从增加运动到减少情绪化饮食和体重/腰围:改进理论驱动的治疗肥胖的社会心理目标

J. Annesi
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摘要

短期后的糟糕结果表明,通过行为手段治疗肥胖需要取得进展。社会心理干预目标的研究尤为重要。由于可能产生跨越社会经济和种族/民族界线的广泛影响,还需要能够以大规模和经济的方式有效传播的方法。这项研究评估了参与社区管理的肥胖治疗的妇女,她们采用类似的课程,分别是手册治疗(n = 39)和面对面治疗(n = 44)。社会认知理论、自我调节理论、情绪-行为模型和合作理论的范式指导了体重/身体成分变化的社会心理预测因素的分析,并得出了情绪性进食相关的结论,特别是在女性中。两种治疗方式在运动、情绪障碍、运动和饮食的自我调节、情绪性饮食、体重和腰围方面都有显著改善,其中面对面治疗方式的改善更大。模型拟合检验表明,除了自我调节因子在第3个月得分最强外,基线-时间2变化项是计划回归模型中后续变量的较好预测因子。增加锻炼预示着情绪障碍的减少。情绪→运动自我调节→饮食自我调节→情绪性饮食,以及(运动相关的)情绪变化→情绪性饮食的直接路径显著。情绪性饮食的减少显著预示着6个月和12个月后体重和腰围的减少。情绪与自我调节的关系支持情绪-行为模型,而运动相关自我调节对饮食自我调节的预测则支持协同作用理论。研究结果可用于进一步的研究和应用,针对行为肥胖治疗中的心理社会变化。
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From Increased Exercise to Reductions in Emotional Eating and Weight/Waist Circumference: Refining Theory-Driven Psychosocial Targets for Treating Obesity
Overwhelmingly poor results beyond the short term suggest advances in treating obesity through behavioral means are required. Research on psychosocial intervention targets is particularly important. Because of possible widespread impacts crossing socioeconomic and racial/ethnic lines, methods that can effectively be disseminated in a large-scale and economical manner are also needed. This research assessed women participating in community-administered obesity treatments with similar curricula that were either manual-based ( n = 39) or in-person-based ( n = 44). Along with conclusions that emotional eating is relevant, especially in women, the paradigms of social cognitive theory, self-regulation theory, the mood-behavior-model, and coaction theory guided analyses of psychosocial predictors of weight/body composition changes. Both treatment formats were associated with significant improvements in exercise, mood disturbance, self-regulation of exercise and eating, emotional eating, weight, and waist circumference, with significantly greater improvements associated with the in-person format. Tests of model-fitting indicated that baseline–Time 2 change terms were the better predictor of the subsequent variable in planned regression models, except the self-regulation factors where Month 3 scores were strongest. Increased exercise predicted a reduction in mood disturbance. The path from mood→self-regulation of exercise→self-regulation of eating→emotional eating was significant, along with the direct path from (exercise-associated) changes in mood→emotional eating. Emotional eating reduction significantly predicted reduced weight and waist circumference over 6 and 12 months. The relation between mood and self-regulation supported the mood-behavior-model, whereas the prediction of self-regulation of eating by exercise-related self-regulation affirmed coaction theory. Findings may be used to inform further research and applications targeting psychosocial changes within behavioral obesity treatments.
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