We tested the effects of emotional eating in long-term weight-loss so that both treatment processes and theory could be improved. Women with obesity participated in treatments of either high interpersonal contact and behavioral methods (n = 39) or low interpersonal contact and educational methods (n = 36) through community-based settings. We assessed mood, emotional eating, self-regulation, self-efficacy, and weight. Changes in the psychosocial measures were significantly greater in the high interpersonal contact/behavioral methods group. That group had a mean weight reduction of 6.5% and 6.8% over 6 and 24 months, respectively, which was significantly greater than the 2.9% and 1.8% loss in the low interpersonal contact/educational methods group at the same time points. Using aggregate data, change in eating self-regulation significantly mediated the prediction of reduced anxiety- and depression-related emotional eating over 6 months by improvements in tension and depression, respectively. The emotional eating reductions were significantly associated with weight loss over both 6 and 24 months. Increased physical activity was significantly associated with reduced tension and depression. We also found that the relationship between changes in physical activity and tension was significantly mediated by a change in exercise-related self-efficacy. Increased exercise self-regulation significantly predicted improved eating regulation, with eating-related self-efficacy change being a significant mediator. Our findings suggest an array of psychosocial targets for behavioral weight-management treatments that have large-scale applications.
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Abraham, C., & Michie, S. (2008). A taxonomy of behavior change techniques used in interventions. Health Psychology,27, 379–387. https://doi.org/10.1037/0278-6220.127.116.119.
Altaman, D. G., & Bland, J. M. (1999). Treatment allocation in controlled trails: Why randomise? British Medical Journal,318, 1209. https://doi.org/10.1136/bmj.318.7192.1209.
Andrews, R. A., Lowe, R., & Clair, A. (2011). The relationship between basic need satisfaction and emotional eating in obesity. Australian Journal of Psychology,63, 207–213. https://doi.org/10.1111/j.1742-9536.2011.00021.x.
Annesi, J. J. (2012). Supported exercise improves controlled eating and weight through its effects on psychosocial factors: Extending a systematic research program toward treatment development. Permanente Journal,16(1), 7–18. https://doi.org/10.7812/TPP/11-136.
Annesi, J. J., & Johnson, P. H. (2017). Contrasting university-based and older-age samples on weight-loss effects and their behavioral and psychosocial predictors associated with the weight loss for life protocol. Clinical Health Promotion,7, 5–11. https://doi.org/10.29102/clinhp.17002.
Annesi, J. J., & Marti, C. N. (2011). Path analysis of cognitive-behavioral exercise treatment-induced changes in psychological factors leading to weight loss. Psychology and Health,26, 1081–1098. https://doi.org/10.1080/08870446.2010.534167.
Annesi, J. J., Unruh, J. L., Marti, C. N., Gorjala, S., & Tennant, G. (2011). Effects of The Coach Approach intervention on adherence to exercise in obese women: Assessing mediation of social cognitive theory factors. Research Quarterly for Exercise and Sport,82, 99–108. https://doi.org/10.1080/02701367.2011.10599726.
Annesi, J. J., & Vaughn, L. L. (2011). Relationship of exercise volume with change in depression and its association with self-efficacy to control emotional eating in severely obese women. Advances in Preventive Medicine. https://doi.org/10.4061/2011/514271.
Arnow, B., Kenardy, J., & Agras, W. S. (1995). The Emotional Eating Scale: The development of a measure to assess coping with negative affect by eating. International Journal of Eating Disorders,18, 79–90. https://doi.org/10.1002/1098-108X(199507)18:1%3c79:AID-EAT2260180109%3e3.0.CO;2-V.
Baker, C. W., & Brownell, K. D. (2000). Physical activity and maintenance of weight loss: Physiological and psychological mechanisms. In C. Bouchard (Ed.), Physical activity and obesity (pp. 311–328). Champaign, IL: Human Kinetics.
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.
Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY: Freeman.
Bandura, A. (2005). The primacy of self-regulation in health promotion. Applied Psychology: An International Review,54, 245–254. https://doi.org/10.1111/j.1464-0597.2005.00208.x.
Baranowski, T., Cerin, E., & Baranowski, J. (2009). Steps in the design, development and formative evaluation of obesity prevention-related behavior change trials. International Journal of Behavioral Nutrition and Physical Activity,6, 6. https://doi.org/10.1186/1479-5868-6-6.
Baranowski, T., Lin, L. S., Wetter, D. W., Resnicow, K., & Hearn, M. D. (1997). Theory as mediating variables: Why aren’t community interventions working as desired? Annals of Epidemiology,7(Suppl), S89–S95. https://doi.org/10.1016/s1047-2797(97)80011-7.
Baumeister, R. F., Vohs, K. D., & Tice, D. M. (2008). The strength model of self-control. Current Directions in Psychological Science,16, 351–355. https://doi.org/10.1111/j.1467-8721.2007.00534.x.
Brownell, K. D. (2004). The LEARN program for weight management (10th ed.). Dallas, TX: American Health Publishing.
Clark, M. M., Abrams, D. B., Niaura, R. S., Eaton, C. A., & Rossi, J. S. (1991). Self-efficacy in weight management. Journal of Consulting and Clinical Psychology,59, 739–744. https://doi.org/10.1037/0022-006X.59.5.739.
Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah, NJ: Erlbaum.
Cooper, Z., Doll, H. A., Hawker, D. M., Byrne, S., Bonner, G., Eeley, E., et al. (2010). Testing a new cognitive behavioural treatment for obesity: A randomized controlled trial with three-year follow-up. Behavior Research and Therapy,48, 706–713. https://doi.org/10.1016/j.brat.2010.03.008.
Cromwell, J. B., Hannan, M. J., Labys, W. C., & Terraza, M. (1994). Multivariate tests for time series models. Thousand Oaks, CA: Sage.
Eldredge, K. L., & Agras, W. S. (1996). Weight and shape overconcern and emotional eating in binge eating disorder. International Journal of Eating Disorders,19, 71–82. https://doi.org/10.1002/(SICI)1098-108X(199601)19:1%3c73:AID-EAT9%3e3.0.CO;2-T.
Franz, M. J., VanWormer, J. J., Crain, L., Boucher, J. L., Histon, T., Caplan, W., et al. (2007). Weight-loss outcomes: A systematic review and meta-analyses of weight-loss clinical trials with a minimum of 1-year follow-up. Journal of the American Dietetic Association,107, 1755–1767. https://doi.org/10.1016/j.jada.2007.07.017.
Gendolla, G. H. E., & Brinkman, K. (2005). The role of mood states in self-regulation: Effects on action preferences and resource mobilization. European Psychologist,10, 187–198. https://doi.org/10.1027/1016-9040.10.3.187.
Gianini, L. M., White, M. A., & Masheb, R. M. (2013). Eating pathology, emotion regulation, and emotional overeating in obese adults with binge eating disorder. Eating Behavior,14, 309–313. https://doi.org/10.1016/j.eatbeh.2013.05.008.
Godin, G. (2011). The Godin-Shephard Leisure-Time Physical Activity Questionnaire. Health and Fitness Journal of Canada,4(1), 18–22.
Green, L. W., Sim, L., & Breiner, H. (Eds.). (2013). Evaluating obesity prevention efforts: A plan for measuring progress. Washington, DC: National Academies Press.
Grogan, S. (2006). Body image and health: Contemporary perspectives. Journal of Health Psychology,11, 523–530. https://doi.org/10.1177/1359105306065013.
Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2017). Prevalence of obesity among adults and youth: United States, 2015–2016. In: NCHS data brief, Number 288. Hyattsville, MD: National Center for Health Statistics. Retrieved May 15, 2019 from https://www.cdc.gov/nchs/data/databriefs/db288.pdf.
Halmi, K. A. (2013). Perplexities of treatment resistance in eating disorders. BMC Psychiatry,13, 292. https://doi.org/10.1186/1471-244X-13-292.
Jacobs, D. R., Ainsworth, B. E., Hartman, T. J., & Leon, A. S. (1993). A simultaneous evaluation of 10 commonly used physical activity questionnaires. Medicine and Science in Sports and Exercise,25, 81–91.
Jeffery, R. W., Drewnowski, A., Epstein, L. H., Stunkard, A. J., Wilson, G. T., Wing, R. R., et al. (2000). Long-term maintenance of weight loss: Current status. Health Psychology,19(Suppl. 1), 5–16. https://doi.org/10.1037/0278-6133.19.Suppl1.5.
Jetté, M., Sidney, K., & Blumchen, G. (1990). Metabolic equivalents (METs) in exercise testing, exercise prescription and evaluation of functional capacity. Clinical Cardiology,13, 555–565. https://doi.org/10.1002/clc.4960130809.
Johnson, S. S., Paiva, A. L., Mauriello, L., Prochaska, J. O., Redding, C., & Velicer, W. F. (2014). Coaction in multiple behavior change interventions: Consistency across multiple studies on weight management and obesity prevention. Health Psychology,33, 475–480. https://doi.org/10.1037/a0034215.
Kaiser Permanente Health Education Services. (2008). Cultivating Health weight management kit (8th ed.). Portland, OR: Kaiser Permanente.
Kiernan, M., Brown, S. D., Schoffman, D. E., Lee, K., King, A. C., Taylor, B., et al. (2013). Promoting healthy weight with “stability skills first”: A randomized trial. Journal of Consulting and Clinical Psychology,81, 336–346. https://doi.org/10.1037/a0030544.
Landers, D. M., & Arent, S. M. (2001). Physical activity and mental health. In R. N. Singer, H. A. Hausenblas, & C. M. Janelle (Eds.), Handbook of research on sport psychology (2nd ed., pp. 740–765). New York, NY: Wiley.
MacLean, P. S., Wing, R. R., Davidson, T., Epstein, L., Goodpaster, B., Hall, K. D., et al. (2015). NIH working group report: Innovative research to improve maintenance of weight loss. Obesity,23, 7–15. https://doi.org/10.1002/oby.20967.
Maes, S., & Karoly, P. (2005). Self-regulation assessment and intervention in physical health and illness: A review. Applied Psychology,54, 245–277. https://doi.org/10.1111/j.1464-0597.2005.00210.x.
Mann, T., Tomiyama, J., Westling, E., Lew, A. M., Samuels, B., & Chatman, J. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychologist,62, 220–233. https://doi.org/10.1037/0003-066X.62.3.220.
Marcus, B. H., Selby, V. C., Niaura, R. S., & Rossi, J. S. (1992). Self-efficacy and the stages of exercise behavior change. Research Quarterly for Exercise and Sport,63, 60–66. https://doi.org/10.1080/02701367.1992.10607557.
Mata, J., Silva, M. N., Vieira, P. N., Carraça, E. V., Andrade, A. M., Coutinho, S. R., et al. (2009). Motivational “spill-over” during weight control: Increased self-determination and exercise intrinsic motivation predict eating self-regulation. Health Psychology,28, 709–716. https://doi.org/10.1037/a0016764.
McNair, D. M., & Heuchert, J. W. P. (2009). Profile of Mood States technical update. North Tonawanda, NY: Multi-Health Systems.
McNair, D. M., Lorr, M., & Droppleman, L. F. (1992). POMS manual: Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service.
Oaten, M., & Cheng, K. (2006). Longitudinal gains in self-regulation from regular physical exercise. British Journal of Health Psychology,11, 717–733.
Paul, K., & van Strien, T. (2011). Emotional eating, rather than lifestyle behavior, drives weight gain in a prospective study in 1562 employees. Journal of Occupational and Environmental Medicine,53, 1287–1293. https://doi.org/10.1097/JOM.0b013e31823078a2.
Penéau, S., Ménard, E., Méjean, C., Bellisle, F., & Hercberg, S. (2013). Sex and diet modify the association between emotional eating and weight status. American Journal of Clinical Nutrition,97, 1307–1313. https://doi.org/10.3945/ajcn.112.054916.
Pereira, M. A., FitzGerald, S. J., Gregg, E. W., Joswiak, M. L., Ryan, W. J., Suminski, R. R., et al. (1997). A collection of physical activity questionnaires for health-related research. Medicine and Science in Sports and Exercise,29(Suppl. 6), S1–S205.
Polivy, J., & Herman, C. (2006). An evolutionary perspective on dieting. Appetite,47, 30–35. https://doi.org/10.1016/j.appet.2006.02.009.
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods,40, 879–891. https://doi.org/10.3758/BRM.40.3.879.
Rideout, C. A., & Barr, S. I. (2009). “Restrained eating” vs “trying to lose weight”: How are they associated with body weight and tendency to overeat among postmenopausal women? Journal of the American Dietetic Association,109, 890–893. https://doi.org/10.1016/j.jada.2009.02.009.
Schafer, J. L., & Graham, J. W. (2002). Missing data: Our view of the state of the art. Psychological Methods,7, 147–177. https://doi.org/10.1037/1082-989X.7.2.147.
Schneider, K. L., Panza, E., Appelhans, B. M., Whited, M. C., Oleski, J. L., & Pagoto, S. L. (2012). The Emotional Eating Scale: Can a self-report measure predict observed emotional eating? Appetite,58, 563–566. https://doi.org/10.1016/j.appet.2012.01.012.
Teixeira, P. J., Carraça, E. V., Marques, M. M., Rutter, M. M., Oppert, J.-M., De Bourdeaudhuij, I., et al. (2015). Successful behavior change in obesity interventions in adults: A systematic review of self-regulation mediators. BMC Medicine,13, 84. https://doi.org/10.1186/s12916-015-0323-6.
Trost, S. G., Owen, N., Bauman, A. E., Sallis, J. F., & Brown, W. (2002). Correlates of adults’ participation in physical activity: Review and update. Medicine and Science in Sports and Exercise,34, 1996–2001. https://doi.org/10.1249/01.MSS.0000038974.76900.92.
U.S. Department of Health and Human Services. (2008). 2008 Physical activity guidelines for Americans. Washington, DC: U.S. Department of Health and Human Services.
van Strien, T. (2018). Causes of emotional eating and matched treatment of obesity. Current Diabetes Reports,18(6), 1–8. https://doi.org/10.1007/s11892-018-1000-x.
Wang, Y., Beydoun, M. A., Liang, L., Caballero, B., & Kumanyika, S. (2008). Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity,16, 2323–2330. https://doi.org/10.1038/oby.2008.351.
Wang, L., Zhang, Z., McArdle, J. J., & Salthouse, T. A. (2009). Investigating ceiling effects in longitudinal analysis. Multivariate Behavioral Research,43, 476–496. https://doi.org/10.1080/00273170802285941.
Warziski, M. T., Sereika, S. M., Styn, M. A., Music, E., & Burke, L. E. (2008). Changes in self-efficacy and dietary adherence: The impact on weight loss in the PREFER study. Journal of Behavioral Medicine,31, 81–92. https://doi.org/10.1007/s10865-007-9135-2.
White, I. R., Horton, N. J., Carpenter, J., & Pocock, S. J. (2011). Strategy for intention to treat data in randomized trials with missing outcome data. British Medical Journal,342, d40. https://doi.org/10.1136/bmj.d40.
This research was funded in part by a grant from Blue Cross Blue Shield of Georgia.
Conflict of Interest
The author declares that they have no conflict of interest.
All study procedures involving human participants were in accordance with the ethical standards of the institution and/or national research committee, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Institutional Review Board of Kennesaw State University, Kennesaw, Georgia, Study #13173.
Informed consent was obtained from all individual participants included in the study.
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Annesi, J.J. Psychosocial Correlates of Emotional Eating and Their Interrelations: Implications for Obesity Treatment Research and Development. J Primary Prevent (2020). https://doi.org/10.1007/s10935-020-00580-6
- Eating behavior