Evaluating the utility of temporal self-regulation theory for understanding physical activity outcomes in a behavioral weight loss maintenance program.

OBJECTIVE: Physical activity (PA) is critical for weight loss maintenance (WLM) success. Clarifying mechanisms behind PA engagement may suggest new WLM intervention targets. This study examined an application of temporal self-regulation theory (TST) to enhance our understanding of PA during WLM. METHODS AND MEASURES: Participants (n = 214) who achieved a ≥ 5% weight loss during a 4-month weight loss intervention were recruited into an 18-month WLM trial. TST constructs (i.e. PA beliefs, intention, behavioral prepotency, self-regulatory capacity) were measured via self-report measures. PA was subsequently assessed over a 7-day period with waist-worn Actigraph GT9X. Robust linear regression models and generalized linear mixed models tested the association between PA beliefs and intention, and the associations between intention, behavioral prepotency, self-regulatory capacity and device-measured PA at baseline and 18-months. RESULTS: Short-term positive beliefs were associated with intention at baseline and 18-months, whereas short-term negative beliefs were associated with intention at 18-months only. Intention was associated with moderate/vigorous PA (MVPA) minutes and bouted MVPA at baseline and 18-months. The intention by self-regulatory capacity interaction was significant at baseline. CONCLUSION: Findings lend some support for the use of TST for understanding PA and suggest that short-term beliefs about PA may represent a meaningful target for intervention.

Impact of social connectedness on weight loss outcomes in an online program.

Obesity is linked to many negative health consequences. While online behavioral weight loss programs (BWL) are an effective treatment for obesity, weight losses are modest. Social connectedness has been found to improve weight loss outcomes and previous findings suggests that it may be especially important for people of color. The present study investigated the impact of social connectedness (structural connectedness, or network size; relationship quality, and functional connectedness, or social support) on weight loss outcomes in an online BWL program and whether Black race or Hispanic ethnicity moderates the relationship between social connectedness and weight loss. Participants (N = 387) enrolled in a 16-week online BWL program and completed measures of social connectedness before treatment and had their weight measured. Individuals with less structural connectedness (smaller social networks) had greater weight losses. Further, higher levels of functional connectedness (affectionate support, positive support, and relationship quality) mediated the relationship between smaller network size and better weight loss outcomes. Black race / Hispanic ethnicity did not moderate the relationship between social connectedness and weight loss. These findings suggest that the quality of one's relationships, not the size of one's social network, is important for weight loss. Future studies may examine whether online BWL programs that build relationship quality and affectionate and positive support in participants' existing social networks improve overall weight loss outcomes.

Episodic future thinking, delay discounting, and exercise during weight loss maintenance: The PACE trial.

OBJECTIVES: Weight loss maintenance (WLM) is the next major challenge in obesity treatment. While most individuals who lose weight intend to keep their weight off, weight regain is common. Temporal Self-Regulation Theory posits that whether intentions lead to behavior depends on self-regulatory capacity, including delay discounting (DD; the tendency to discount a larger future reward in favor of a smaller immediate reward). Episodic Future Thinking (EFT; mental imagery of a future event for which a health goal is important) may improve DD and promote behavior change. Described herein is a trial protocol designed to examine whether EFT improves DD within the context of weight loss maintenance. METHOD: Participants who lose ≥5% of initial body weight in an online behavioral weight loss intervention will be randomly assigned to a standard weight loss maintenance program (WLM-STD) or a weight loss maintenance program plus EFT (WLM + EFT). Both interventions involve periodic phone and in-person treatment sessions. Participants in WLM + EFT will engage in daily EFT training via smartphone. To control for contact, participants in WLM-STD will engage in daily Healthy Thinking (reviewing strategies for weight management) on their smartphone. Our primary hypothesis is that WLM + EFT will yield better improvements in DD compared to WLM-STD. We will also explore whether DD mediates the relationship between intervention allocation and physical activity (secondary outcome). Weight and contextual variables will be explored. CONCLUSIONS: This study is the first to test whether EFT improves DD within the context of weight loss maintenance; results from this experimental medicine approach could have important implications for understanding the impact of both EFT and DD on sustained behavior change. (PsycInfo Database Record (c) 2020 APA, all rights reserved).