (BMI) and there is little evidence that ann. behav. med. (2021) XX:1–14the prevalence is decreasing [1, 2]
The individual indirect effect for dietary restraint was significant for the 12 week intervention, whereas all three indirect effects were significant for the 52 week intervention
Given the similarities in the duration and mode of delivery, the findings indicate that the different behavior change techniques (BCTs) used, and mechanisms of action targeted, resulted in differences in weight change
Summary
Two thirds of adults in the UK and USA are classed as being overweight or obese based on their body mass index (BMI) and there is little evidence that ann. behav. med. (2021) XX:1–14the prevalence is decreasing [1, 2]. The heterogeneity in the size and duration of treatment effect may be due to differences in the behavior change techniques (BCTs) used in an intervention and the mechanisms of actions targeted. Identifying relevant mechanisms of action associated with the desired outcome will enable the evidence-based selection of BCTs to include in an intervention [9]. This is important for weight loss maintenance as weight regained postintervention is commonly reported (e.g., [7]). A greater understanding of the mechanisms of action associated with short- and longer-term weight loss is needed to inform the design of effective interventions, through the selection of appropriate BCTs, that result in both weight loss and weight loss maintenance. Purpose: To investigate whether dietary restraint, habit strength, or diet self-regulation mediated the impact of a behavioral weight-management intervention on weight loss and weight loss maintenance
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
