Directional Effects of Self-Regulation and Self-Efficacy Changes Within a Weight-Loss Treatment Focused on Exercise and Sweets Consumption: Accounting for Emotional Eating in Women with Obesity

<b>Background/Objectives:</b> Emotional eating is an important factor in the behavioral treatment of obesity, especially in women. Improvements in both exercise frequency and sweets intake have demonstrated positive changes in weight for this subgroup. However, the psychosocial mechanisms of those factors are minimally understood, and any favorable results have largely been transient. Within cognitive-behavioral treatments, increasing self-regulation and self-efficacy have been intervention targets, however, more data on their temporal effects, interrelationships, and specific foci are required to improve weight-loss outcomes. <b>Methods:</b> Women with obesity and either high emotional eating (<i>n</i> = 54) or low emotional eating (<i>n</i> = 52) levels participated in a 6-month cognitive-behavioral treatment. <b>Results:</b> Two models were specified: (a) where change in self-regulation predicted weight losses over six and twelve months mediated by changes in self-efficacy leading to behavioral changes; and (b) where self-efficacy was instead the predictor variable, followed by self-regulation changes. Two significant paths of improvement were observed: (a) a merged measure of self-regulation → eating self-efficacy → sweets intake → weight, and (b) a merged measure of self-efficacy → exercise self-regulation → weight. Predictive strengths were generally unaffected by emotional eating level (high or low). Together, improvements in sweets intake and exercise, but not fruit/vegetable consumption, significantly accounted for weight loss for both groups. <b>Conclusions:</b> The findings suggest that behavioral weight-loss treatments focus first on self-regulation, then on self-efficacy, and target sweets intake and exercise in women with obesity, independent of their emotional eating levels.