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Dagens #fsvoversigt:
Successful behavior change in obesity interventions in adults: a systematic
review of self-regulation mediators.
BMC Med. 2015;13:84
Authors: Teixeira PJ, Carraça EV, Marques MM, Rutter H, Oppert JM, De
Bourdeaudhuij I, Lakerveld J, Brug J
Abstract
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 resource allocation. This article
reviews 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.
METHODS: A comprehensive search of peer-reviewed articles, published since
2000, was conducted on electronic databases (for example, MEDLINE) and journal
reference lists. Experimental studies were eligible if they reported
intervention effects on hypothesized mediators (self-regulatory and
psychological mechanisms) and the association between these and the outcomes of
interest (weight change, physical activity, and dietary intake). Quality and
content of selected studies were analyzed and findings summarized. Studies with
formal mediation analyses were reported separately.
RESULTS: Thirty-five studies were included testing 42 putative mediators. Ten
studies used formal mediation analyses. Twenty-eight studies were randomized
controlled trials, mainly aiming at weight loss or maintenance (n = 21).
Targeted participants were obese (n = 26) or overweight individuals, aged
between 25 to 44 years (n = 23), and 13 studies targeted women only. In terms
of study quality, 13 trials were rated as "strong", 15 as "moderate", and 7
studies as "weak". In addition, methodological quality of formal mediation
analyses was "medium". 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 consisten
t 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 populations.
PMID: 25907778 [PubMed - indexed for MEDLINE]
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Dette abstract er hentet via PubMed fra National Library of Medicine, USA
(http://www.ncbi.nlm.nih.gov/About/disclaimer.html).
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Se abstractet i PubMed: http://evidens.link/1XDSLuB
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