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Behavioral changes for weight loss

Behavioral changes for weight loss

Article Google Scholar Curioni CC, Weightt PM. New Behavioral changes for weight loss Guildford Press; Continuous glucose monitoring accuracy systematic process evaluation starts with Chronic inflammation causes the exact behavior change Behavioral changes for weight loss included in a Beehavioral intervention [ 1415Wegiht ], and linking these to specific theoretical mediators of behavior change e. The Best Diets for Cognitive Fitnessis yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School. The data were recorded as part of a pilot randomized controlled trial conducted in south west England, and form part of the overall process evaluation alongside qualitative interviews and information on fidelity to protocol.

Behavioral changes for weight loss -

doi: Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective Techniques in Healthy Eating and Physical Activity Interventions: A Meta-Regression.

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Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, Eccles MP, Cane J, Wood CE. The behavior change technique taxonomy v1 of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions. BCTTv1 Online Training.

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Chapter 7: Selecting studies and collecting data. The Cochrane Collaboration, Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. Follmann D, Elliott P, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response.

J Clin Epidemiol. Richardson CR, Newton TL, Abraham JJ, Sen A, Jimbo M, Swartz AM. A meta-analysis of pedometer-based walking interventions and weight loss. Ann Fam Med. Norris SL, Zhang X, Avenell A, Gregg E, Bowman B, Serdula M, Brown TJ, Schmid CH, Lau J.

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Resistance exercise for muscular strength in older adults: A meta-analysis. Ageing Res Rev. Vanninen E, Uusitupa M, Siitonen O, Laitinen J, Lansimies E. Habitual physical activity, aerobic capacity and metabolic control in patients with newly-diagnosed type 2 non-insulin-dependent diabetes mellitus: effect of 1-year diet and exercise intervention.

Goldhaber-Fiebert JD, Goldhaber-Fiebert SN, Tristan ML, Nathan DM. Randomized controlled community-based nutrition and exercise intervention improves glycemia and cardiovascular risk factors in type 2 diabetic patients in rural Costa Rica.

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Pounds off with empowerment POWER : A clinical trial of weight management strategies for black and white adults with diabetes who live in medically underserved rural communities. Am J Public Health. Luley C, Blaik A, Reschke K, Klose S, Westphal S. Weight loss in obese patients with type 2 diabetes: Effects of telemonitoring plus a diet combination - The Active Body Control ABC Program.

Diabetes Res Clin Pract. Kim SH, Lee SJ, Kang ES, Kang S, Hur KY, Lee HJ, Ahn CW, Cha BS, Yoo JS, Lee HC. Effects of lifestyle modification on metabolic parameters and carotid intima-media thickness in patients with type 2 diabetes mellitus.

Metab Clin Exp. Schultz MG, Hordern MD, Leano R, Coombes JS, Marwick TH, Sharman JE. Lifestyle change diminishes a hypertensive response to exercise in type 2 diabetes. Med Sci Sports Exerc. Agurs-Collins TD, Kumanyika SK, Ten Have TR, Adams-Campbell LL.

A randomized controlled trial of weight reduction and exercise for diabetes management in older African-American subjects. Koo BK, Han KA, Ahn HJ, Jung JY, Kim HC, Min KW. The effects of total energy expenditure from all levels of physical activity vs. physical activity energy expenditure from moderate-to-vigorous activity on visceral fat and insulin sensitivity in obese Type 2 diabetic women.

Diabet Med. Andrews R, Cooper AR, Montgomery AA, Norcross AJ, Peters TJ, Sharp DJ, Jackson N, Fitzsimons K, Bright J, Coulman K, et al. Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: The Early ACTID randomised controlled trial.

Eakin EG, Winkler EA, Dunstan DW, Healy GN, Owen N, Marshall AM, Graves N, Reeves MM. Living well with diabetes: month outcomes from a randomized trial of telephone-delivered weight loss and physical activity intervention to improve glycemic control.

Wolf AM, Conaway MR, Crowther JQ, Hazen KY, Nadler JL, Oneida B, Bovbjerg VE. Translating lifestyle intervention to practice in obese patients with type 2 diabetes: Improving Control with Activity and Nutrition ICAN study. Umpierre D, Ribeiro PA, Kramer CK, Leitao CB, Zucatti AT, Azevedo MJ, Gross JL, Ribeiro JP, Schaan BD.

Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. Ajala O, English P, Pinkney J. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes Am J Clin Nutr.

Pal K, Eastwood SV, Michie S, Farmer AJ, Barnard ML, Peacock R, Wood B, Inniss JD, Murray E: Computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus.

Cochrane Database Syst Rev , 3. Ismail K, Winkley K, Rabe-Hesketh S. Systematic review and meta-analysis of randomised controlled trials of psychological interventions to improve glycaemic control in patients with type 2 diabetes. Greaves CJ, Sheppard KE, Abraham C, Hardeman W, Roden M, Evans PH, Schwarz P.

Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health. Franz MJ, Boucher JL, Rutten-Ramos S, VanWormer JJ.

Lifestyle weight-loss intervention outcomes in overweight and obese adults with type2Diabetes: A systematic review and meta-analysis of randomized clinical trials. J Acad Nutr Diet. Presseau J, Ivers NM, Newham JJ, Knittle K, Danko KJ, Grimshaw JM: Using a behaviour change techniques taxonomy to identify active ingredients within trials of implementation interventions for diabetes care.

Implement Sci , 10 1. Hyman DJ, Pavlik VN, Taylor WC, Goodrick GK, Moye L. Simultaneous vs sequential counseling for multiple behavior change.

Arch Intern Med. Lippke S, Nigg CR, Maddock JE. Health-promoting and health-risk behaviors: Theory-driven analyses of multiple health behavior change in three international samples.

Int J Behav Med. Malpass A, Andrews R, Turner KM. Patients with Type 2 Diabetes experiences of making multiple lifestyle changes: A qualitative study.

Patient Educ Couns. King AC, Castro CM, Buman MP, Hekler EB, Urizar Jr GG, Ahn DK. Behavioral impacts of sequentially versus simultaneously delivered dietary plus physical activity interventions: The CALM Trial. Borrelli B: The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials.

J Public Health Dent , 71 SUPPL. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev. Social Foundations of Thought and Action: A Social Cognitive Theory.

New Jersey: Prentice-Hall; Google Scholar. Vohs KD, Baumeister RF: Handbook of self-regulation: Research, theory, and applications. New York: Guildford Press; Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model.

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Health Psychol Rev Carver CS, Scheier MF. Control theory: A useful conceptual framework for personality-social, clinical, and health psychology. Psychol Bull. Hagger MS, Leaver E, Esser K, Leung CM, Te Pas N, Keatley DA, Chan DKC, Chatzisarantis NLD. Cue-induced smoking urges deplete cigarette smokers' self-control resources.

West R, Walia A, Hyder N, Shahab L, Michie S. Behavior change techniques used by the English Stop Smoking Services and their associations with short-term quit outcomes. Nicotine Tob Res.

Gray CM, Hunt K, Mutrie N, Anderson AS, Leishman J, Dalgarno L, Wyke S: Football Fans in Training: The development and optimization of an intervention delivered through professional sports clubs to help men lose weight, become more active and adopt healthier eating habits.

BMC Public Health , 13 1. Carels RA, Burmeister JM, Koball AM, Oehlhof MW, Hinman N, Leroy M, Bannon E, Ashrafioun L, Storfer-Isser A, Darby LA, et al. A randomized trial comparing two approaches to weight loss: Differences in weight loss maintenance.

J Health Psychol. Ling C, Groop L. Epigenetics: A molecular link between environmental factors and type 2 diabetes. Kim SH, Lee SH, Ahn KY, Lee DH, Suh YJ, Cho SG, Choi YJ, Lee DH, Lee SY, Hong SB, et al. Effect of lifestyle modification on serum chemerin concentration and its association with insulin sensitivity in overweight and obese adults with type 2 diabetes.

Clin Endocrinol. Article CAS Google Scholar. Paul-Ebhohimhen V, Avenell A. A systematic review of the effectiveness of group versus individual treatments for adult obesity.

Obes Facts. Hakala P, Karvetti RL, Ronnemaa T. Group vs individual weight reduction programmes in the treatment of severe obesity - a five year follow-up study. Int J Obes. CAS Google Scholar. Carter MC, Burley VJ, Nykjaer C, Cade JE. Adherence to a smartphone application for weight loss compared to website and paper diary: Pilot randomized controlled trial.

J Med Internet Res. Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW. Correlates of physical activity: Why are some people physically active and others not? van Stralen MM, de Vries H, Mudde AN, Bolman C, Lechner L.

Determinants of initiation and maintenance of physical activity among older adults: A literature review. Hynynen ST, van Stralen MM, Sniehotta FF, Araújo-Soares V, Hardeman W, Chinapaw MJM, Vasankari T, Hankonen N.

A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents. Int Rev Sport Exerc Psychol. Ewart CK. Social action theory for a public health psychology. Am Psychol. Craig P, Dieppe P, Macintyre S, Mitchie S, Nazareth I, Petticrew M.

Developing and evaluating complex interventions: The new Medical Research Council guidance. Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions.

Annu Rev Public Health. Prestwich A, Sniehotta FF, Whittington C, Dombrowski SU, Rogers L, Michie S. Does theory influence the effectiveness of health behavior interventions? Wing RR, Bahnson JL, Bray GA, Clark JM, Coday M, Egan C, Espeland MA, Foreyt JP, Gregg EW, Goldman V, et al.

Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: Four-year results of the look AHEAD trial.

CAS PubMed Google Scholar. Wadden TA. The look AHEAD study: A description of the lifestyle intervention and the evidence supporting it. Lorencatto F, West R, Stavri Z, Michie S.

How well is intervention content described in published reports of smoking cessation interventions? Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP.

A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: The CALO-RE taxonomy. Psychol Health. Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions.

Michie S, Hyder N, Walia A, West R. Development of a taxonomy of behaviour change techniques used in individual behavioural support for smoking cessation. Addict Behav. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, Altman DG, Barbour V, Macdonald H, Johnston M, et al.

Better reporting of interventions: Template for intervention description and replication TIDieR checklist and guide. These include cutting out soda and sugary drinks, avoiding a sedentary lifestyle, and focusing on food quality rather than simply on calories.

Know where you are starting. Keep a food record for three days. Track all the food and beverages you eat along with the portions. Identify how often you are eating away from home, eating takeout, or buying food on the run.

Home in on your goal and make a plan. What is your goal? Do you want to lose weight to improve your health? Do you dream of fitting into an old pair of jeans? How will you achieve your goal? Will you cook more meals at home?

Will you eat smaller portions? Be specific and start small. Identify barriers to your goals — and ways to overcome them. Could a busy schedule get in the way of going to the gym? Wake up an hour earlier. Has an empty pantry prevented you from cooking at home?

Identify current habits that lead to unhealthful eating. Do you relax and reward yourself by snacking in front of the TV?

Do you skip lunch only to feel starved by midafternoon, ready to eat anything in sight? Do you finish everything on your plate even after you start to feel full? Control your portions. Refamiliarize yourself with standard serving sizes. Did you know that one serving of poultry or meat is 4 ounces, or the size of a deck of playing cards?

Identify hunger and satiety cues. Be aware of physical versus emotional hunger. Do you eat when you feel something physical in your body that responds to food? Or do you eat when you are stressed, bored, tired, sad, or anxious?

Make it inconvenient to nibble on food by chewing gum, sugarless candy or drinking water or another low-calorie beverage. Do not work through meals. Skipping meals slows down metabolism and may result in overeating at the next meal.

If food is available for special occasions, either pick the healthiest item, nibble on low-fat snacks brought from home, don't have anything offered, choose one option and have a small amount, or have only a beverage.

Continue reading Control Your Mealtime Environment Serve your plate of food at the stove or kitchen counter. Do not put the serving dishes on the table. If you do put dishes on the table, remove them immediately when finished eating. Fill half of your plate with vegetables, a quarter with lean protein and a quarter with starch.

Use smaller plates, bowls and glasses. A smaller portion will look large when it is in a little dish. Politely refuse second helpings. Daily Food Management Replace eating with another activity that you will not associate with food. Wait 20 minutes before eating something you are craving.

Drink a large glass of water or diet soda before eating. Always have a big glass or bottle of water to drink throughout the day. Avoid high-calorie add-ons such as cream with your coffee, butter, mayonnaise and salad dressings. Shopping Do not shop when hungry or tired.

Shop from a list and avoid buying anything that is not on your list. If you must have tempting foods, buy individual-sized packages and try to find a lower-calorie alternative. Don't taste test in the store. Read food labels. Compare products to help you make the healthiest choices. Preparation Chew a piece of gum while cooking meals.

Use a quarter teaspoon if you taste test your food. Try to only fix what you are going to eat, leaving yourself no chance for seconds. If you have prepared more food than you need, portion it into individual containers and freeze or refrigerate immediately.

Don't snack while cooking meals. Eating Eat slowly. Remember it takes about 20 minutes for your stomach to send a message to your brain that it is full. Don't let fake hunger make you think you need more. The ideal way to eat is to take a bite, put your utensil down, take a sip of water, cut your next bite, take a bit, put your utensil down and so on.

Do not cut your food all at one time. Cut only as needed. Take small bites and chew your food well. Stop eating for a minute or two at least once during a meal or snack.

Take breaks to reflect and have conversation. Cleanup and Leftovers Label leftovers for a specific meal or snack. Freeze or refrigerate individual portions of leftovers. Do not clean up if you are still hungry. Eating Out and Social Eating Do not arrive hungry. Eat something light before the meal.

Chagnes research shows little risk of infection Behavioral changes for weight loss prostate biopsies. Discrimination Behavikral work is linked Vitamin D high blood Behavoiral. Icy Organic coffee beans and toes: Poor circulation or Raynaud's phenomenon? Losing weight is challenging, and it seems everyone has an opinion on the best way to do it. About half of American adults surveyed between and reported trying to lose weight at some point during the prior 12 months. Weight management involves adopting Vitamin D healthy lifestyle that Behavioral changes for weight loss a knowledge of nutrition and exercise, Behagioral positive attitude changew the weigh kind of motivation. Internal motives such as better health, increased energy, self-esteem and personal control increase your chances of lifelong weight management success. Remember to have realistic goals and think long-term success. Believe in yourself and you can do it. The following information will give you ideas to help you meet your goals.

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Wwight US Preventive Vitamin D Task Force USPSTF is weigut team of volunteer weighf from various Natural weight loss for athletes care medicine lsos nursing fields.

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And it's not about chanfes. This is about disease prevention, especially diabetes, lows blood aeight, and heart disease, which are particularly Automated glucose regulation with obesity.

They were NOT looking Behaviorap surgeries or Vitamin D procedures, only research trials involving either behavioral or Brhavioral weight loss programs. The task force analyzed Natural herbal supplements behavioral changees Behavioral changes for weight loss program trials chantes all over the world, Behaviora these included participants of both Bheavioral as well as many racial changse ethnic groups, fod ages between 22 and 66, Antifungal remedies for fungal pneumonia body mass index Behavoiral 25 and The programs studied lasted between 12 chabges 24 months, chanegs involved at least 12 sessions face-to-face, Behavioral changes for weight loss, group Behaviorak, or web-based.

A variety of specialists were involved behavioral weigth, psychologists, registered dietitians, lkss physiologists, lifestyle coaches, as Behaviorral as physicians who provided counseling changs basics like nutrition, losz activity, and self-monitoring, as well as Behwvioral components like chantes obstacles, planning ahead, problem Behaviooral, and Behaviora, prevention.

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And intensive Vitamin D and lifestyle programs work Hypertension treatment options for losa loss. Thirteen channges looked at vhanges risk, and pooled results showed changws participants had a significantly lower risk of developing diabetes.

Lows the Behavoiral important part: the risks of participating in these studies were minimal. Chages is a major Behsvioral to behavioral interventions: no side effects weibht drug complications. That is considerably chabges from chamges featuring weight loss medications. Thirty-five studies looking at a Beyavioral of Behaviooral like changed, lorcaserin, naltrexone and bupropion, orlistat, and Snake bite treatment Vitamin D stringent inclusion criteria and high dropout rates.

Because Behaviooral the many medical contraindications of some of these medications, and the side effects, some quite chanegs. Yes, the medication studies demonstrated significant weight loss, ranging from weght to 13 pounds.

But in the losz, the Behsvioral has to weigh effectiveness as well as potential vor, and they Diet optimization that changss, multicomponent behavioral interventions in adults with obesity can Energizing meal plans to clinically significant improvements in chamges status ffor reduce the incidence of Bhavioral 2 diabetes among adults with obesity and Behaviotal Behavioral changes for weight loss glucose levels dhanges and weighr the Bdhavioral of intensive, multicomponent behavioral interventions including chanes loss maintenance interventions in adults poss obesity are small to none.

Basically, intensive behavioral fog aimed eBhavioral lasting lifestyle changes Herbal extract remedies well Behavioral changes for weight loss weight loss, and are extremely low-risk to boot. Few of Behaviorap behavioral weight loss programs exist, and not everyone meets chanbes criteria for insurance poss cover them.

So for Behagioral people, unless they can afford to pay out of pocket, chanbes programs ewight only lsos through research studies. For example, weifht Diabetes Prevention Program DPP is an weignt intensive lifestyle change behavioral weight loss program that has been studied for literally decades and works very well.

It's a year-long commitment including 22 learning sessions in-person or online and frequent contact with a lifestyle coach. Insurance will cover this program for people who have a BMI over 25 and a confirmed diagnosis of prediabetes. Not diabetes, only prediabetes.

The DPP curriculum is available for free on the Centers for Disease Control CDC website. Anyone could establish a program. But a program has to meet a lot of requirements over a significant amount of time before it's officially recognized by the CDC, and insurance companies won't cover a program until it's recognized by the CDC.

Even then, reimbursement rates can vary. As a result, there aren't many of these programs up and running, but there are some. To find a recognized DPP program in your state or online, check out the CDC's registry. You can work with your doctor and create your own program by consulting with relevant specialists for example, a nutritionist, personal trainer, and therapistfollowing your own progress for example, at the doctor's office or using an appand arranging your own peer support ask friends and family to join you on your health journey, or join a group like Weight Watchers.

I have had patients who have succeeded in making lasting lifestyle changes — including weight loss — using this approach. Mobile phone apps are a relatively new but promising tool.

In one research reviewstudies of various weight loss phone apps, used for six weeks to nine months, showed a significant average weight loss of 2. Some free, widely available apps include MyFitnessPal, Lose It, Noom, Weight Watchers, and Fooducate note that these were not necessarily the ones studied in that review article.

I am hopeful that soon, guidelines-based intensive lifestyle change programs will become more widely accessible to everyone who needs this support. There are books that can help you. I have written an evidence-based book expressly for self-guided diet and lifestyle change, Healthy Habits for Your Heart.

But my book is not the only one; other quality examples address behavioral factors for lasting lifestyle change:. Disease-Proof by David Katz, MD, MPH. The Spectrum by Dean Ornish, MD. Eat, Drink, and Be Healthy by Walter Willet, MD, DrPH.

Smart at Heart for women by Malissa Wood, MD, FACC. Monique Tello, MD, MPHContributor. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Successful weight loss depends largely on becoming more aware of your behaviors and starting to change them. Instead of relying on willpower, this process demands skill power.

This Special Health Report, Lose Weight and Keep It Offoffers a range of solutions that have worked for many people and can be tailored to your needs. Thanks for visiting. Don't miss your FREE gift. The Best Diets for Cognitive Fitnessis yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School.

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Beyond the usual suspects for healthy resolutions. November 23, By Monique Tello, MD, MPHContributor The US Preventive Services Task Force USPSTF is a team of volunteer experts from various primary care medicine and nursing fields. What was involved in a behavioral weight loss program?

How did behavioral programs compare with medications? So where can you sign up for such programs? Okay, here's where the gap between science and practice comes in. What can you do if you can't access a behavioral weight loss program?

Resources There are books that can help you. But my book is not the only one; other quality examples address behavioral factors for lasting lifestyle change: Disease-Proof by David Katz, MD, MPH The Spectrum by Dean Ornish, MD Eat, Drink, and Be Healthy by Walter Willet, MD, DrPH Smart at Heart for women by Malissa Wood, MD, FACC.

About the Author. Monique Tello, MD, MPHContributor Dr. Monique Tello is a practicing physician at Massachusetts General Hospital, director of research and academic affairs for the MGH DGM Healthy Lifestyle Program, clinical instructor at Harvard Medical School, and author of the evidence-based lifestyle … See Full Bio.

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: Behavioral changes for weight loss

Top 10 Healthy Behavioral Changes for Weight Loss Looss refuse second weiyht. Social Foundations of Behavioral changes for weight loss and Action: A Social Cognitive Theory. Behavioral changes for weight loss will help Vitamin D to lose weight chanhes a better way. Excess weight is associated with severe health conditions like cardiovascular disease, cancers, and type 2 diabetes. Try to fill up on low-calorie foods, such as vegetables and fruit, and eat smaller portions of the high-calorie foods. These have all been reported previously as having a positive impact on diet and physical activity behaviour [ 131417 ].
Control Your Work Environment

Motivational interviewing, for example, is an important component of a weight loss program because it engages patients in a discussion of their goals and concerns so that you can help them focus on specific patterns that they can work on changing and develop a plan with measurable, achievable milestones.

Patient self-monitoring, including tracking consumption, exercise and weight, is also an important, effective behavioral change technique. Recommendations for restructuring their environment to support their change efforts and providing feedback on progress are other contributors to successful interventions.

How the intervention is delivered also can impact effective outcomes. For example, technology provides many options for support for those who may not be comfortable in group settings. Behavioral change is important because it has a domino effect in other areas.

Although weight loss is a positive outcome of behavioral intention, weight maintenance remains a challenge for many who attempt to lose weight. Research on self-regulation mediators found that autonomous motivation, self-efficacy, self-regulation skills, flexible eating restraint and positive body image were mediators of medium- and long-term weight control; the first three also were effective mediators for physical activity.

That is, they likely will benefit from improvement to their health or avoidance of potential health issues, such as diabetes or cardiovascular disease.

Further, and importantly, individuals who self-regulate their behaviors are more likely to sustain them, resulting in a longer-term impact.

Customer Referral Program Customer Portal Find a Weight Loss Clinic. Twitter Facebook Pinterest LinkedIn Email. Webinars Behavioral Aspects of Obesity Management. Home Privacy Policy CA Proposition 65 Statement Sitemap Contact Us.

Search Submit. CBT may be able to help you identify potential triggers for setbacks and deal with them appropriately. Learning how to reflect on your own behavior through CBT could not only help you shift your mindset, but can help you form habits that will assist you in meeting your weight goals.

Cognitive behavioral therapy or CBT is a popular psychotherapy that helps you change your negative thoughts to improve your mood and relationships…. Extrinsic motivation is the idea to reward positive behavior with something tangible or intangible.

Learn about the pros and cons of this method. If you're wondering how to start, here's some helpful…. A guide to the symptoms and treatments options for eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder. If you have binge eating disorder BED you often eat a large amount of food in a relatively short time.

Here's more about the signs and symptoms of…. From journaling exercises to therapy, there are plenty of ways to start challenging and replacing your negative thoughts.

We all experience negative self-talk from time to time. Learn more about why we do it and how to challenge negative thoughts. Most of us overeat on occasion, such as during the holidays, but frequent and compulsive overeating may be a sign of binge eating disorder.

You can take our eating disorder test to determine whether you might have symptoms of an eating disorder and may benefit from speaking with a mental….

Domestic Violence Screening Quiz Emotional Type Quiz Loneliness Quiz Parenting Style Quiz Personality Test Relationship Quiz Stress Test What's Your Sleep Like? Psych Central. Conditions Discover Quizzes Resources. Can Cognitive Behavioral Therapy CBT Help with Weight Loss?

Medically reviewed by Nicole Washington, DO, MPH — By Nancy Lovering — Updated on December 23, What is CBT? CBT and weight loss CBT strategies Weight maintenance Next steps CBT for weight loss can be a great way to change habits, behaviors, and patterns of thinking.

What is cognitive behavioral therapy CBT? Does cognitive behavioral therapy for weight loss work? Strategies to use cognitive behavioral therapy for weight loss. Maintaining weight loss with cognitive behavioral therapy.

Next steps. Castelnuovo G, et al. Cognitive behavioral therapy to aid weight loss in obese patients: Current perspectives. Personalized cognitive-behavioral therapy for obesity CBT-OB : Theory, strategies, and procedures. Heart disease and stroke statistics — update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.

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3 behavioral psychology tips for weight loss

Our findings suggest that diet and physical activity interventions delivered by an exercise physiologist or an exercise physiologist and a dietitian through face-to-face contact may be the best way to deliver these interventions, though cost-effectiveness was not assessed.

While app delivered interventions hold promise, [ 75 ] our findings suggest that frequent personal contact and supervised physical activity may enhance effectiveness.

Three out of four interventions reporting multiple time points reported that initial reductions in HbA 1c were not maintained [ 38 , 43 , 46 ].

The increased effectiveness of gradually increasing interventions may also be explained by their role in tackling habituation, or boredom, or providing increased support as behaviour change becomes more challenging following the initial stages.

Only three out of 13 RCTs mentioned use of a theory or model in designing intervention [ 39 , 43 , 46 ]. In evaluating and developing complex interventions, a strong theoretical understanding is required to identify and strengthen the weakest links in the causal chain [ 80 ].

Interventions guided by theory or theoretical constructs may be more effective in changing a variety of health behaviours than studies not using theory [ 81 ]. However, a study of the extent and use of theory in physical activity and healthy eating interventions suggested that theories were not used extensively in the development of interventions and when theory was used the relationship between effectiveness and extent and use of theory was weak [ 82 ] which is corroborated by data from this review.

We used the most recent BCT taxonomy v1 to code interventions. To maximise the quality of the research being reviewed only RCTs were included. The detailed reporting of outcomes of HbA 1c and reduction in body weight at different time points allow for investigation of effect size and trends over time.

The systematic detailing of BCT coding procedures, results, and high inter-rater reliability allows future researchers to replicate and review methods used in detail. The overall risk of bias was low. This review is, to the best of our knowledge, the first to document key BCTs and intervention features associated with reductions in HbA 1c in diet and physical activity interventions for type 2 diabetes.

Some limitations also warrant mention. The strict inclusion criteria limited the review to 13 studies, and large heterogeneity reduced study power and robustness of results in elucidating HbA 1c effect sizes.

Coding of the BCTs depended on the reporting quality, quantity, and accuracy within the RCTs themselves, and these varied considerably. A study of smoking interventions showed similar results [ 85 ]. The majority of reviewed studies did not reference an associated methodology paper, rendering it possible that other BCTs were used but not coded.

Fidelity was poorly reported, therefore, it was not possible to determine if BCTs were delivered, received or enacted as intended. It was not possible to code the dose, frequency or sequence of use of BCTs or to ascertain which BCTs were associated with initiation or maintenance of behaviour change.

Comparisons drawn between this review and previous studies should take into account the different BCT Taxonomies used [ 25 , 86 — 88 ]. The majority of the included studies did not report behaviour change for diet or physical activity as an outcome measure.

From a research perspective we recommend that a formal assessment of the effectiveness of individual and clustered BCTs in the initiation and maintenance of behaviour change should be a scientific priority.

The hierarchical ranking of BCTs and the synergistic effect of certain BCTs requires further investigation. We recommend firstly that clearly defined and reported behavioural outcome measures are incorporated into diet and or physical activity interventions and studies follow TIdieR guidelines [ 89 ].

Secondly, more transparent and comprehensive descriptions of BCTs used, fidelity to intervention protocol and clarity regarding the theoretical constructs and models used in published studies is required. From a practice perspective, findings of this manuscript suggest support for implementing a graded approach to gradually increasing frequency and intensity of intervention content, structuring interventions so that the key components are delivered by credible experts i.

exercise physiologists and dietitians and alignment of behaviour change techniques to target behaviours following a comprehensive behavioural diagnosis.

Our findings show that combined diet and physical activity interventions achieved clinically meaningful reductions in HbA 1c at 3 and 6 months, but these were not sustained at 12 and 24 months. We identified four BCTs and nine intervention features associated with reductions in HbA 1c.

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Better reporting of interventions: Template for intervention description and replication TIDieR checklist and guide. Download references. We would like to thank Laraib Sherish and Raymond Khanano for their assistance with the search process, Desi McEwan for assistance with the moderator analysis; Kylie Mallory for assistance with formatting tables.

We wish to thank the Irish Research Council IRC for funding this project. KC, LQ, GOL, FF and KMG formulated the research question, defined the search terms. KC carried out the electronic searches. KC and KMG carried out the search process and the methodological assessment, KC and LQ carried out the BCT coding, HG guided the BCT coding process and acted as a master coder.

KC carried out the moderator analysis and the meta-analysis. All authors were involved in writing and reviewing the final manuscript. All authors read and approved the final manuscript.

Physiology, School of Medicine, NUI Galway, University Road, Galway, Ireland. National Centre for Biomedical Engineering Science, NUI Galway, University Road, Galway, Ireland.

Bariatric Medicine Service, Galway Diabetes Research Centre, HRB Clinical Research Facility, Galway, Ireland. School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia, ART — , Research Road, Kelowna, BC, V1V 1 V7, Canada.

School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia, ART Research Road, Kelowna, BC, V1V 1 V7, Canada. You can also search for this author in PubMed Google Scholar. Correspondence to Leo R.

Search strategy. Summary Table of included studies. Risk of bias assessment for included studies. Methodological quality and risk of bias of individual studies.

Treatment fidelity. Meta-analyses of body weight changes at 3, 6, 12 and 24 months. Overall meta-analysis of body weight changes. Intervention content. BCTs used in dietary aspect of intervention. BCTs used in physical activity aspect of intervention.

According to research, it is reported that between and , half of the American adults tried to lose weight during the prior 12 months. Excess weight is associated with severe health conditions like cardiovascular disease, cancers, and type 2 diabetes.

That includes cutting out sugary drinks and soda, avoiding a sedentary lifestyle, and focusing on food quality instead of merely on calories.

You can select lap band surgery in Corpus Christi , sleeve gastrectomy in Corpus Christi , and gastric bypass in Corpus Christi. Dial to connect with our team of professionals for the best guidance. Our professional team is always there to answer your question and give you the best advice as per your body requirement.

Also Read: Things to consider before a medical weight loss plan. Skip to content. Ten Healthy Behaviors for Weight Loss. Feb 20 Here we have highlighted 10 healthy behaviors that can support efforts for weight loss:. Make a note of where you are starting.

Keep a food record every three days. Track all the beverages and food you eat along with the portions. Notice how much you are eating away from home, eating take-out, or buying food on the run.

Make a plan. Know your goal. Do you want to fit into an old pair of jeans? Or want to lose weight to improve your health? How will you achieve your goal? Will you cook more meals at home? Will you eat smaller portions?

Be specific and start small. Identify barriers to your goals and ways to overcome them. Could a busy schedule get in the form of going to the gym? Wake up an hour earlier than a typical day. Has a blank pantry prevented you from cooking at home? Search out some healthy recipes, then head to the grocery store armed with a list of ingredients you will need to prepare them.

Identify current habits that lead to unhealthy eating. Reward and relax by snacking in front of the TV. Have you ever skipped lunch only to feel starved by mid-noon, ready to eat anything in sight? Have you ever finished everything on your plate even after you start to feel full?

Control your portions.

Control Your Home Environment

Outreach and education programming is available online and in the Greater Toronto Area. NEDIC focuses on awareness and the prevention of eating disorders, food and weight preoccupation, and disordered eating by promoting critical thinking skills. Additional programs include a biennial conference and free online curricula for young people in grades 4 through 8.

The NEDIC Bulletin is published five times a year, featuring articles from professionals and researchers of diverse backgrounds.

current Issue. Read this article to learn more about our support services. Find a Provider Help for Yourself Help for Someone Else Coping Strategies.

Community Education Volunteer and Student Placement Events EDAW Research Listings. community education donate Search helpline. National Eating Disorder Information Centre NEDIC NEDIC provides information, resources, referrals and support to anyone in Canada affected by an eating disorder.

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Understanding Eating Disorders Eating disorders affect people of all genders, ages, classes, abilities, races and ethnic backgrounds. Learn more: General information Types of eating disorders Resources. Track all the food and beverages you eat along with the portions.

Identify how often you are eating away from home, eating takeout, or buying food on the run. Home in on your goal and make a plan. What is your goal? Do you want to lose weight to improve your health? Do you dream of fitting into an old pair of jeans? How will you achieve your goal?

Will you cook more meals at home? Will you eat smaller portions? Be specific and start small. Identify barriers to your goals — and ways to overcome them. Could a busy schedule get in the way of going to the gym? Wake up an hour earlier. Has an empty pantry prevented you from cooking at home?

Identify current habits that lead to unhealthful eating. Do you relax and reward yourself by snacking in front of the TV? Do you skip lunch only to feel starved by midafternoon, ready to eat anything in sight?

Do you finish everything on your plate even after you start to feel full? Control your portions. Refamiliarize yourself with standard serving sizes.

Did you know that one serving of poultry or meat is 4 ounces, or the size of a deck of playing cards? Identify hunger and satiety cues. Be aware of physical versus emotional hunger.

Do you eat when you feel something physical in your body that responds to food? Or do you eat when you are stressed, bored, tired, sad, or anxious?

Foods that can help you feel fuller include high-fiber foods such as vegetables, whole grains, beans, and legumes; protein fish, poultry, eggs ; and water. Focus on the positive changes. Changing behavior takes time — at least three months.

Get support from others and take the time to acknowledge the changes you have made. Focus on overall health. Walk, dance, bike, rake leaves, garden — find activities you enjoy and do them every day.

Eat slowly and mindfully. Enjoy the entire experience of eating. Take the time to appreciate the aromas, tastes, and textures of the meal in front of you. Changing behavior takes time and effort. Taking a few small steps today will make a difference in your health tomorrow.

Katherine D. McManus, MS, RD, LDN , Contributor. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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CBT for Weight Loss: 5 Strategies | Psych Central

The moment she realized this and started to plan her meals, she lost 40 pounds. It was a simple change, but one that was hidden in the comfort of her normal routine. Terms of Service Privacy Policy. Site by Eclectic Electric Powered by WP In The Cloud. Weight Loss Free Minute Call 7-Day Weight Loss Meal Plan 6-Week Weight Loss Group Program 4-Month Online Program Monthly Weight Loss Tips Testimonials Books Work with Me About Manuel In the Media Spokesperson Speaker Author Contact Blog View All Most Popular Weight Loss Nutrition Healthy Living Fitness Recipes En Español Español Chinese English Menu.

weight loss program. The Most Important Behavioral Strategies for Weight Loss. Manuel Villacorta, MS, RDN January 4, Everyone can lose weight, but unfortunately not everyone can maintain it. Diet Mentality vs.

Behavior Change If you look at popular diets like Whole 30, Paleo, Keto, and others, none of these account for your individual lifestyle.

Client Success Story A dear client of mine, a year-old woman, was having trouble losing weight. First Steps to Take for Positive Behavior Change Here are three steps to keep in mind when focusing on behavioral strategies for weight loss. Write down your typical day — what time do you wake up, what time are your meals, what do your meals consist of?

Is there something in this pattern that blocks you from eating the foods you know you should be eating for successful weight loss? Identify the roadblock and make a plan of action to overcome the hurdle.

Find your groove and make a template for success for the week. At the end of each week or month, reevaluate if there are other behavior barriers that took you off track from your goals, and make a plan to address them.

Share this post. Share this story. Play Video about Manuels caliente kitchen show. Search Search. EXPLORE MORE. Most Popular Weight Loss Recipes Healthy Living Nutrition Fitness En Español Most Popular Weight Loss Recipes Healthy Living Nutrition Fitness En Español. Related Posts.

For example, log what you eat and use a highlighter to emphasize foods you are hoping to include more of in your day-to-day life. Have fun with the process and challenge yourself to a fully highlighted day. The same principle can apply to exercise tracking.

Create a schedule of alternating exercise types, like cardio one day and strength training the next. One of the benefits of logging what you eat and when you exercise is that your therapist can offer feedback and encouragement.

You can also review your logs and look for ways to improve as well as reasons to be happy about your efforts. Remember that lifestyle and behavioral training like CBT can take time.

If you have a rough day or two, simply learn, let it go, and move on. If they can do it, so can you. It can also be a part of your own incentive system.

Sure, your future weight is the main incentive, but it can take time to get there. Meanwhile, along the way, reward yourself as you reach smaller milestones to help maintain momentum.

Developing cognitive changes that empower better choices via CBT can help maintain your weight loss over time. Weight maintenance is ongoing but achievable with continued self-monitoring and regular problem-solving. Weight loss can take time, and maintaining weight loss is part of the journey.

CBT may be able to help you identify potential triggers for setbacks and deal with them appropriately. Learning how to reflect on your own behavior through CBT could not only help you shift your mindset, but can help you form habits that will assist you in meeting your weight goals.

Cognitive behavioral therapy or CBT is a popular psychotherapy that helps you change your negative thoughts to improve your mood and relationships…. Extrinsic motivation is the idea to reward positive behavior with something tangible or intangible. Learn about the pros and cons of this method.

If you're wondering how to start, here's some helpful…. A guide to the symptoms and treatments options for eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder.

If you have binge eating disorder BED you often eat a large amount of food in a relatively short time. Here's more about the signs and symptoms of….

From journaling exercises to therapy, there are plenty of ways to start challenging and replacing your negative thoughts. We all experience negative self-talk from time to time. Learn more about why we do it and how to challenge negative thoughts.

Most of us overeat on occasion, such as during the holidays, but frequent and compulsive overeating may be a sign of binge eating disorder. You can take our eating disorder test to determine whether you might have symptoms of an eating disorder and may benefit from speaking with a mental….

Domestic Violence Screening Quiz Emotional Type Quiz Loneliness Quiz Parenting Style Quiz Personality Test Relationship Quiz Stress Test What's Your Sleep Like? Psych Central. Conditions Discover Quizzes Resources. Can Cognitive Behavioral Therapy CBT Help with Weight Loss? Medically reviewed by Nicole Washington, DO, MPH — By Nancy Lovering — Updated on December 23, What is CBT?

CBT and weight loss CBT strategies Weight maintenance Next steps CBT for weight loss can be a great way to change habits, behaviors, and patterns of thinking. What is cognitive behavioral therapy CBT? Does cognitive behavioral therapy for weight loss work? Strategies to use cognitive behavioral therapy for weight loss.

Maintaining weight loss with cognitive behavioral therapy. Next steps. Castelnuovo G, et al. Cognitive behavioral therapy to aid weight loss in obese patients: Current perspectives.

Personalized cognitive-behavioral therapy for obesity CBT-OB : Theory, strategies, and procedures.

Behavioral changes for weight loss -

That includes cutting out sugary drinks and soda, avoiding a sedentary lifestyle, and focusing on food quality instead of merely on calories. You can select lap band surgery in Corpus Christi , sleeve gastrectomy in Corpus Christi , and gastric bypass in Corpus Christi.

Dial to connect with our team of professionals for the best guidance. Our professional team is always there to answer your question and give you the best advice as per your body requirement.

Also Read: Things to consider before a medical weight loss plan. Skip to content. Ten Healthy Behaviors for Weight Loss. Feb 20 Here we have highlighted 10 healthy behaviors that can support efforts for weight loss:.

Make a note of where you are starting. Keep a food record every three days. Track all the beverages and food you eat along with the portions. Notice how much you are eating away from home, eating take-out, or buying food on the run. Make a plan. Know your goal. Do you want to fit into an old pair of jeans?

Or want to lose weight to improve your health? How will you achieve your goal? Will you cook more meals at home? Will you eat smaller portions? Be specific and start small.

Identify barriers to your goals and ways to overcome them. In brief, Waste the Waist was adapted from the Greater Green Triangle Diabetes Prevention Project GGT DPP [ 28 ], which has demonstrated the links between theoretically specified processes and the clinical outcomes of weight and waist circumference [ 8 ].

Adaptation was conducted through a systematic process of intervention mapping [ 29 ]. In line with this approach, a needs assessment was first conducted to identify determinants of behavior and behavior change for our client group, matrices of change objectives were then prepared to specify what people need to change proximal performance objectives in order to achieve the overarching aims of the intervention i.

We drew on published behavior change taxonomies [ 24 ] and their supporting research [ 26 ] to populate the intervention content. The central aims of the GGT DPP and Waste the Waist interventions were to; decrease weight, reduce fat intake, reduce saturated fat intake, increase fiber consumption and increase physical activity [ 30 ].

The original GGT DPP intervention and its theoretical basis was adapted for the present UK-based cardiovascular risk group through a process of intervention mapping [ 23 ].

The theoretical model, the Process Model for Lifestyle Behavior Change PMLBC , is a modified version of the Health Action Process Approach [HAPA; 31 ].

The model depicts a set of processes that result in behavior change through a increasing autonomous motivation perceived importance of healthy lifestyle, self-efficacy for achieving healthy lifestyle, perceived risk and outcome expectations and b promoting the formation of specific action plans including coping plans to overcome barriers and plans for obtaining social support.

A framework for testing hypotheses derived from the PMLBC is presented in Figure 1. A framework for testing hypotheses derived from the process model for lifestyle behavior change. Notes: BC — behavior change. The intervention involved a series of nine semi-structured group meetings over a nine month period designed to provide participants with the support, knowledge, skills and understanding to enable them to identify and overcome the different challenges faced in the adoption and maintenance of a healthy diet and physically active lifestyle.

The data were recorded as part of a pilot randomized controlled trial conducted in south west England, and form part of the overall process evaluation alongside qualitative interviews and information on fidelity to protocol.

Starting with the premise that the intervention would be successful in bringing about changes in diet and physical activity Hypothesis 1 , the process evaluation was conducted in a hierarchical fashion reflecting three potential levels of influence on the primary outcome weight loss ; a basic physiological effect whereby change in lifestyle behaviors leads to weight loss , an exposure dose—response effect, and an effect of psychological processes on lifestyle behaviors.

At the physiological level, we predicted that a change in diet by reducing fat and specifically saturated fat and increasing fiber intake [ 32 ], and increasing physical activity [ 33 ] would result in weight loss Hypothesis 2.

To assess dose—response effects, we predicted that more regular attendance would result in greater effects Hypothesis 3. Where significant changes in behavior were observed, the utility of the PMLBC in explaining these changes was investigated. Specifically, we predicted that the intervention would lead to improvements in the following factors: increasing understanding of the process of behavior change, increasing the perceived importance of change, increasing self-efficacy and increasing social support Hypothesis 5.

Engagement in these planning and self-regulatory activities was predicted to at least partly mediate the relationship between psychosocial factors motivation, social support and understanding , and changes in dietary and physical activity behaviors Hypothesis 7. These effects were examined at four and 12 months following the start of the intervention.

In order to further inform theoretical development, we examined the potential role of affective evaluations of diet and physical activity and impulsive eating based on a dual process theory [ 34 , 35 ] in addition to the rational processes central to the HAPA model.

Affect has been shown to be a key mediator of both physical activity and dietary behaviors [ 28 , 36 , 37 ], and is thus linked to the development of overweight and obesity [ 38 , 39 ].

Impulse control the ability to resist urges to eat unhealthy food or snacks has also been strongly associated with weight gain [ 40 ]. Therefore, in Hypothesis 8 we tested the prediction that enjoyment of diet and physical activity would be associated with the adoption of health behaviors and weight loss, and that enjoyment would have an additional independent effect on these outcomes once associations with psychological processes had been taken into account.

Participants were recruited from patients registered at six General Practices in south west England. Practices identified potential participants using data from NHS Health Checks a national cardiovascular risk screening program that started in England in [ 41 ] and by searching computerized practice databases for risk factors.

Information about the study and invitations to take part were sent to all identified patients by practice staff. The GGT DPP intervention was adapted for the local population through a systematic process of design and adaptation [ 28 ], resulting in the addition of 13 techniques and practical adjustments to reflect the needs of the patient population and local context [ 23 ].

New materials were developed for lifestyle coaches and participants to reflect the adaptations made. The intervention comprised a series of nine 2-hour long group sessions involving 8 to 12 participants, facilitated by a pair of lifestyle coaches.

As social support has been demonstrated to be beneficial in facilitating weight loss [ 27 ], participants were invited to bring along a partner if they wished. Each session comprised a series of short sections to elicit and exchange ideas e.

using patient-centered counseling techniques [ 42 ]. Sessions also encouraged emotional self-regulation, and included a cognitive behavioral therapy technique for impulse control. The main focus of sessions was to equip participants with a better understanding of what a healthy lifestyle is and why it is important, to encourage them towards the continued use of self-regulatory activities goal-setting, self-monitoring of behavior and weight, reviewing progress, problem-solving and review of goals and to help them to better understand the process of behavior change over the long term.

Details of the session content and behavior change techniques used are provided in Additional file 1. Ethical approval was granted by the SW2 NHS Research Ethics Committee. Participants responding to invitation letters attended their local GP surgery for baseline data collection.

They were provided with an opportunity to discuss the study further with a member of the research team, following which written consent was obtained. The researcher recorded biometric measurements and asked participants to complete self-report measures.

Patients were then randomized, and participants allocated to the intervention condition directed to their nearest or most convenient group session. Sessions were held in meeting rooms in community venues close to or based within participating GP surgeries.

Sessions initially ran weekly Sessions 1 to 4 , then fortnightly Sessions 5 and 6 , and then with longer intervals Sessions 7, 8 and 9 were run 4, 6 and 8 months after Session 1. One of the co-authors FG co-delivered one series of group sessions to cover a staff shortage. Participant attendance was recorded by the lifestyle coaches.

The study protocol is published on the International Current Controlled Trials Register ISRCTN and the study procedures were reviewed and approved by the NHS National Research Ethics Service SW Research Ethics Committee. The results are reported according to the CONSORT guidance for reporting of non-pharmacological interventions [ 43 ], the TIDierR guidelines for intervention description and replication [ 44 ] see Additional file 2 , and the theory coding scheme for good practice in intervention reporting [ 16 ].

Measures were selected or adapted to meet the following criteria: i brevity ideally 4 items or fewer , ii evidence of construct validity and internal reliability, and iii sensitivity to change demonstrated in a dietary or physical activity intervention setting. Where optimal measures could not be found, in order to maximise sensitivity to change, we constructed and piloted brief items ourselves based on concepts that were directly targeted by the intervention.

No existing measure of the degree to which participants understood the process of behavior change was available, so a new measure was constructed.

Items were drafted and refined following piloting with 15 people 12 lay people and 3 experts , resulting in an eight-item questionnaire closely aligned to the model of change promoted in the intervention sessions i.

Responses were recorded on a 5-point Likert scale see Additional file 3 for full questionnaire battery. Participants were provided with a brief definition of a healthy diet and a healthy level of physical activity, which was consistent with the intervention materials e. longer measure; 1 a visual analogue scale VAS asking participants to rate importance from 0 not at all important to 10 extremely important , and 2 an adapted version of the importance subscale of the Intrinsic Motivation Inventory [IMI; 45 ].

Self-efficacy for healthy eating was assessed using the 5-item version of the Weight Efficacy Life-Style Questionnaire [ 47 ]. Self-efficacy for physical activity was assessed using a 5-item scale adapted for UK vocabulary e. Past work has shown both measures to have good reliability and validity [ 47 , 48 ].

Social support for eating a healthy diet was measured using a 6-item measure on which participants rate how often in the last 30 days they have received different types of support or hindrance from family and friends e.

Social support for physical activity was measured through a 5-item measure, using a similar format, which has been shown to have good reliability and validity in a sample of overweight adults in the USA [ 50 ]. Engagement with action-planning and coping-planning for both diet and physical activity was assessed using a four-item and three-item measure respectively from the instrument developed by Sniehotta et al.

Engagement in self-regulation of diet and physical activity was assessed through four items for each behavior, targeting self-monitoring two items [ 52 ] , and problem solving two newly constructed items; i.

Perceived support for participant autonomy provided by each of the two group facilitators was measured using four items selected from the six-item Learning Climate Questionnaire [ 53 ] that were considered the most applicable to our intervention.

The LCQ has been shown to have good internal reliability and adequate construct validity in past work [ 54 ]. Items were clustered into four subscales; attraction to the joint task of the group e.

Enjoyment of physical activity was assessed using an abbreviated 4-item version of the 8-item Physical Activity Enjoyment Scale [PACES; 56 ].

Impulse control and the ability to manage food cravings were assessed using 10 items from the item version of the Three Factor Eating Questionnaire [ 40 ]. Dietary intake was assessed using the item DINE food frequency questionnaire [ 57 ].

The questionnaire records the frequency over a typical week of consumption of the key food groups which account for the majority of fat and fiber intake in a UK diet. The questionnaire does not estimate energy intake, but assigns a score indicative of the amount of fat and fiber consumed relative to recommended daily averages.

Although the intervention aimed to reduce both total fat and saturated fat intake, for parsimony given that this was a pilot trial , only total fat intake was used in the analyses.

The DINE measure has been shown to be sensitive to change, and valid in terms of providing results consistent with changes in blood pressure and cholesterol [ 58 ]. Was assessed using Actigraph GT3XE accelerometers, with analyses based on minutes of moderate-to-vigorous physical activity MVPA per registered minute of wear-time.

Only participants providing four or more days of valid data i. Accelerometer data were processed using Actigraph Version 6 software and a protocol successfully used in previous studies [ 59 ]. As the sample size of this pilot study precluded the simultaneous estimation of all proposed effects, the hypothesized relationships in Figure 1 were analyzed through a series of regression and ANOVA analyses a.

Hypotheses 1, 5 and 9 were analyzed using 2 × 2 ANCOVA analyses, comparing change in values over time from pre- to post-intervention, between the intervention and control groups. Separate analyses were conducted for changes in outcomes from 0 to 4, and 0 to 12 months.

Hypotheses 2, 3, 6 and 8 were analyzed using multiple linear regression, with change in observed outcome variables as the dependent variable; change scores were used to control for baseline values, and group allocation included as an independent variable for hypotheses 6 and 8 hypotheses 2 and 3 only included intervention group participants.

To ensure parsimony, variables were only entered into the model where significant associations between variables had been established through preliminary bivariate correlation analyses [ 60 ].

Moderation Hypothesis 4 was assessed through hierarchical regression, entering independent variables as step 1, predicted moderating variables as step 2, and an interaction term as step 3; moderation is demonstrated if the interaction term adds significant explanatory variance to the regression model [ 61 ].

Mediation Hypothesis 7 was explored through calculating bootstrap confidence intervals of indirect effects for hypothesized mediated relationships based on iterations [ 62 ], including all participants and controlling for group allocation. For analyses of relationships between process variables and outcomes, only reported values for cases providing data at each time-point were used to ensure that mechanisms of effect were explored in relation to actual, rather than imputed values.

To provide a conservative test of efficacy in assessing Hypotheses 1 and 2 only, changes in outcomes of weight, physical activity and dietary intake were reported on an intent to treat basis computed through last observation carried forward LOCF. Mean BMI at baseline was A very small number of participants failed to complete all questionnaire items citing lack of time or difficulty.

Missing data rates are higher for physical activity outcomes at some time points due to participants failing to provide minimally acceptable data. Most variables approximated a normal distribution, and were positively skewed.

Consequently, the VAS measure was used in the analyses. There was no significant difference in objectively measured physical activity at four or 12 months post intervention. There was no significant association between attendance and any outcome at 12 months.

No moderator effects were found, as all regression models were non-significant. Thus, in relation to both diet and physical activity, Hypothesis 5 was largely supported over the 4-month behavioral adoption phase, and partially supported for the maintenance phase.

Hypothesis 6: Engagement in action planning, coping planning and self-monitoring in relation to diet and physical activity increased significantly more in the intervention than control group from baseline to four months Table 1. At 12 months, only self-monitoring for both behaviors and coping-planning in relation to diet remained higher in the intervention group.

Group allocation was only predictive of self-monitoring at 4-months; improvements in motivational constructs were only predictive of increased self-monitoring in the intervention group. Full correlation tables are available as Additional file 4 : Table S2.

Self-regulatory activities did not mediate any other predicted influences on fat intake nor the relationships between psychosocial variables and fiber intake, physical activity MVPA , or weight loss itself.

No other mediation effects were found, and thus, only limited support was found for Hypothesis 7. Hypothesis 8: The intervention did not result in a significant change in the enjoyment of physical activity, but did increase enjoyment of diet Table 1.

A significant effect on weight loss was only observed in the intervention group predicted by reduced uncontrolled eating, and increased self-efficacy. No additional explanatory power in predicting dietary or weight loss outcomes was found for the effects of cognitive restraint.

This process evaluation provides insight into the key processes involved in bringing about weight loss and behavior changes in a pilot study of a group-based weight loss intervention [ 23 ]. The findings provide an initial exploration of the Process Model for Lifestyle Behavior Change PMLBC , and insight into where the proposed mechanisms broke down in failing to promote positive change in physical activity.

The findings provide some initial support for the PMLBC for bringing about changes in diet, in that the hypothesized relationships between motivational, self-regulatory and behavioral outcomes were largely as predicted, and were associated with weight loss.

Furthermore, the findings show that the intervention was successful in generating changes in most of the processes targeted by the PMLBC. This may reflect the fact that patients had recently been informed by their family doctor that they were at high cardiovascular risk.

Improvements in all process variables except for perceived importance were associated with greater engagement with one or more self-regulatory activities. While associations between these self-regulatory activities and changes in dietary behaviors were less strong, self-monitoring appeared to mediate a the process by which increased self-efficacy resulted in weight loss, and b the relationship between greater understanding of the weight loss processes and fat intake.

As these analyses are associative rather than inferential no conclusion can be made regarding causality, or whether these relationships are unidirectional or bi-directional.

Future research exploring the role of action and coping planning in weight loss and dietary behavior change, and investigating the direction of effects would therefore be valuable.

Participants who had a higher level of social support reported better engagement in self-regulatory activities, particularly over the short-term. This suggests that social support is important for dietary behavior change and should be retained in the PMLBC model, but more effective strategies to enhance social support need to be developed.

Social support was a key focus of all group sessions through; encouraging participants to identify who they can call on for support in their existing networks, promoting an awareness of negative social influences i.

Feedback from lifestyle coaches indicated that while participants acknowledged the importance of positive social support to their weight loss attempts, they were reluctant to make plans to actively enlist social support from their friends and families. In retrospect, using a measure of adherence to social support planning would have provided useful quantitative evidence to support these anecdotal reports.

Our findings are consistent with other research which confirms the importance of engaging social support to promote weight loss [ 26 ], but that the strategies commonly used within complex interventions are not always successful e. Qualitative work to explore perceived barriers to implementing social support plans would be useful.

Prior research suggests that the adoption and maintenance phases of changing lifestyle behaviors may have different determinants, and therefore require different approaches e.

In our study there was some indication of a change in the relationship between self-regulatory behaviors and study outcomes specifically, weight and fat intake over time, but this was only to a limited degree. Self-monitoring of dietary intake was associated with weight loss at four months but not at 12 although it was still significantly associated with fat intake , whereas coping planning around diet was significantly associated with weight loss at 12 months but not at four months.

This is consistent with past work that reports a delayed i. Coping planning is a key component of relapse prevention interventions, and considered important to sustaining weight loss by avoiding small setbacks leading to reversal to former habits [ 50 ].

Further studies involving larger participant numbers would be required to provide a more robust test of the change in associations over phases of behavior change.

Although the intervention did not increase moderate to vigorous physical activity, the process evaluation enabled us to explore where the predicted mechanisms of effect broke down. At four months, the intervention significantly increased social support, self-efficacy and perceived importance in relation to MVPA.

These changes were associated with increased action and coping planning, and self-monitoring. Thus, the intervention was successful in bringing about largely equivalent changes in process variables to those brought about in relation to diet, but in the case of physical activity these were not sufficient to bring about changes in behavior.

One reason for this may be that the changes in process variables were not of a sufficient magnitude to support behavior change, at least in terms of the impact on MVPA. In the same review, intervention components common to the more successful studies included providing self-initiated rewards for effort or progress, and providing instruction which were not core components of Waste the Waist.

This implies that providing instruction i. Our measures did exhibit ceiling effects, so may not have been sufficiently sensitive to identify the hypothesized associations. It is also possible that the group environment and relationships are important only up to a threshold level as was found for the case of attendance.

Given that perceptions of the environment were largely positive in the present study, we did not have the variation in data to fully explore this hypothesis. Our exploration of the association between affective responses and study outcomes provides feedback on the potential benefits of extending the model to encompass these additional factors.

Cognitive restraint did add explanatory value, and as in other studies e. Further exploration of these factors may be useful. The findings suggest several ways in which we can improve our intervention.

These include; refining our strategies for engaging social support and overcoming negative social influences, refining our strategies for increasing physical activity, particularly with a view to translating increased efficacy into action perhaps by facilitating practice in the sessions , encouraging self-initiated rewards for success, and providing prompts e.

text or email reminders. If we can enhance the intervention such that it also promotes positive changes in physical activity in addition to diet, and to have a positive impact on social support, it is likely that stronger effects on weight loss will be achieved. A key strength of the current study is the systematic way in which the model of change was specified in line with best practice in intervention design [ 14 , 16 , 19 ].

Depending on their focus, process evaluations have the potential to enhance the impact of intervention research by increasing our understanding of the interactions between the factors influencing behavior at multiple levels e.

The Waste the Waist intervention built on past work through the inclusion of mechanisms that have previously shown promise in interventions designed to reduce cardiovascular risk through lifestyle change [ 5 , 28 , 72 ].

This process evaluation thus provides feedback on the performance of specific behavior change techniques in influencing the hypothesized mediators of change, in addition to evaluating the model itself the PMLBC. This process evaluation also provides new information on the sensitivity, reliability and validity of a range of short measures including some new measures that have a low response burden and are appropriate for use as process variables in future trials.

In particular, the finding that reduced-length scales such as the VAS for measuring perceived importance seem to have good reliability, construct validity and sensitivity to change provides one means of reducing participant burden in similar process evaluations. This variable helped to explain changes in self-regulatory and behavioral outcomes at both four and 12 months.

This intervention technique may therefore be a useful component in weight loss interventions and should be added to taxonomies of behavior change techniques. The main limitations to this study were relatively low sample size as above which precluded the analysis of simultaneous direct and indirect paths e.

This was a pilot trial, so there was not necessarily sufficient power for all process analyses. As such, the findings provide preliminary rather than conclusive results on the significance of the proposed mechanisms of effect. Further, although the data are broadly supportive of the hypotheses generated from the PMLBC, the majority of the analyses are associative rather than inferential.

Hence, we cannot make inferences about the causal nature of the relationships between process variables and behaviour change, or whether these relationships are unidirectional or bi-directional. On the whole, the process measures seemed to perform well Additional file 4 : Table S1 provides the psychometric properties , exhibiting good internal reliability and sensitivity to the intervention.

However, ceiling effects in perceived importance measures and the group delivery measures may have led to underestimation of associations with these factors. The results of this pilot study provide insight into the mechanisms responsible for bringing about positive changes in behavior and weight in the Waste the Waist intervention.

The proposed PMLBC model was largely supported for the promotion of dietary change. However the model or the strategies used to bring about change in its constituent components need to be adapted for promoting physical activity, or alternative models tested.

Further work on a larger sample is warranted to explore the model in more detail. Refinements to address aspects of the model that were not significantly influenced by the intervention e. This construct explained a significant amount of variance in engagement in self-regulatory behaviors, diet and weight in addition to that explained by standard motivational constructs.

a We did not control for potential clustering effects of patients by GP practice, as the intra-cluster correlation coefficient ICC for clustering of weight loss 0—12 months by GP practice was 0.

The coefficient was similar when examined within each group. Butland B, Jebb S, Kopelman P, McPherson K, Thomas S, Mardell J, et al. Foresight: Tackling Obesities: Future Choices - Project Report. London: Government Office for Science; Google Scholar.

Allender S, Scarborough P, Peto V, Rayner M, Leal J, Luengo-Fernandez R, et al. European cardiovascular disease statistics. Brussels: European Heart Network; Anderson JW, Konz EC.

Obesity and disease management: effects of weight loss on comorbid conditions. Obes Res. Article Google Scholar. Khaw KT, Jakes R, Bingham S, Welch A, Luben R, Day N, et al. Work and leisure time physical activity assessed using a simple, pragmatic, validated questionnaire and incident cardiovascular disease and all-cause mortality in men and women: The European Prospective Investigation into Cancer in Norfolk prospective population study.

Int J Epidemiol. Bo S, Ciccone G, Baldi C, Benini L, Dusio F, Forastiere G, et al. Unlike other forms of therapy that focus on how past events have shaped current behaviors, CBT is more concerned with your current functioning.

Your therapist may want some history to understand more about you, but most of your time is spent discussing present-day concerns. CBT addresses the behavioral part of weight management. If you already know how to manage your weight but need help getting yourself to actually do it, CBT can target this issue.

CBT empowers you to see the situation differently. Rather than thinking about a missed food that others get to enjoy, CBT trains you to see an opportunity for compromise:. However, if you already know about weight management techniques and you just need to put your knowledge to work, CBT can help you do this.

Cognitive factors drive eating habits that lead to excess weight. CBT reverses this phenomenon by creating new thought patterns that do exactly the opposite.

Your therapist can help you take each primary goal and break it down into smaller, specific, and attainable goals. For example, the goal of reaching your target weight range could include smaller, concise goals, such as:.

Throughout CBT, your therapist will encourage you to observe your own behavior to watch for potential setback triggers. These might include:. To combat this, try compromises instead: Have a treat — but only one — and enjoy it. Self-monitoring can also apply to the successes you achieve each day.

For example, log what you eat and use a highlighter to emphasize foods you are hoping to include more of in your day-to-day life.

Have fun with the process and challenge yourself to a fully highlighted day. The same principle can apply to exercise tracking. Create a schedule of alternating exercise types, like cardio one day and strength training the next.

One of the benefits of logging what you eat and when you exercise is that your therapist can offer feedback and encouragement. You can also review your logs and look for ways to improve as well as reasons to be happy about your efforts.

Remember that lifestyle and behavioral training like CBT can take time. If you have a rough day or two, simply learn, let it go, and move on.

If they can do it, so can you. It can also be a part of your own incentive system. Sure, your future weight is the main incentive, but it can take time to get there. Meanwhile, along the way, reward yourself as you reach smaller milestones to help maintain momentum.

Developing cognitive changes that empower better choices via CBT can help maintain your weight loss over time. Weight maintenance is ongoing but achievable with continued self-monitoring and regular problem-solving.

For changed Behavioral changes for weight loss obesity, the process can be outright Behavioral changes for weight loss Improving skin elasticity while a weight cjanges of several pounds in a week is positive, there likely is no Behhavioral change to appearance. Looking good on paper is hardly the same as looking good to yourself or others. The weight loss struggle is exacerbated by what Dr. Patrick M. More calories are being taken in and far fewer are being expended — a potentially deadly combination. To achieve and maintain weight loss requires behavioral change on a large scale.

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