Disclosure: The authors declared no conflict of interest.
Examining behavioral processes through which lifestyle interventions promote weight loss: Results from PREMIER
Article first published online: 4 DEC 2013
Copyright © 2013 The Obesity Society
Volume 22, Issue 4, pages 1002–1007, April 2014
How to Cite
Fitzpatrick, S. L., Bandeen-Roche, K., Stevens, V. J., Coughlin, J. W., Rubin, R. R., Brantley, P. J., Funk, K. L., Svetkey, L. P., Jerome, G. J., Dalcin, A., Charleston, J. and Appel, L. J. (2014), Examining behavioral processes through which lifestyle interventions promote weight loss: Results from PREMIER. Obesity, 22: 1002–1007. doi: 10.1002/oby.20636
Author Contributions: Lawrence Appel, Richard Rubin, Janelle Coughlin, Arlene Dalcin, and Gerald Jerome have an institutional (Johns Hopkins University) conflict of interest with Healthways, Inc.
- Issue published online: 26 MAR 2014
- Article first published online: 4 DEC 2013
- Accepted manuscript online: 10 OCT 2013 01:15PM EST
- Manuscript Accepted: 30 SEP 2013
- Manuscript Received: 10 JUN 2013
To examine the behavioral processes through which lifestyle interventions impacted weight loss.
The analyses were limited to overweight and obese Black and White adults randomized to a PREMIER lifestyle intervention (N = 501). Structural equation modeling was conducted to test the direct and indirect relationships of session attendance, days of self-monitoring diet and exercise, change in diet composition and exercise, and 6-month weight change.
Greater session attendance was associated with increased self-monitoring, which was in turn significantly related to reduction in percent energy from total fat consumed. Change in percent energy from fat and self-monitoring was associated with 6-month percent change in weight. Both a decrease in fat intake and increase in self-monitoring are potential mediators of the relationship between attendance and weight change.
The findings provide a reasonable model that suggests regular session attendance and use of behavioral strategies like self-monitoring are associated with improved behavioral outcomes that are associated with weight loss.