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Background An improved understanding of psychosocial factors related to weight loss is required to improve the continually poor outcomes of behavioral obesity treatments beyond their first several weeks or months. The aim of this investigation was to inform future research and improve obesity-treatment foci via an increased understanding of interrelations of treatment-associated changes in self-regulation, emotional eating, and weight.
Methods Stratified randomization yielded matched groups of United States-based White and Black women with obesity within self-regulation-focused or knowledge-focused treatment content lasting 1 year (both n = 47; overall Mage = 48 years). Changes in self-regulation and emotional eating over 3 months, weight over 6, 12, and 24 months, and baseline mood were assessed, and contrasted by group. Regression analyses assessed the relationship of changes in weight by self-regulation change, with mediation effects of emotional eating change also accounted.
Results Effect sizes for improvements in self-regulation, emotional eating, and weight were greater in the self-regulation-focused group on all variables. Incorporating data aggregated across both groups, change in emotional eating significantly mediated the prediction of weight changes by change in self-regulation. Baseline negative mood significantly moderated the emotional eating → weight change relationships within those mediation models.
Conclusion Findings suggest value in a self-regulation-centered obesity treatment approach in women. It also indicated that emotional eating and initial mood of participants are factors to carefully address in future behavioral treatments seeking increased short- and long-term weight losses.