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Excess weight is a significant contributor to morbidity and mortality in the United States. Unfortunately, overweight and obesity persist despite increased awareness of and access to weight management strategies. Recent efforts focus on identifying factors that prevent individuals from engaging in healthy and sustainable eating and exercise behaviors to facilitate weight loss. Body dissatisfaction is an established risk factor for unhealthy eating and unhealthy exercise behavior. Despite its high prevalence among overweight and obese adults, body dissatisfaction has received limited recognition as a potential barrier to weight loss. The current study was designed to 1) evaluate the relationship of body dissatisfaction to health behaviors important for weight loss (eating and exercise) and to quality of life, 2) evaluate the treatment effects of a body dissatisfaction intervention developed for adolescent females (the Body Project) among adult women attempting weight loss, and 3) evaluate the effects of the intervention on eating and exercise behavior and on adherence to behavioral recommendations for weight loss.Forty-four overweight and obese women (71% Caucasian; 37.9 ±7.6 years of age; BMI: 30.5 ± 2.9) were recruited in three cohorts from the Columbus metropolitan area. Prospective participants were screened for eligibility including self-reported body shape and weight concerns and desire for weight loss. Eligible participants completed a 90- minute baseline assessment including body dissatisfaction, internalization of the thin ideal, eating and exercise behaviors, and quality of life. At the time of baseline assessment, all participants received brief psychoeducation regarding current national guidelines for healthy weight loss. Participants were then randomized to one of two four-week treatment conditions: a control group (n=21) that engaged in daily tracking of dietary intake and physical activity; or an intervention group (n=23) that completed daily tracking in addition to attending four weekly, one-hour body image meetings. At baseline, greater body dissatisfaction was associated with more emotional eating and lower eating self-efficacy but not with exercise self-efficacy. Higher body dissatisfaction was also associated with lower mental and weight-related quality of life. Stigma moderated the relationship of body dissatisfaction to emotional eating and quality of life while body appreciation moderated the relationship between body image and quality of life. At the end of the four-week intervention period, participants in both conditions achieved BMI reductions and reported reduced body dissatisfaction, and improved mental, physical, and weight-related quality of life. There were no improvements in thin ideal internalization, eating and exercise-related variables, or negative affect in either condition. In addition, there were no differences between conditions in adherence to dietary and physical activity recommendations or daily tracking. Results of the study confirm that body dissatisfaction is associated with behaviors and beliefs that may impact weight loss, but the body image intervention utilized in the current study failed to produce any unique effect on body image, eating behavior and exercise behavior, or quality of life beyond the health behavior tracking control condition. The results provide additional support for the growing literature highlighting body image disturbances as a public health concern.

Obesity is a major public health concern in the United States today with over 65% of Americans considered overweight or obese, as defined by a BMI equal to or greater than 25. Although a number of weight management interventions have been developed and implemented, often programs do not facilitate long-term success. Behavioral weight management programs have implemented mindfulness training as an adjunct to target barriers to long-term weight loss, but results have been equivocal. The aim of this observational study was to assess the relationship between mindfulness and factors that have been linked to obesity and treatment outcome in a weight management treatment program with no mindfulness component. Overweight and obese participants (n=80) were recruited from a 3- or 6-month university-based behavioral weight management program. The weight management program targeted behavioral factors to facilitate weight loss via weekly classes directed by nutrition, exercise, and behavioral specialists in addition to providing individual support and access to exercise facilities. Participants completed self-report questionnaires at the start of the program and again at program completion. The sample was primarily female (78.8%) and Caucasian (78.8%) with an average age of 45.8 (¿¿11.5) years and an average BMI of 47.8 (¿¿12.0) kg/m¿¿ at baseline. Analysis of variance and regression analyses were used to analyze data. Results indicate that greater overall mindfulness was associated with less emotional eating and avoidant coping, higher eating self-efficacy, and greater quality of life (mental and weight-specific) at baseline. However, change in mindfulness during the program was only associated with change in physical quality of life, and in an unexpected direction. Increased mindfulness was associated with reduced physical quality of life. Additionally, exploratory analyses of the mindfulness facets suggest mindfulness may influence weight-related variables and quality of life variables through different mechanisms. Baseline BMI was associated with physical QOL and weight-specific quality of life, but was not associated with mindfulness or other psychosocial variables. Thus, mindfulness is associated with obesity-specific factors, providing support for the potential benefits of being mindful during weight management. Results of this study provide evidence consistent with theoretical arguments in favor of mindfulness intervention. However, these findings indicate the need to better understand mindfulness among individuals participating in weight management. Before evidence-based interventions can be developed, further research is needed to identify and understand the mechanisms through which mindfulness may effect change in weight management outcomes. These findings suggest that mindfulness is associated with weight-related variables in both expected and unexpected directions. Further research is needed to explore positive and negative correlates of mindfulness in the context of behavioral weight management.