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Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis

BACKGROUND: Changes in body image and subjective well-being variables (e.g. self-esteem) are often reported as outcomes of obesity treatment. However, they may, in turn, also influence behavioral adherence and success in weight loss. The present study examined associations among obesity treatment-re...

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Autores principales: Palmeira, António L, Markland, David A, Silva, Marlene N, Branco, Teresa L, Martins, Sandra C, Minderico, Cláudia S, Vieira, Paulo N, Barata, José T, Serpa, Sidónio O, Sardinha, Luis B, Teixeira, Pedro J
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645358/
https://www.ncbi.nlm.nih.gov/pubmed/19203389
http://dx.doi.org/10.1186/1479-5868-6-9
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author Palmeira, António L
Markland, David A
Silva, Marlene N
Branco, Teresa L
Martins, Sandra C
Minderico, Cláudia S
Vieira, Paulo N
Barata, José T
Serpa, Sidónio O
Sardinha, Luis B
Teixeira, Pedro J
author_facet Palmeira, António L
Markland, David A
Silva, Marlene N
Branco, Teresa L
Martins, Sandra C
Minderico, Cláudia S
Vieira, Paulo N
Barata, José T
Serpa, Sidónio O
Sardinha, Luis B
Teixeira, Pedro J
author_sort Palmeira, António L
collection PubMed
description BACKGROUND: Changes in body image and subjective well-being variables (e.g. self-esteem) are often reported as outcomes of obesity treatment. However, they may, in turn, also influence behavioral adherence and success in weight loss. The present study examined associations among obesity treatment-related variables, i.e., change in weight, quality of life, body image, and subjective well-being, exploring their role as both mediators and outcomes, during a behavioral obesity treatment. METHODS: Participants (BMI = 31.1 ± 4.1 kg/m(2); 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. The intervention included regular group meetings promoting lasting behavior changes in physical activity and dietary intake. Body image, quality of life, subjective well-being, and body weight were measured at baseline and treatment's end. Mediation was tested by multiple regression and a resampling approach to measure indirect effects. Treatment group assignment was the independent variable while changes in weight and in psychosocial variables were analyzed alternatively as mediators and as dependent variables. RESULTS: At 12 months, the intervention group had greater weight loss (-5.6 ± 6.8% vs. -1.2 ± 4.6%, p < .001) and larger decreases in body size dissatisfaction (effect size of 1.08 vs. .41, p < .001) than the comparison group. Significant improvements were observed in both groups for all other psychosocial variables (effect sizes ranging from .31–.75, p < .05). Mediation analysis showed that changes in body image and body weight were concurrently mediators and outcomes of treatment, suggesting reciprocal influences. Weight loss partially mediated the effect of treatment on quality of life and on self-esteem but the reciprocal effect was not observed. CONCLUSION: Changes in weight and body image may reciprocally affect each other during the course of behavioral obesity treatment. No evidence of reciprocal relationships was found for the other models under analysis; however, weight changes partially explained the effects of treatment on quality of life and self-esteem. Weight and psychosocial changes co-occur during treatment and will probably influence each other dynamically, in ways not yet adequately understood. Results from this study support the inclusion of intervention contents aimed at improving body image in weight management programs.
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spelling pubmed-26453582009-02-20 Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis Palmeira, António L Markland, David A Silva, Marlene N Branco, Teresa L Martins, Sandra C Minderico, Cláudia S Vieira, Paulo N Barata, José T Serpa, Sidónio O Sardinha, Luis B Teixeira, Pedro J Int J Behav Nutr Phys Act Research BACKGROUND: Changes in body image and subjective well-being variables (e.g. self-esteem) are often reported as outcomes of obesity treatment. However, they may, in turn, also influence behavioral adherence and success in weight loss. The present study examined associations among obesity treatment-related variables, i.e., change in weight, quality of life, body image, and subjective well-being, exploring their role as both mediators and outcomes, during a behavioral obesity treatment. METHODS: Participants (BMI = 31.1 ± 4.1 kg/m(2); 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. The intervention included regular group meetings promoting lasting behavior changes in physical activity and dietary intake. Body image, quality of life, subjective well-being, and body weight were measured at baseline and treatment's end. Mediation was tested by multiple regression and a resampling approach to measure indirect effects. Treatment group assignment was the independent variable while changes in weight and in psychosocial variables were analyzed alternatively as mediators and as dependent variables. RESULTS: At 12 months, the intervention group had greater weight loss (-5.6 ± 6.8% vs. -1.2 ± 4.6%, p < .001) and larger decreases in body size dissatisfaction (effect size of 1.08 vs. .41, p < .001) than the comparison group. Significant improvements were observed in both groups for all other psychosocial variables (effect sizes ranging from .31–.75, p < .05). Mediation analysis showed that changes in body image and body weight were concurrently mediators and outcomes of treatment, suggesting reciprocal influences. Weight loss partially mediated the effect of treatment on quality of life and on self-esteem but the reciprocal effect was not observed. CONCLUSION: Changes in weight and body image may reciprocally affect each other during the course of behavioral obesity treatment. No evidence of reciprocal relationships was found for the other models under analysis; however, weight changes partially explained the effects of treatment on quality of life and self-esteem. Weight and psychosocial changes co-occur during treatment and will probably influence each other dynamically, in ways not yet adequately understood. Results from this study support the inclusion of intervention contents aimed at improving body image in weight management programs. BioMed Central 2009-02-09 /pmc/articles/PMC2645358/ /pubmed/19203389 http://dx.doi.org/10.1186/1479-5868-6-9 Text en Copyright © 2009 Palmeira et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Palmeira, António L
Markland, David A
Silva, Marlene N
Branco, Teresa L
Martins, Sandra C
Minderico, Cláudia S
Vieira, Paulo N
Barata, José T
Serpa, Sidónio O
Sardinha, Luis B
Teixeira, Pedro J
Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis
title Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis
title_full Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis
title_fullStr Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis
title_full_unstemmed Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis
title_short Reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis
title_sort reciprocal effects among changes in weight, body image, and other psychological factors during behavioral obesity treatment: a mediation analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645358/
https://www.ncbi.nlm.nih.gov/pubmed/19203389
http://dx.doi.org/10.1186/1479-5868-6-9
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