Maintenance of lost weight beyond 6 months in adults with obesity remains problematic. To reliably impact obesity over the long term, an improved understanding of treatment-associated changes in psychosocial factors is required. Women are especially susceptible to body image concerns and emotional eating; however, associations among those variables within weight-management processes have been limited to either cross-sectional or short-term analyses. Women with obesity (Mage = 47.4 years, SD = 8.6) who participated in either a year-long YMCA-based cognitive-behavioral treatment emphasizing self-regulation of exercise and eating (n = 54), or a similar treatment that also included brief phone follow-ups of learned self-regulatory skills monthly during a second treatment year (n = 74), were assessed on weight and waist circumference changes over 6 and 24 months and changes in body satisfaction and emotional eating over 12 months. Improvements on all measures were significant with no time × group interaction. In aggregated analyses, there were significant direct relationships between changes in weight over 6 and 24 months, between changes in body satisfaction and emotional eating, and between those psychosocial changes and weight changes. Within serial multiple mediation models incorporating lagged variable analyses, only the path from changes in weight from baseline–Month 6→body satisfaction from baseline–Month 12→weight from baseline–Month 24 was significant. Results were similar when waist circumference was entered in place of weight. Findings suggest body satisfaction requires an increased focus within behavioral treatments for women with obesity to maximize their maintenance or extension of early reductions in weight and waist circumference.

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Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License