BEHAVIORAL AND COGNITIVE CORRELATES OF WEIGHT LOSS IN A WORKSITE WEIGHT LOSS INTERVENTION.
and obesity remain at epidemic levels and are associated with increased morbidity and
mortality as well as increased health care costs. Both behavioral and lifestyle
interventions are recommended for weight loss in obese individuals, but the
widely-suggested goal of 5-10% weight loss to achieve significant health benefits is not
routinely achieved even in intensive weight ... read moreloss intervention studies. Identifying
behavioral and cognitive correlates associated with successful weight loss in different
types of interventions could inform the development of more effective and sustainable
programs for weight control. Worksites are increasingly being suggested as important
settings for body weight management interventions. However, to date, there have been no
studies examining predictors of weight loss in worksite weight control interventions. We
examined changes in behavioral and cognitive measures in a group-randomized controlled
trial of a behavioral weight loss intervention versus wait-listed control at worksites.
Analysis presented here compare participants at the intervention sites versus those at
the control sites. Questionnaires administered at baseline and at 6 months measured
eating behaviors (Eating Inventory), food cravings (Craving Inventory, Food Cravings
Questionnaire-State and Trait), weight self efficacy (Weight Efficacy Lifestyle
Questionnaire) and quality of life (WHO-BREF quality of life questionnaire). These
indices, as well as measures of program adherence such as frequency of self-monitoring
of body weight and meeting attendance were examined as correlates of weight change. To
better inform future efforts in worksites we developed an intervention specific feedback
questionnaire to determine which programmatic components of the intervention were most
useful to participants. Weight change was greater in the intervention participants (I)
than in participants in the wait-listed control (C), (Mean ±SD ∆ I=-8.1 kg
± 6.8 kg, ∆ C=+0.9 kg ± 3.6 kg, p<0.001). The intervention resulted
in increased restraint (∆I=5.43±4.25, ∆C=0.29±3.80, p<0.001),
decreased disinhibition (∆I=-2.50±3.63, ∆C=0.66±1.85,
p<0.001) and decreased hunger (∆I=-2.79±3.13, ∆C=0.56±2.63,
p<0.001) relative to the control group. These individuals also showed significant
reductions in all aspects of craving, increases in weight self efficacy and its 5
situational dimensions, and improvements in the 4 quality of life domains. Within the
intervention group, weight change was significantly correlated with decreased hunger
(r=0.36, p=0.001), decreased food craving-trait (r=-0.24, p=0.04), increased total
weight self efficacy (r=-0.34, p=0.01), session attendance (r=-0.4, p=0.003) and
frequency of weight self monitoring (r=-0.3, p=0.029). All programmatic components were
perceived as useful by participants and each component was correlated with weight
change. These findings demonstrate that positive changes in behavioral and cognitive
attributes can be achieved in the context of a multi-component group based weight loss
program implemented within a worksite setting and advance the understanding of
behavioral and cognitive attributes as determinants of weight loss. These findings also
provide guidance for refinement of future worksite weight loss
Thesis (Ph.D.)--Tufts University, 2012.
Submitted to the Dept. of Biochemical and Molecular Nutrition.
Advisor: Sai Das.
Committee: Susan Roberts, Tammy Scott, Edward Saltzman, and Gerard Dallal.
Keywords: Nutrition, and Behavioral psychology.read less