Analysis of mediation and reciprocal effects of changes in weight, self-esteem, and exercise in a behavioral weight loss treatment
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2008
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Improving the treatment of obesity remains a critical
challenge. Several health behaviour change models, often
based on a social-cognitive framework, have been used to
design weight management interventions (Baranowski et
al., 2003). However, most interventions have only produced
modest weight reductions (Wadden et al., 2002) and socialcognitive
variables have shown limited power to predict
weight outcomes (Palmeira et al., 2007). Other predictors, and possibl alte nati e e planatory models, are needed to better understand the mechanisms by which weight loss
and other obesity treatment-outcomes are brought about
(Baranowski, 2006). Self-esteem is one of these possible
mechanisms, because is commonly reported to change
during the treatment, although these changes are not
necessarily associated with weight loss (Blaine et al., 2007;
Maciejewski et al., 2005). This possibility should be more
evident if the program integrates regular exercise, as it
promotes improvements in subjective well-being (Biddle &
Mutrie, 2001), with possible influences on long-term behavioral adherence (e.g. diet, exercise). Following the reciprocal effects model tenets (Marsh & Craven, 2006), we
expect that the influences between changes in weight, selfesteem
and exercise to be reciprocal and might present one
of the mechanisms by which obesity treatments can be
improved.