Demographic and Social-Cognitive Factors Associated with Weight Loss in Overweight, Pre-diabetic Participants of the PREVIEW Study

Abstract

PurposeWeight loss has been demonstrated to be a successful strategy in diabetes prevention. Although weight loss is greatly influenced by dietary behaviors, social-cognitive factors play an important role in behavioral determination. This study aimed to identify demographic and social-cognitive factors (intention, self-efficacy, outcome expectancies, social support, and motivation with regard to dietary behavior and goal adjustment) associated with weight loss in overweight and obese participants from the PREVIEW study who had pre-diabetes.MethodProspective correlational data from 1973 adult participants were analyzed. The participants completed psychological questionnaires that assessed social-cognitive variables with regard to dietary behavior. Stepwise multiple regression analyses were performed to identify baseline demographic and social-cognitive factors associated with weight loss.ResultsOverall, being male, having a higher baseline BMI, having a higher income, perceiving fewer disadvantages of a healthy diet (outcome expectancies), experiencing less discouragement for healthy eating by family and friends (social support), and lower education were independently linked to greater weight loss. When evaluating females and males separately, education was no longer associated with weight loss.ConclusionThe results indicate that a supportive environment in which family members and friends avoid discouraging healthy eating, with the application of a strategy that uses specific behavior change techniques to emphasize the benefits of outcomes, i.e., the benefits of a healthy diet, may support weight loss efforts. Weight loss programs should therefore always address the social environment of persons who try to lose body weight because family members and friends can be important supporters in reaching a weight loss goal.

Baseline Psychosocial and Demographic Factors Associated with Study Attrition and 12‐Month Weight Gain in the DIETFITS Trial

“…Consistent with most prior research, the current analysis did not find gender or race/ethnicity to be associated with study attrition. However, past studies have yielded inconsistent results for other baseline variables that were not found to be linked to study attrition in DIETFITS, including marital status , employment status , BMI , and depressive symptoms . Furthermore, unlike prior research, we did not find perceived stress to be a correlate of attrition .…”

“…Unlike past research on multiple correlates of weight change, age was not significantly associated with weight change in our overall sample , though our findings are consistent with those from other behavioral weight‐loss interventions . Our finding that gender was not a significant correlate of weight change is consistent with some research , while other studies have found males to lose more weight than females . Finally, consistent with prior research, baseline levels of depressive symptoms did not impact weight outcomes.…”

“…We also identified significant correlates of weight outcomes that have previously not been associated with weight outcomes, including selfefficacy for nutrition change (34), amotivation (i.e., lack of motivation to engage in an activity) (34)(35)(36)(37)(38)(39), health-related quality of life (SF-36) (43), and cognitive restraint (9). Unlike past research on multiple correlates of weight change, age was not significantly associated with weight change in our overall sample (33,42,43), though our findings are consistent with those from other behavioral weight-loss interventions (39,43).…”

“…Our findings are consistent with those from Burmeister et al, who found that more symptoms of food addiction, which may be indicative of internalized weight bias and body shame, were associated with reduced weight loss at 7 weeks among adults in a weight-loss program (30 Younger age, not having a college education, and having higher initial levels of self-efficacy for dietary change and outcome expectations increased the odds of attrition from the trial. In past research on behavioral weight-loss studies, age has often found to be associated with attrition (5,33,34) although not always (7). Lower education has been found to correlate with attrition in some (5,7,35) but not all studies (33,36).…”

“…Younger age, not having a college education, and having higher initial levels of self‐efficacy for dietary change and outcome expectations increased the odds of attrition from the trial. In past research on behavioral weight‐loss studies, age has often found to be associated with attrition although not always . Lower education has been found to correlate with attrition in some but not all studies .…”