Theory to treatment to theory: Evolving a community-based obesity intervention

Abstract

Within weight-loss treatments, a better understanding of psychosocial correlates of exercise and controlled eating is required to improve lagging outcomes. Within this two-phase study, women with obesity participating in community-based treatments with educational (Phase 1 n = 57, Phase 2 n = 44) and behavioral (Phase 1 n = 80, Phase 2 n = 53) formats were contrasted on psychosocial variables over 3 and 6 months and their interrelations based on the mood-behavior-model and coaction theory. Phase 1 findings informed curricular extensions in Phase 2. In Phase 1, there were significant overall improvements in total mood disturbance, self-regulation of exercise, self-regulation of eating, and weight, which were more pronounced in the behavioral vs. educational format group (−3.5 % vs. −1.4 % weight loss, respectively). Mediation analyses indicated that change in self-regulation of exercise mediated the prediction of change in self-regulation of eating by mood change. Phase 2 findings were similar; however, effect sizes were greater (−6.2 % vs. −2.9 % weight loss, respectively). Within both phases, increased self-regulation of eating significantly predicted weight reduction. Paths from changes in mood→self-regulation of exercise→self-regulation of eating suggested future program attention focus on treatment-associated mood change reinforcing self-regulation, and self-regulation generalizing from an exercise to eating context. Methods of progressing treatment curricula via theory-testing were suggested.