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 .
A 3-Year Randomized Trial of Lifestyle Intervention for Cardiovascular Risk Reduction in the Primary Care Setting: The Swedish Björknäs Study
Background Successfully transferring the findings of expensive and tightly controlled programmes of intensive lifestyle modification to the primary care setting is necessary if such knowledge is to be of clinical utility . The objective of this study was to test whether intensive lifestyle modification , shown previously in tightly-controlled clinical trials to be efficacious for diabetes risk-reduction among high-risk individuals , can reduce cardiovascular risk factor levels in the primary care setting . Methodology / Principal Findings The Swedish Björknäs study was a r and omized controlled trial conducted from 2003 to 2006 with follow-up on cardiovascular risk factors at 3 , 12 , 24 and 36 months . A total of 151 middle-aged men and women at moderate- to high-risk of cardiovascular disease from northern Sweden were r and omly assigned to either an intensive lifestyle intervention ( n = 75 ) or control ( n = 76 ) group . The intervention was based broadly on the protocol of the Diabetes Prevention Program . The three-month intervention period was administered in the primary care setting and consisted of supervised exercise sessions and diet counselling , followed by regular group meetings during three years . The control group was given general advice about diet and exercise and received st and ard clinical care . Outcomes were changes in anthropometrics , aerobic fitness , self-reported physical activity , blood pressure , and metabolic traits . At 36 months post-r and omisation , intensive lifestyle modification  reduced waist circumference ( −2.2 cm : p = 0.001 ) , waist-hip ratio ( −0.02 : p<0.0001 ) , systolic blood pressure ( −4.9 mmHg : p = 0.036 ) , and diastolic blood pressure ( −1.6 mmHg : p = 0.005 ) , and improved aerobic fitness ( 5 % ; p = 0.038 ) . Changes in lipid or glucose values did not differ statistically between groups . At 36 months , self-reported time spent exercising and total physical activity had increased more in the intervention group than in the control group ( p<0.001 ) . Conclusion / Significance A program of intensive lifestyle modification undertaken in the primary health care setting can favourably influence cardiovascular risk-factor profiles in high-risk individuals . Trial Registration Clinical Trials.gov
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 .