California State University, Monterey Bay, Seaside, CA, USA.
Mind Body Wellbeing, LLC, Manahawkin, NJ, USA.
J Behav Med. 2024 Oct;47(5):900-912. doi: 10.1007/s10865-024-00494-2. Epub 2024 May 18.
Given the traditional methods of treating obesity through education on controlling eating and increasing exercise have largely failed beyond the very short term, a more intensive focus on psychosocial correlates of those weight-loss behaviors has been suggested. Multiple behavioral theories incorporate self-regulation, self-efficacy, and mood; however, their interrelations and effects over both the short and long term within cognitive-behavioral obesity treatments remain unclear. Within a novel community-based program with women with obesity who had either low (n = 29) or high (n = 71) mood disturbance scores, there were significant improvements in exercise- and eating-related self-regulation and eating-related self-efficacy-primary targets of that intervention-with no significant difference in those changes by mood disturbance grouping. Changes in the summed exercise- and eating-related self-regulation scores significantly mediated relationships between changes in eating-related self-efficacy and weight (over both 6 and 12 months). There were similar results with mediation assessed via the extent exercise-related self-regulation carried over to eating-related self-regulation. In both of those models a reciprocal relationship between self-regulation and self-efficacy changes was indicated. In serial multiple mediation equations, paths of changes in exercise-related self-regulation → eating-related self-regulation → eating-related self-efficacy → weight were significant. However, paths were not significant when change in self-efficacy was entered as the predictor (initial) variable. Findings suggest viability in first focusing on exercise-related self-regulation, then eating-related self-regulation, in the course of increasing self-efficacy and probabilities for inducing enough sustained weight loss to improve obesity-associated health risks. Benefits of field-based research findings generalizing to weight-management applications were suggested.
鉴于通过教育控制饮食和增加运动来治疗肥胖的传统方法在短期之外基本上已经失败，因此有人建议更加关注这些减肥行为的社会心理相关因素。多种行为理论都包含自我调节、自我效能和情绪；然而，在认知行为肥胖治疗中，它们在短期和长期内的相互关系和影响仍不清楚。在一个针对肥胖女性的基于社区的新计划中，这些女性的情绪困扰得分较低（n=29）或较高（n=71），与该干预措施的主要目标相关的运动和饮食相关的自我调节以及饮食相关的自我效能都有显著改善，而情绪困扰分组对这些变化没有显著影响。运动和饮食相关的自我调节得分的变化显著调节了饮食相关自我效能与体重之间的关系（在 6 个月和 12 个月都有变化）。通过评估与运动相关的自我调节对饮食相关的自我调节的影响程度来进行中介作用的评估，结果类似。在这两种模型中，都表明了自我调节和自我效能变化之间存在互惠关系。在序列多重中介方程中，与运动相关的自我调节变化→饮食相关的自我调节→饮食相关的自我效能→体重的路径是显著的。然而，当将自我效能的变化作为预测（初始）变量输入时，路径就不显著了。研究结果表明，在增加自我效能和提高诱导足够持续减肥以改善肥胖相关健康风险的可能性的过程中，首先关注与运动相关的自我调节，然后是与饮食相关的自我调节，这种方法是可行的。研究结果还表明，将基于现场的研究结果推广到体重管理应用中具有益处。
