Temporal Aspects of Psychosocial Mediators of the Exercise-Weight Loss Maintenance Relationship Within Scalable Behavior-Change Treatments

Study background Limited knowledge of psychological correlates of weight loss is associated with continuing failures of behavioral obesity treatments beyond the short term.Purpose This study aimed to inform health professionals’ obesity interventions via an increased knowledge of mediators of the exercise-weight loss maintenance relationship.Methods Women participated in 6-month obesity treatments within community settings emphasizing moderate exercise and self-regulation skills development via primarily in-person (n = 54) or primarily written (n = 54) means. Changes in mood, self-regulating eating, and weight over 6, 12, and 24 months were assessed. A moderated mediation model was tested using the PROCESS macro instruction.Results Improvements in mood, self-regulating eating, and weight were significantly greater in the in-person group. The relationship between a dichotomous measure of completing at least 3 sessions of exercise per week (or not) and change in weight over 6 months was no longer significant when the mediators of changes in negative mood and self-regulation of eating were sequentially entered. Paths of exercise→negative mood reduction→eating self-regulation increase→weight loss over 6, 12 and 24 months were significant. Exercise self-regulation at Month 3 significantly moderated the mood change→eating self-regulation change relationship.Conclusions Based on the identified paths, scalable obesity-treatment content and emphases were informed. This could help guide health professionals’ actions concerning the management of obesity.