Predicting short-term weight loss using four leading health behavior change theories

António L Palmeira, Pedro J Teixeira, Teresa L Branco, Sandra S Martins, Cláudia S Minderico, José T Barata, Sidónio O Serpa, Luís B Sardinha, António L Palmeira, Pedro J Teixeira, Teresa L Branco, Sandra S Martins, Cláudia S Minderico, José T Barata, Sidónio O Serpa, Luís B Sardinha

Abstract

Background: This study was conceived to analyze how exercise and weight management psychosocial variables, derived from several health behavior change theories, predict weight change in a short-term intervention. The theories under analysis were the Social Cognitive Theory, the Transtheoretical Model, the Theory of Planned Behavior, and Self-Determination Theory.

Methods: Subjects were 142 overweight and obese women (BMI = 30.2 +/- 3.7 kg/m2; age = 38.3 +/- 5.8 y), participating in a 16-week University-based weight control program. Body weight and a comprehensive psychometric battery were assessed at baseline and at program's end.

Results: Weight decreased significantly (-3.6 +/- 3.4%, p < .001) but with great individual variability. Both exercise and weight management psychosocial variables improved during the intervention, with exercise-related variables showing the greatest effect sizes. Weight change was significantly predicted by each of the models under analysis, particularly those including self-efficacy. Bivariate and multivariate analyses results showed that change in variables related to weight management had a stronger predictive power than exercise-specific predictors and that change in weight management self-efficacy was the strongest individual correlate (p < .05). Among exercise predictors, with the exception of self-efficacy, importance/effort and intrinsic motivation towards exercise were the stronger predictors of weight reduction (p < .05).

Conclusion: The present models were able to predict 20-30% of variance in short-term weight loss and changes in weight management self-efficacy accounted for a large share of the predictive power. As expected from previous studies, exercise variables were only moderately associated with short-term outcomes; they are expected to play a larger explanatory role in longer-term results.

Figures

Figure 1
Figure 1
Weight Change from Initial Weight per Subject. Each bar represents a participant and their weight change from initial weight (black bars reflect weight gain, grey bars represent weigh loss).

References

    1. Baskin ML, Ard J, Franklin F, Allison DB. Prevalence of obesity in the United States. Obes Rev. 2005;6:5–7. doi: 10.1111/j.1467-789X.2005.00165.x.
    1. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. Jama. 2004;291:2847–2850. doi: 10.1001/jama.291.23.2847.
    1. Rennie KL, Jebb SA. Prevalence of obesity in Great Britain. Obes Rev. 2005;6:11–12. doi: 10.1111/j.1467-789X.2005.00164.x.
    1. Wadden TA, Brownell KD, Foster GD. Obesity: responding to the global epidemic. J Consult Clin Psychol. 2002;70:510–525. doi: 10.1037/0022-006X.70.3.510.
    1. Teixeira PJ, Going SB, Sardinha LB, Lohman TG. A review of psychosocial pre-treatment predictors of weight control. Obes Rev. 2005;6:43–65. doi: 10.1111/j.1467-789X.2005.00166.x.
    1. Ajzen I. The Theory of Planned Behavior. Organization Behavior and Human Processes. 1991;50:179–211. doi: 10.1016/0749-5978(91)90020-T.
    1. Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12:38–48.
    1. Bandura A. Self-Efficacy. The Exercise of Control. New York , W.H. Freeman and Company; 1997.
    1. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55:68–78. doi: 10.1037/0003-066X.55.1.68.
    1. Baranowski T, Cullen KW, Nicklas T, Thompson D, Baranowski J. Are current health behavioral change models helpful in guiding prevention of weight gain efforts? Obes Res. 2003;11 Suppl:23S–43S.
    1. Culos-Reed N, Gyurcsik N, Brawley L. Using theories of Motivated Behavior to Understand Physical Activity. In: Singer RN, Hausenblas HA, Janelle CM, editor. Handbook of Sport Psychology. New York , John Wiley & Sons; 2001. pp. 695–717.
    1. Sherwood NE, Jeffery RW. The behavioral determinants of exercise: implications for physical activity interventions. Annu Rev Nutr. 2000;20:21–44. doi: 10.1146/annurev.nutr.20.1.21.
    1. Bandura A. Social cognitive theory: an agentic perspective. Annu Rev Psychol. 2001;52:1–26. doi: 10.1146/annurev.psych.52.1.1.
    1. Bandura A. Health Promotion from the Perspective of Social Cognitive Theory. Psychology and Health. 1998. pp. 623–649.
    1. Cullen KW, Baranowski T, Smith SP. Using goal setting as a strategy for dietary behavior change. J Am Diet Assoc. 2001;101:562–566. doi: 10.1016/S0002-8223(01)00140-7.
    1. Fontaine KR, Cheskin LJ. Self-efficacy, attendance, and weight loss in obesity treatment. Addict Behav. 1997;22:567–570. doi: 10.1016/S0306-4603(96)00068-8.
    1. Trost SG, Kerr LM, Ward DS, Pate RR. Physical activity and determinants of physical activity in obese and non-obese children. Int J Obes Relat Metab Disord. 2001;25:822–829. doi: 10.1038/sj.ijo.0801621.
    1. Rimal RN. Closing the knowledge-behavior gap in health promotion: the mediating role of self-efficacy. Health Commun. 2000;12:219–237. doi: 10.1207/S15327027HC1203_01.
    1. Dennis KE, Goldberg AP. Weight control self-efficacy types and transitions affect weight-loss outcomes in obese women. Addict Behav. 1996;21:103–116. doi: 10.1016/0306-4603(95)00042-9.
    1. Wadden TA, McGuckin BG, Rothman RA, Sargent SL. Lifestyle modification in the management of obesity. J Gastrointest Surg. 2003;7:452–463. doi: 10.1016/S1091-255X(03)00048-9.
    1. Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Martin CJ, Metcalfe LL, Finkenthal NR, Blew RB, Sardinha LB, Lohman TG. Weight loss readiness in middle-aged women: Psychosocial predictors of success for behavioral weight reduction. J Behav Med. 2002;25:499–523. doi: 10.1023/A:1020687832448.
    1. Armitage CJ, Conner M. Efficacy of the Theory of Planned Behaviour: a meta-analytic review. Br J Soc Psychol. 2001;40:471–499. doi: 10.1348/014466601164939.
    1. Gollwitzer PM. Implementation intentions: Strong effects of simple plans. American Psychologist. 1999;54:493–503. doi: 10.1037/0003-066X.54.7.493.
    1. Prestwich A, Lawton R, Conner M. The use of implementation intentions and the decision balance sheet in promoting exercise behaviour. Psychology & Health. 2003;18:707–721. doi: 10.1080/08870440310001594493.
    1. Conner M, Norman P, Bell R. The theory of planned behavior and healthy eating. Health Psychol. 2002;21:194–201. doi: 10.1037/0278-6133.21.2.194.
    1. Povey R, Conner M, Sparks P, James R, Shepherd R. Interpretations of healthy and unhealthy eating, and implications for dietary change. Health Educ Res. 1998;13:171–183. doi: 10.1093/her/13.2.171.
    1. Courneya KS, Bobick T. Integrating the Theory of Planned Behavior with the Processes and States of Change in the Exercise Domain. Psychology of Sport and Exercise. 2000;1:41–56. doi: 10.1016/S1469-0292(00)00006-6.
    1. Jones LW, Sinclair RC, Rhodes RE, Courneya KS. Promoting exercise behaviour: an integration of persuasion theories and the theory of planned behaviour. Br J Health Psychol. 2004;9:505–521. doi: 10.1348/1359107042304605.
    1. Baranowski T, Cullen KW, Baranowski J. Psychosocial correlates of dietary intake: advancing dietary intervention. Annu Rev Nutr. 1999;19:17–40. doi: 10.1146/annurev.nutr.19.1.17.
    1. Marshall SJ, Biddle SJ. The transtheoretical model of behavior change: a meta-analysis of applications to physical activity and exercise. Ann Behav Med. 2001;23:229–246. doi: 10.1207/S15324796ABM2304_2.
    1. Jeffery RW, French SA, Rothman AJ. Stage of change as a predictor of success in weight control in adult women. Health Psychol. 1999;18:543–546. doi: 10.1037/0278-6133.18.5.543.
    1. Suris AM, Trapp MC, DiClemente CC, Cousins J. Application of the transtheoretical model of behavior change for obesity in Mexican American women. Addict Behav. 1998;23:655–668. doi: 10.1016/S0306-4603(98)00012-4.
    1. Williams GC, Minicucci DS, Kouides RW, Levesque CS, Chirkov VI, Ryan RM, Deci EL. Self-determination, smoking, diet and health. Health Educ Res. 2002;17:512–521. doi: 10.1093/her/17.5.512.
    1. Ryan RM, Frederick C, Lepes D, Rubio N, Sheldon KM. International Journal of Sport Psychology. Vol. 28. Edizioni Luigi Pozzi; 1997. Intrinsic motivation and exercise adherence. pp. 335–354.
    1. Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Metcalfe LL, Blew RM, Sardinha LB, Lohman TG. Exercise motivation, eating, and body image variables as predictors of weight control. Med Sci Sports Exerc. 2006;38:179–188. doi: 10.1249/01.mss.0000180906.10445.8d.
    1. Williams GC, Grow VM, Freedman ZR, Ryan RM, Deci EL. Motivational predictors of weight loss and weight-loss maintenance. J Pers Soc Psychol. 1996;70:115–126. doi: 10.1037/0022-3514.70.1.115.
    1. Brug J, Oenema A, Ferreira I. Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions. Int J Behav Nutr Phys Act. 2005;2:2. doi: 10.1186/1479-5868-2-2.
    1. Rothman AJ. "Is there nothing more practical than a good theory?": Why innovations and advances in health behavior change will arise if interventions are used to test and refine theory. Int J Behav Nutr Phys Act. 2004;1:11. doi: 10.1186/1479-5868-1-11.
    1. Jeffery RW. How can Health Behavior Theory be made more useful for intervention research? Int J Behav Nutr Phys Act. 2004;1:10. doi: 10.1186/1479-5868-1-10.
    1. Franck RG, Baum A, Wallander JL. In: Handbook of Clinical Health Psychology: Models and Perspectives in Health Psychology. Boll TJ, editor. 3rd. Washington, DC , APA; 2004.
    1. Teixeira PJ, Palmeira AL, Branco TL, Martins SS, Minderico CM, Barata JT, Silva AM, Sardinha LB. Who will lose weight? A cross-cultural reexamination of predictors of weight loss in women. Int J Behav Nutr Phys Act. 2004;1:12. doi: 10.1186/1479-5868-1-12.
    1. Brownell KD. The LEARN program for weight control. Dallas, TX , American Health Publishing Company; 1997.
    1. Clark MM, Abrams DB, Niaura RS, Eaton CA, Rossi JS. Self-efficacy in weight management. J Consult Clin Psychol. 1991;59:739–744. doi: 10.1037/0022-006X.59.5.739.
    1. Palmeira AL, Teixeira P, Branco TL, Martins SS, Minderico CM, Barata JT, Serpa SO, Sardinha LB. In: Prediction of 16-Month Weight Change In Women Using Variables Derived From Different Behavior Change Theoretical Models: Amsterdam. Oenema A, Willemieke K, Brug J, editor. 2005. p. 146.
    1. Foster GD, Wadden TA, Vogt RA, Brewer G. What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes. J Consult Clin Psychol. 1997;65:79–85. doi: 10.1037/0022-006X.65.1.79.
    1. Palmeira AL, Francisco C, Teixeira P. In: Validação Preliminar De Um Instrumento De Avaliação Dos Processos De Mudança No Controlo De Peso: Lisboa. Ribeiro JLP, editor. 2004.
    1. Conner M, Sparks P. The theory of planned behaviour and health behaviours. In: Conner M, Norman P, editor. Predicting health behaviour: Research and practice with social cognition models. Buckingham, England , Open University Press.; 1996. p. 121–162.
    1. Palmeira AL, Teixeira P. In: Validação Preliminar De Um Instrumento De Avaliação Da Teoria Do Comportamento Planeado No Controlo De Peso: Lisboa. Ribeiro JLP, editor. 2004.
    1. Sallis JF, Pinski MA, Grossman RB, Patterson TL, Nader PR. The development of self-efficacy scales for health-related diet and exercise behaviors. Health Edu Res. 1988;3:283–292. doi: 10.1093/her/3.3.283.
    1. Sousa H, Rosa J. Psicologia do Desporto e Actividades Físicas. Lisboa , ULHT; 2002. Validação preliminar da escala de auto-eficácia para o exercício.
    1. Steinhardt MA, Dishman RK. Reliability and validity of expected outcomes and barriers for habitual physical activity. J Occup Med. 1989;31:536–546. doi: 10.1097/00043764-198906000-00011.
    1. Sallis JF, Grossman RM, Pinski RB, Patterson TL, Nader PR. The development of scales to measure social support for diet and exercise behaviors. Prev Med. 1987;16:825–836. doi: 10.1016/0091-7435(87)90022-3.
    1. Silva J, Rosa J. Psicologia do Desporto e Actividades Físicas. Lisboa , ULHT; 2002. Validação Preliminar da Escala de Suporte Social para o Exercício.
    1. Palmeira AL, Gomes PF, Teixeira P. In: Validação Preliminar De Um Instrumento De Avaliação Dos Processos De Mudança No Exercício: Lisboa. Ribeiro JLP, editor. 2004.
    1. Nigg CR, Norman GJ, Rossi JS, Benisovich SV. Processes of exercise behavior change: Redeveloping the scale.: San Diego, CA.. 1999.
    1. Palmeira AL, Teixeira P. In: Validação Preliminar De Um Instrumento De Avaliação Da Teoria Do Comportamento Planeado No Exercício: Lisboa. Ribeiro JLP, editor. 2004.
    1. McAuley E, Duncan T, Tammen VV. Psychometric properties of the Intrinsic Motivation Inventory in a competitive sport setting: a confirmatory factor analysis. Res Q Exerc Sport. 1989;60:48–58.
    1. Fonseca AM, Brito AP. Propriedades psicométricas da versão portuguesa do Intrinsic Motivation Inventory (IMIp) em contextos de actividade física e desportiva. Análise Psicológica. 2001;1:59–76.
    1. Cohen J, Cohen P. Applied multiple regression/correlation analysis for the behavioral sciences. 2nd Edition. Hillsdale, NJ , Lawrence Erlbaum Associates; 1983.
    1. Kraemer HC, Wilson GT, Fairburn CG, Agras WS. Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry. 2002;59:877–883. doi: 10.1001/archpsyc.59.10.877.
    1. Jakicic JM, Wing RR, Winters-Hart C. Relationship of physical activity to eating behaviors and weight loss in women. Med Sci Sports Exerc. 2002;34:1653–1659. doi: 10.1097/00005768-200210000-00018.
    1. Wadden TA, Butryn ML, Byrne KJ. Efficacy of lifestyle modification for long-term weight control. Obes Res. 2004;12 Suppl 3:151S–62S.
    1. Lappalainen R, Tuomisto MT, Giachetti I, D'Amicis A, Paquet S. Recent body-weight changes and weight loss practices in the European Union. Public Health Nutrition. 1999;2:135–141.
    1. Martin PD, Dutton GR, Brantley PJ. Self-efficacy as a predictor of weight change in African-American women. Obes Res. 2004;12:646–651.
    1. USDHHS . Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, MD , NIH - National Heart, Lung, and Blood Institute; 1998.
    1. USDHHS . The practical guide to the identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, MD , NIH - National Heart, Lung, and Blood Institute; 2000.
    1. Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr. 1997;66:239–246.
    1. Dishman RK, Ickes W. Self-motivation and adherence to therapeutic exercise. J Behav Med. 1981;4:421–438. doi: 10.1007/BF00846151.
    1. Rose EA, Parfitt G, Williams S. Exercise causality orientations, behavioural regulation for exercise and stage of change for exercise: exploring their relationships. Psychology of Sport and Exercise. 2005;6:399–414. doi: 10.1016/j.psychsport.2004.07.002.
    1. Wadden TA, Vogt RA, Foster GD, Anderson DA. Exercise and the maintenance of weight loss: 1-year follow-up of a controlled clinical trial. J Consult Clin Psychol. 1998;66:429–433. doi: 10.1037/0022-006X.66.2.429.
    1. Kahneman D, Diener E, Schwartz N. Well-Being: Foundations of Hedonic Psychology. New York , Russel Sage Foudantion; 2003.
    1. Schwartz MB, Brownell KD. Obesity and Body Image. Body Image. 2004;1:43–56. doi: 10.1016/S1740-1445(03)00007-X.

Source: PubMed

3
Abonnieren