Identified mediators for medium-/long-term weight control were higher levels of autonomous motivation , self-efficacy/barriers , self-regulation skills ( such as self-monitoring ) , flexible eating restraint , and positive body image .
For physical activity , significant putative mediators were high autonomous motivation , self-efficacy , and use of self-regulation skills .
For dietary intake , the evidence was much less clear , and no consistent mediators were identified .
Conclusions This is the first systematic review of mediational psychological mechanisms of successful outcomes in obesity-related lifestyle change interventions .
Despite limited evidence , higher autonomous motivation , self-efficacy , and self-regulation skills emerged as the best predictors of beneficial weight and physical activity outcomes ; for weight control , positive body image and flexible eating restraint may additionally improve outcomes .
These variables represent possible targets for future lifestyle interventions in overweight/obese population
Background Relapse is high in lifestyle obesity interventions involving behavior and weight change .
Identifying mediators of successful outcomes in these interventions is critical to improve effectiveness and to guide approaches to obesity treatment , including re source allocation .
This article review s the most consistent self-regulation mediators of medium- and long-term weight control , physical activity , and dietary intake in clinical and community behavior change interventions targeting overweight/obese adults .
Extended-care programs for weight management in rural communities: the treatment of obesity in underserved rural settings (TOURS) randomized trial.
BACKGROUND Rural counties in the United States have higher rates of obesity , sedentary lifestyle , and associated chronic diseases than nonrural areas , yet the management of obesity in rural communities has received little attention from research ers . METHODS Obese women from rural communities who completed an initial 6-month weight-loss program at Cooperative Extension Service offices in 6 medically underserved rural counties ( n = 234 ) were r and omized to extended care or to an education control group .  The extended-care programs entailed problem-solving counseling delivered in 26 biweekly sessions via telephone or face to face . Control group participants received 26 biweekly newsletters containing weight-control advice . RESULTS Mean weight at study entry was 96.4 kg . Mean weight loss during the initial 6-month intervention was 10.0 kg . One year after r and omization , participants in the telephone and face-to-face extended-care programs  regained less weight ( mean [ SE ] , 1.2 [ 0.7 ] and 1.2 [ 0.6 ] kg , respectively ) than those in the education control group ( 3.7 [ 0.7 ] kg ; P = .03 and .02 , respectively ) . The beneficial effects of extended-care counseling were mediated by greater adherence to behavioral weight-management strategies , and cost analyses indicated that telephone counseling was less expensive than face-to-face intervention . CONCLUSIONS Extended care delivered either by telephone or in face-to-face sessions improved the 1-year maintenance of lost weight compared with education alone . Telephone counseling constitutes an effective and cost-efficient option for long-term weight management . Delivering lifestyle interventions via the existing infrastructure of the Cooperative Extension Service represents a viable means of adapting research for rural communities with limited access to preventive health services . Trial Registration clinical trials.gov Identifier : NCT00201006
Identified mediators for medium-/long-term weight control were higher levels of autonomous motivation , self-efficacy/barriers , self-regulation skills ( such as self-monitoring ) , flexible eating restraint , and positive body image .
For physical activity , significant putative mediators were high autonomous motivation , self-efficacy , and use of self-regulation skills .
For dietary intake , the evidence was much less clear , and no consistent mediators were identified .
Conclusions This is the first systematic review of mediational psychological mechanisms of successful outcomes in obesity-related lifestyle change interventions .
Despite limited evidence , higher autonomous motivation , self-efficacy , and self-regulation skills emerged as the best predictors of beneficial weight and physical activity outcomes ; for weight control , positive body image and flexible eating restraint may additionally improve outcomes .
These variables represent possible targets for future lifestyle interventions in overweight/obese population
Background Relapse is high in lifestyle obesity interventions involving behavior and weight change .
Identifying mediators of successful outcomes in these interventions is critical to improve effectiveness and to guide approaches to obesity treatment , including re source allocation .
This article review s the most consistent self-regulation mediators of medium- and long-term weight control , physical activity , and dietary intake in clinical and community behavior change interventions targeting overweight/obese adults .