Annesi James J
University of Alabama at Birmingham, Birmingham, AB, USA.
Central Coast YMCA, Monterey, CA, USA.
Int J Behav Med. 2023 Jun;30(3):334-344. doi: 10.1007/s12529-022-10106-5. Epub 2022 Jun 9.
Behavioral obesity treatments have generally been unsuccessful at facilitating long-term weight reductions. Increased physical activity/exercise is a strong predictor of maintained weight loss. It has been proposed this is more linked to increases in exercise-related self-regulation carrying-over to eating-related self-regulation than through direct energy expenditures.
Women with obesity participated in 10-month community-based behavioral treatments that had theory-based foci on either self-regulation skills building (n = 59) or knowledge of weight loss methods (n = 54). Physical activity/exercise, exercise-related self-regulation, and eating-related self-regulation were assessed at baseline and months 3, 6, and 12 in the prediction of weight and waist circumference changes over 24 months.
Significant overall improvements on all measures were found, which were significantly greater in the self-regulation-focused group than the knowledge-focused group. Mean reductions in waist circumference/weight were - 4.64 cm/ - 5.17 kg (- 5.5% of baseline weight) and - 0.66 cm/ - 1.19 kg (- 1.2% of baseline weight), respectively. Aggregated data indicated that early increase in physical activity/exercise significantly predicted 24-month reductions in both weight and waist circumference. Serial mediation analyses indicated that a sequential path from exercise-related self-regulation (baseline-month 3) → eating-related self-regulation (baseline-month 6) → eating-related self-regulation (baseline-month 12) fully mediated the physical activity/exercise-weight/waist circumference change relationships. Energy expenditures from physical activity/exercise accounted for 21% of lost weight.
Findings of this field research supported benefits of progressively building self-regulation skills, first for physical activity/exercise then controlled eating, through accordingly focused behavioral treatments. Opportunities for tailoring large-scale community-based interventions grounded in theory were enhanced.
行为肥胖治疗在促进长期体重减轻方面总体上并不成功。增加身体活动/锻炼是维持体重减轻的有力预测因素。有人提出，这与运动相关的自我调节能力的提高对饮食相关的自我调节产生的影响有关，而不仅仅是通过直接的能量消耗。
肥胖女性参加了为期10个月的社区行为治疗，治疗重点基于理论，分为自我调节技能培养组（n = 59）和减肥方法知识组（n = 54）。在基线以及第3、6和12个月时，评估身体活动/锻炼、运动相关的自我调节和饮食相关的自我调节，以预测24个月内体重和腰围的变化。
所有测量指标均有显著的总体改善，以自我调节为重点的组比以知识为重点的组改善更为显著。腰围/体重的平均减少量分别为-4.64厘米/-5.17千克（占基线体重的-5.5%）和-0.66厘米/-1.19千克（占基线体重的-1.2%）。汇总数据表明，早期身体活动/锻炼的增加显著预测了24个月内体重和腰围的减少。系列中介分析表明，从运动相关的自我调节（基线至第3个月）→饮食相关的自我调节（基线至第6个月）→饮食相关的自我调节（基线至第12个月）的顺序路径完全介导了身体活动/锻炼与体重/腰围变化之间的关系。身体活动/锻炼的能量消耗占体重减轻的21%。
该实地研究的结果支持通过相应重点的行为治疗逐步培养自我调节技能的益处，首先是针对身体活动/锻炼，然后是控制饮食。增强了基于理论定制大规模社区干预措施的机会。
