E5 (Free Paper Session): Self-determination Theory
PREVIOUS WEIGHT LOSS ATTEMPTS: ASSOCIATIONS WITH SELF- DETERMINATION AND BODY IMAGE IN OVERWEIGHT AND OBESE WOMEN
Authors: Eliana Carraça- Faculty of Human Movement, Technical University of Lisbon, Marlene Silva - Faculty of Human Movement, Technical University of Lisbon , Paulo Vieira - Faculty of Human Movement, Technical University of Lisbon, Silvia Coutinho - Faculty of Human Movement, Technical University of Lisbon, Margarida Castro - Faculty of Human Movement, Technical University of Lisbon, Claudia Minderico - Faculty of Human Movement, Technical University of Lisbon, David Markland - School of Sport Health and Exercise Sciences, Bangor University, Pedro Teixeira - Faculty of Human Movement, Technical University of Lisbon
Purpose: In weight control programs, the number of previous weight loss attempts is a consistent negative moderator of success. We sought to analyze if, and by what mechanisms self-determination and body image predict previous dieting attempts, in overweight and obese women. Methods: Before starting obesity treatment, 255 women (37.5±7.1 yr; 31.6±4.1 kg/m2) completed a comprehensive body image psychosocial battery, the Self-Determination Scale (sub-scales: self-awareness, perceived choice) and a weight/dieting history questionnaire. Regression analysis, using Preacher and Hayes (2007) procedures to test indirect/mediated effects, were used for statistical analyses. Results: Previous weight loss attempts (WLA) were predicted by body shape concerns (BSC, r=0.34; p<0.001), r="-0.15;" p="0.035)," r="0.16;" p="0.021)," r="0.25;" r="-0.45;">
EXERCISE INTRINSIC MOTIVATION, AUTONOMOUS SELF-REGULATION, AND PSYCHOLOGICAL MOTIVES AS MEDIATORS OF PHYSICAL ACTIVITY DURING WEIGHT MANAGEMENT
Authors: Marlene Silva - Faculty of Human Movement, Pedro Teixeira - Faculty of Human Movement, Paulo Vieira - Faculty of Human Movement, Margarida Castro - Faculty of Human Movement, Claudia Minderico - Faculty of Human Movement, Silvia Coutinho - Faculty of Human Movement, Antonio Palmeira - Universidade Lusofona de Humanidades e Tecnologias, David Markland - Bangor University
Purpose: To analyse the role of exercise intrinsic motivation (IM), locus of causality (LC), autonomous self-regulation (ASR), and psychological motives (PM) as mediators of physical activity (PA) during an obesity treatment program based on Self-Determination Theory (SDT). Methods: 255 women (37.5±7.1y; 31.6±4.2kg/m2) participated and were assigned to intervention/control groups. The intervention (30 weekly sessions) was specifically designed to increase PA, following SDT principles. Controls received a general health education program. Assessments included putative SDT mediators and PA: walking, moderate + vigorous PA (7-day PAR), and lifestyle PA. Multiple regression was used to test for mediation, as forwarded by Baron and Kenny. Indirect/mediated effects were tested using procedures described by Preacher and Hayes (2007). Results: The intervention significantly changed all putative SDT mediators (p<0.001) p="0.017).">
SUCCESSFUL APPLICATION OF SELF-DETERMINATION THEORY TO BEHAVIORAL WEIGHT MANAGEMENT: RESULTS FROM A RANDOMIZED CONTROLLED TRIAL IN WOMEN
Authors: Pedro J. Teixeira - Faculty of Human Movement, Marlene N. Silva - Faculty of Human Movement, Paulo N. Vieira - Faculty of Human Movement, Claudia S. Minderico - Faculty of Human Movement, Margarida M. Castro - Faculty of Human Movement, Silvia Coutinho - Faculty of Human Movement, Teresa Santos - Faculty of Human Movement, Luis B Sardinha - Faculty of Human Movement
Purpose: To describe a weight management program for overweight/obese women centered on physical activity (PA) and based on Self-Determination Theory, and report results for key intervention outcomes. Method: 255 women (37.5±7.1y; 31.6±4.1kg/m2) were randomized into intervention/control groups. The program included 30 weekly/bi-weekly group meetings; autonomous motivation and a more internal PA/diet behavioral regulation were targeted. The autonomy-supportive treatment climate was hypothesized to enhance self-determination, perceived competence, and intrinsic motivation for PA, aiming for lasting behavioral/weight changes. Physical activity (7-day PAR, Ob-PAR) and weight were assessed at baseline and 12 months (83.2% retention). Mediation analysis was tested with multiple regression and indirect effects estimated with the Preacher and Hayes procedure. Results: Intervention-control differences for 12-month changes were: +94±28 min/wk for moderate + vigorous PA, +108±34 min/wk for walking, ES=0.88 for a lifestyle PA index, and -5.0±0.8% for body weight (p<0.003 p="0.002)," r="-0.33," r="-0.15," p="0.032)," r="-0.25," p="0.001)" p="0.005">
ANALYSIS OF RECIPROCAL EFFECTS BETWEEN CHANGES IN WEIGHT AND BODY IMAGE IN A BEHAVIORAL WEIGHT LOSS TREATMENT
Authors: Antonio L. Palmeira - Universidade Lusofona de Humanidades e Tecnologias, Pedro J. Teixeira - Faculty of Human Movement, Technical University of Lisbon, Marlene N Silva - Faculty of Human Movement, Technical University of Lisbon, David A. Markland - Bangor University, Teresa L. Branco - Faculty of Human Movement, Technical University of Lisbon, Sandra Martins - Faculty of Human Movement, Technical University of Lisbon, Claudia Minderico - Faculty of Human Movement, Technical University of Lisbon, Luis B. Sardinha - Faculty of Human Movement, Technical University of Lisbon
Purpose: To analyse the reciprocity between changes in weight and changes in body shape concerns (BSC), analyzed alternatively as a mediator and an outcome, during a behavioral obesity treatment program in women. Methods: Subjects (BMI=31.1±4.1 kg/m2; Age=38.4±6.7 y) were 144 women who attended a 12-month obesity treatment program and a comparison group (n=49), who received a general health education program. Weight, BSC and exercise level were assessed at baseline and 12-months. Multiple mediation was tested by multiple regression, analyzing total/direct/indirect effects of each variable, while controlling for other mediators (see Preacher & Hayes, 2007). Treatment/comparison was the independent variable, exercise was analyzed as a mediator, while changes in weight and BSC were analyzed alternatively as mediators and dependent variables. Results: Weight loss was greater in the treatment group (-5.6±6.8% vs. 1.2±4.6%, p<.001). Both groups improved their body image (p<.001) and the intervention group was more active at treatment's end (p<.001). The BSC mediation model explained 24% of weight change (p<.001). Total, direct, and total indirect effects were significant, suggesting that changes in BSC partially mediated treatment effects on weight. The weight change mediation model explained 17% of treatment-induced change in BSC (p<.001). The specific indirect effects showed that weight change completely mediated change in body image. Exercise was not a mediator in either model. Conclusion: The reciprocal effects hypothesis was confirmed; changes in weight and body image appear to influence each other during the course treatment, adjusting for physical activity. The strongest effect was observed for weight as a mediator of changes in concerns with body shape and feelings of being too fat.
A Sessions: Symposia | |
A1: The Scale Is The Limit? Weighing Obesity Interventions from an Ethical Perspective.Chair: Sofie Vandamme, Department of Medical Ethics and Philosophy, Erasmus MC, Rotterdam, The Netherlands |
“You Should Lose Weight!”: A Note Of (Evidence-Based) Caution Before You Say These Words
Authors: Teixeira, Pedro
Abstract: Purpose: For those involved in treatment obesity, such as behavioral/lifestyle therapies, facing questions with ethical implications is common. This presentation will identify critical decisions to be made before/during treatment, highlight relevant research findings, and provide ethically-sound recommendations. Methods: Empirical and theoretical support for this presentation comes from the author's clinical/practical experience and from key/representative studies available in the obesity literature. Results: Recommending that someone loses weight (and advising on how to do it) generally assumes the expert/provider to be sufficiently certain about the following aspects, among others: i) When is body weight/fat more likely to impair physical health? The weight-morbidity association is strong only at the highest obesity levels, and effect-moderators (e.g., physical activity) exist and must be considered; ii) How much weight loss can realistically be "promised"? The best studies show... not a lot (beyond 5%)! However, predictor studies provide some guidance on maximizing (and/or anticipating) individual success level; iii) How to deal with very high weight loss goals? Evidence suggests more intrinsic motivations and moderate expectations may pay off; iv) What is the most effective treatment? The one that succeeds in increasing physical activity adherence; v) How long should treatment last? According to the (limited) evidence, the longer the better; but alternatives to continuous care should be sought; vi) Are there risks of weight loss? They can be minimized and do not outweigh benefits. Conclusion: Only by adequately addressing these (and other) questions can the provider intervene more ethically: disclose all relevant information, provide choice, not cause harm, effectively allocate limited resources, keep the patient's best interest (and dignity) in mind, and support his/her autonomy.
B1: It’s About Time: Modeling Real-Time Assessment Data on Physical Activity and Nutrition.
Chair: Jutta Mata, Faculty of Human Movement – Technical University of Lisbon, Lisbon, Portugal & Max Planck Institute for Human Development, Berlin, Germany; Mark Pereira, University of Minnesota, Minneapolis, MN, USA
Using Ecological Momentary Assessment To Understand The Role Of Psychosocial And Environment Factors In Weight Control
Authors: Mata, Jutta; Santos, Teresa; Vieira, Paulo N. ; Silva, Marlene N.; Coutinho, Silvia; Teixeira, Pedro J.