International Journal of Behavioral Nutrition and Physical Activity (Feb 2009)

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

  • Barata José T,
  • Vieira Paulo N,
  • Minderico Cláudia S,
  • Martins Sandra C,
  • Branco Teresa L,
  • Silva Marlene N,
  • Markland David A,
  • Palmeira António L,
  • Serpa Sidónio O,
  • Sardinha Luis B,
  • Teixeira Pedro J

DOI
https://doi.org/10.1186/1479-5868-6-9
Journal volume & issue
Vol. 6, no. 1
p. 9

Abstract

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Abstract 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/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. 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 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.