The relationship between self-efficacy, attributions, and weight loss in a weight rehabilitation program.

Assessed the relationship between self-efficacy, attributions, and weight loss in the context of a weight rehabilitation program. Pretreatment, posttreatment, and followup assessments of self-efficacy, weight loss, and success–failure attributions were obtained from 38 volunteer overweight women (aged 21–65 yrs) participating in the program. Self-efficacy was significantly enhanced as a result of treatment, although it was not significantly related to weight loss during treatment. However, changes in efficacy expectations during follow-up did coincide with weight change during those intervals. In addition, efficacy expectations alone at treatment termination were found to be a significant predictor of weight loss following a 6-wk and 6-mo follow-up. Success–failure attributions contributed significantly to the prediction of efficacy expectations during treatment and during the 6-wk follow-up. Weight loss during treatment was not a significant determinant of treatment-induced self-efficacy enhancement. Results are interpreted in light of the reciprocal interaction between actual behavior change and cognitive factors in the context of a rehabilitation program. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term relationship between weight and aerobic-fitness change in children.

The relationship between changes in relative weight and fitness was assessed 5 years after children began treatment for obesity. Multivariate regression analysis showed that two factors were independently related to fitness change: (a) maintenance of weight loss from the end of 6 months of treatment to the 5-year follow-up and (b) initial fitness level. Children who showed the largest long-term changes in relative weight and the lowest initial fitness showed the largest improvements in fitness. Short-term weight loss was not related to long-term fitness change. These results show that weight loss and fitness are related over 5 years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dieting behaviors and weight change history in female adolescents.

The prevalence of dieting, weight change history, and specific weight loss behaviors was examined in a population-based sample of 1,015 female 9th–12th graders. Healthy weight loss behaviors were reported much more frequently than unhealthy weight loss behaviors (e.g., healthy behaviors: exercise?=?32.4%, decrease fat intake?=?26.0%, reduce snacks?=?25.0%, reduce kilocalorie intake?=?22.4%; unhealthy behaviors: fasting?=?8.1%, diet pills?=?5.4%, vomiting?=?4.4%). Obesity status and restrained eating scores were positively related to greater history of weight loss episodes, pounds lost, and weight fluctuations and to greater use of healthy weight loss methods and weight loss programs. Implications for public health recommendations regarding dieting and its associated behaviors in female adolescents are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of weight control and weight control plus body image therapy for obese men and women.

Participants were 65 obese men and women who were randomly assigned to either weight control or weight control plus cognitive–behavioral body image therapy. Both conditions showed clinically significant improvements in body image at posttreatment and 1-year follow-up. Adding body image therapy to weight control did not result in greater psychological improvements and did not result in better maintenance of body image change when participants regained weight after treatment. Weight loss and maintenance were equivalent between groups. Adding body image therapy did not improve or detract from weight loss. Although body image therapy has been shown to be effective in obese persons, it appears that a well-rounded cognitive–behavioral weight control program is effective as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-efficacy beliefs and change in cognitive performance: MacArthur studies on Successful Aging.

Data from a cohort of relatively high functioning, older men and women were used to test the hypothesis that stronger self-efficacy beliefs predict better maintenance of cognitive performance. Structural equation modeling revealed that stronger baseline instrumental efficacy beliefs predicted better verbal memory performance at follow-up among men but not among women, controlling for baseline verbal memory score and sociodemographic and health status characteristics. For both men and women there were no significant associations between either type of self-efficacy beliefs and measures of nonverbal memory, abstraction, or spatial ability. Consistent with previous research showing relationships between baseline cognitive performance and change in self-efficacy beliefs, better abstraction ability was also predictive of increases in instrumental efficacy beliefs among the men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of health beliefs on weight loss in individuals at high risk for NIDDM

OBJECTIVE: To determine whether perceived risk and other health beliefs held by individuals at high risk for developing NIDDM predict weight loss and behavior change during a behavioral weight loss program to reduce the risk of NIDDM. RESEARCH DESIGN AND METHODS: Health beliefs and objective risk factors for diabetes were examined in 154 overweight men and women with a family history of NIDDM. The effects of these factors on adherence, dietary intake, weight loss, and changes in glucose levels were examined in a subset of 79 of these subjects who participated in a 2-year behavioral weight control program. RESULTS: Those subjects who perceived themselves at highest risk of developing diabetes had a stronger family history of the disease and were more likely to be women than subjects considering themselves at more moderate risk. These participants also rated diabetes as a more serious disease, but were less likely to believe that weight loss would lower their risk. None of these health beliefs were related to attendance at meetings, dietary intake, weight loss, or fasting glucose, but higher perceived seriousness predicted larger reductions in BMI at 1 year. Of the objective risk factors for NIDDM, higher baseline BMI predicted larger weight losses throughout the program, and a stronger family history of diabetes was related to greater weight regain after an initial weight loss. CONCLUSIONS: Perceived risk of developing diabetes and other health beliefs did not predict performance in a behavioral weight loss program. These data suggest that efforts to modify health beliefs by educating high-risk individuals about their risk and benefits of weight loss may not be effective in improving long-term weight loss results.     

The effect of family variables on child weight change.

Analyzed the effects of family variables (e.g., family size, family weight composition, parental weight) on child weight loss in a series of family-based, behaviorally oriented weight control programs for children from 102 families. Results show that the amount of relative weight change was related to initial treatment success, the number of children in the family, and the gender of the child. Children who were more successful lost more weight initially, had fewer siblings, and were female. It is suggested that family size may interact with treatment to determine weight change, possibly by reducing the amount of time a parent has to spend promoting behavior change or the effectiveness of parents in managing their children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stage of change as a predictor of success in weight control in adult women.

Weight change over 3 years was examined in a large and heterogeneous sample of women as a function of stage of change for weight control. Women were classified into Precontemplation, Contemplation, Preparation, and Action stages on the basis of reports of current and past weight control behaviors and future intentions. Stage of change did not predict success in weight control. Mean weight changes over 3 years were 1.1 kg, 1.0 kg, 2.1 kg, and 2.3 kg for Precontemplation, Contemplation, Preparation, and Action stages, respectively. The findings call into question the generality of the stages-of-change classification system across behavioral domains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of decreasing sedentary behavior and increasing activity on weight change in obese children.

Obese children 8–12 years old from 61 families were randomized to treatment groups that targeted increased exercise, decreased sedentary behaviors, or both (combined group) to test the influence of reinforcing children to be more active or less sedentary on child weight change. Significant decreases in percentage overweight were observed after 4 months between the sedentary and the exercise groups (–29.9 vs. –23.2). At 1 year, the sedentary group had a greater decrease in percentage overweight than did the combined and the exercise groups (–28.7 vs. –20.3 and –8.7) and greater decrease in percentage of body fat (–4.7 vs. –2.3). All groups improved fitness during treatment and follow-up. Children in the sedentary group increased their liking for high-intensity activity and reported lower caloric intake than did children in the exercise group. These results support the goal of reducing time spent in sedentary activities to improve weight loss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contingent therapist contact in a behavioral weight control program.

Assigned 45 20–70 yr old overweight clients to 1 of 3 treatment conditions to determine whether contact with the therapist can serve as a reinforcer for the performance of behaviors involved in weight loss. Group 1 had contact with the therapist noncontingent on weight loss. Group 2 had contact with the therapist contingent on meeting weight loss goals of 2 pounds (.91 kg) each week. Group 3 had contact with the therapist if they did not meet the weight loss goals. Results show that although there were nonsignificant differences between the groups in weight loss during treatment, Group 3 regained the most during the subsequent 6 mo and had the poorest results overall. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavior change, weight loss, and physiological improvements in Type II diabetic patients.

53 obese 30–70 yr olds with Type 2 diabetes treated by diet only or oral medication were assigned to a behavior-modification, nutrition-education, or standard-care treatment condition to investigate whether behavior modification would improve short- and long-term results of weight control programs for Ss. The behavior-modification and nutrition-education groups met weekly for 16 wks and were given the same information on nutrition, exercise, and diabetes; however, strategies to change eating behavior were used in the behavior-modification condition. The standard-care condition was identical to the nutrition-education condition except that Ss met only 4 times over the 16-wk treatment period. Results indicate that behavior-modification Ss lost more weight than either the nutrition-education or standard-care Ss during the 16-wk treatment period. However, at 16-mo follow-up, differences in weight loss across treatment conditions were not significant. Physiological parameters and mood improved with initial weight loss, but these changes were not maintained. Physiological changes appeared more directly related to weight loss than to treatment condition. Changes in weight were related to improved eating and exercise habits, and modest weight losses of 4.6–23.6 kg produced significant improvements in blood-sugar control. (46 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Holiday weight management by successful weight losers and normal weight individuals.

This study compared weight control strategies during the winter holidays among successful weight losers (SWL) in the National Weight Control Registry and normal weight individuals (NW) with no history of obesity. SWL (n = 178) had lost a mean of 34.9 kg and had kept ≥13.6 kg off for a mean of 5.9 years. NW (n = 101) had a body mass index of 18.5-24.9 kg/m2. More SWL than NW reported plans to be extremely strict in maintaining their usual dietary routine (27.3% vs. 0%) and exercise routine (59.1% vs. 14.3%) over the holidays. Main effects for group indicated that SWL maintained greater exercise, greater attention to weight and eating, greater stimulus control, and greater dietary restraint, both before and during the holidays. A Group × Time interaction indicated that, over the holidays, attention to weight and eating declined significantly more in SW than in NW. More SWL (38.9%) than NW (16.7%) gained ≥1 kg over the holidays, and this effect persisted 1 month later (28.3% and 10.7%, respectively). SWL worked harder than NW did to manage their weight, but they appeared more vulnerable to weight gain during the holidays. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Planning to lose weight: Randomized controlled trial of an implementation intention prompt to enhance weight reduction among overweight and obese women.

Objective: The trial investigates the effects of augmenting an established weight-reduction intervention with implementation intention prompts. Design: Fifty-five overweight or obese women (ages 18 to 76 years; body mass index from 25.28 to 48.33) enrolled in a commercial weight reduction program were randomly assigned to either an implementation intention prompt or a control condition. Data were collected twice, with a time gap of 2 months. Main Outcome Measures: The primary outcome was participants' change in weight and body mass index from preintervention to follow-up. Results: Repeated measures analysis of variance revealed a significant Time = Condition interaction: On average, implementation intention prompt participants lost 4.2 kg (95% confidence interval = 3.19, 5.07), whereas control participants lost 2.1 kg (95% confidence interval = 1.11, 3.09). The change in frequency of planning mediated the effects of the intervention on weight and body mass index change. Conclusion: Among obese or overweight women participating in a commercial weight loss program, those who learn to form implementation intentions can achieve greater weight reduction. Planning facilitation is a key mechanism explaining enhanced weight loss generated by implementation intention formation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivations for weight loss and behavior change strategies associated with natural recovery from obesity.

Untreated adults (n?=?21) with lengthy weight problem histories who had maintained stable weight loss for a mean of 4.5 years were interviewed and completed questionnaires about their motivations for and behavioral strategies used during weight loss. Currently obese, untreated adults (n?=?20) served as controls. Successful natural recovery was associated with behavior changes like those emphasized in behavioral weight management programs (e.g., healthier food choices, eating more slowly, regular exercise). Motivations for weight loss were largely negative and reflected appearance and psychosocial concerns. Demographic, weight history, and health variables generally did not distinguish the groups. Obesity treatment was widely available but was viewed negatively. These findings reveal natural processes involved in sustained weight loss, highlight the potential importance of separating influences on behavior change from influences on help-seeking, and suggest ways that obesity treatments could be improved to increase their appeal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of self-efficacy on dropout from obesity treatment.

Investigated the link between low weight-control self-efficacy and dropout rate in 414 participants (mean age 38 yrs) in a behavioral program. Ss had an average weight of 185 lb and were an average of 51 lb overweight. Ss were administered a telephone questionnaire during the 1st 12 wks of their participation. Results show that the 101 dropouts were significantly more likely than stayers to report low self-efficacy at the beginning of their memberships. Dropouts were also significantly less likely to feel successful in weight control and behavior change, even though their rates of weight loss did not differ significantly from those of the stayers. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-directed program for weight control: A pilot study.

Designed a treatment program to enable 16 undergraduates to lose weight through the use of self-monitored techniques for changing their eating behaviors. All Ss achieved a stable loss in weight, and their mean loss was significantly greater than the change shown by a group of similarly motivated controls. No additional effects due to a few sessions of aversive counterconditioning were demonstrated, and no general mood changes accompanied the weight loss. The Ss reported a decreased temptation to overeat. It was suggested that similar programs of gradual habit change through self-control of stimulus conditions and reinforcement contingencies might be applied to the treatment of other addictive behaviors, which are also refractory to change. (26 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Common and specific process factors in cardiac rehabilitation: Independent and interactive effects of the working alliance and self-efficacy.

Objective: Therapeutic processes in cardiac rehabilitation programs are virtually unexamined. Models were tested by which changes in the working alliance between patient and staff (agreement on goals/tasks; emotional bond) may affect outcomes in conjunction with changes in patient self-efficacy to change their diets and increase exercise. Design: Cardiac patients (n = 79) participated in a 12-week program, and completed assessments at early, mid, and late treatment. Main Outcome Measures: Changes in cardiac depression, physical health, perceived exertion during exercise, rate/pressure product at submaximal exercise tolerance, weight loss, return to work, total fat intake. Results: Early-treatment changes in agreement on goals/tasks were related to changes in psychosocial factors and perceived exertion during exercise independent of effects of changes in self-efficacy. Early-treatment changes in goals/tasks and self-efficacy interacted to predict changes in cardiorespiratory fitness, weight loss, and return to work such that patients high on both goals/tasks and self-efficacy showed the most gains. Conclusion: Sound therapeutic relationships between patients and staff may play an important role in facilitating the achievement of a wide-range of salutary outcomes during cardiac rehabilitation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term effects of interventions for weight loss using food provision and monetary incentives.

One hundred seventy-seven men and women who had participated in an 18-month trial of behavioral interventions involving food provision and financial incentives were examined 12 months later. Food provision, but not financial incentives, led to better weight loss than standard behavioral treatment during the 18-month trial, but over 12 additional months of no-treatment follow-up, all treated groups gained weight, maintained only slightly better weight losses than a no-treatment control group, and did not differ from each other. Weight loss success during both active treatment and maintenance was associated with increase in exercise, decrease in percentage of energy from fat, increase in nutrition knowledge, and decrease in perceived barriers to adherence. Obesity treatment research should focus on developing better ways to maintain changes in the diet and exercise behaviors needed for sustained weight loss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of successful response to a behavioral weight control clinic.

Attempted to identify what types of persons successfully respond to a behavioral weight control clinic. The 40 participants of the study were physically healthy, 25–45 yrs old, and weighed 150–200 lbs. Measures of psychological functioning during preclinic testing indicated that participants experienced no extreme distress. The treatment was conducted over 4 mo by professional behavioral counselors and resulted in an average weight loss of 12.1 lbs. A prediction model based on problem severity and a model using behavior change both accounted for 25% of the variance in weight loss. Initial weight-loss success was correlated with 2 of the 3 severity variables; Ss reporting frequent binge eating and histories of previous dieting weight loss tended to lose the most weight. Successful weight loss also correlated with decreases in problem eating habits and high-calorie snacking but not with increased activity level. Interviews at the end of 7-mo follow-up were used to compare the 8 Ss who successfully maintained losses with the 13 Ss who showed signs of relapse. Ss who were successful at maintenance used frequent exercise, whereas those who relapsed reported high levels of stress during the follow-up. Implications of these correlates for obesity treatment and the importance of viewing unsuccessful weight control as evidence of negative change are discussed in terms of preventing relapse during follow-up. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of self-efficacy in rehabilitation outcome among chronic low back pain patients.

Examined the role of self-efficacy beliefs in the rehabilitation of 45 low back pain patients participating in a 3-wk rehabilitation program. Increments in self-efficacy beliefs during the rehabilitation program were not associated with improved patient functioning at discharge from the program. However, in support of the theorized role of self-efficacy in behavior change, these increments in self-efficacy significantly predicted better patient functioning and less reported pain at the 6-mo follow-up assessment. Implications of these findings for the rehabilitation of low back pain patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)