Effects of Obesity Treatment Type on Emotional Eating and Weight/Waist Circumference Changes in Women Through Interrelations of Induced Self-Regulation and Self-Efficacy

Obesity is a medical issue of increasing prevalence, with emotional eating being a key contributor to the problem, particularly in women. Theory and previous research suggest that obesity treatment participants’ self-regulatory abilities and self-efficacy to control eating are viable targets for improving emotional eating and related impacts on an unhealthy body composition. However, an improved understanding of interrelations between self-regulatory and self-efficacy changes are needed to inform behavioral treatments, which have had mostly negligible effects beyond the short term. Women were randomized into 6-month community-based obesity treatment conditions of (a) cognitive–behavioral methods with attention on emotional eating (n = 48), (b) cognitive–behavioral methods with no specific attention on emotional eating (n = 48), and (c) weight loss education (n = 50). Study-related improvements were greater in the merged cognitive–behavioral condition (n = 96; aggregated because the two corresponding treatment conditions demonstrated no significant differences). Using data aggregated across all study participants, early change in eating-related self-regulation was a significantly stronger predictor of longer-term change in eating-related self-efficacy than vice versa. Consistent with that finding, paths from treatment condition→change in self-regulation→change in self-efficacy→change in emotional eating over both 6 and 12 months were significant but not where change in self-efficacy was, instead, entered as a predictor of self-regulation change. Lessened emotional eating was significantly associated with concurrent reductions in weight and waist circumference. Consistent with self-regulation theory, findings suggest benefits for cognitive–behavioral obesity treatments over the more common education-based approaches, as well as benefits for first focusing on self-regulation that could empower increases in self-efficacy. Consistent with self-efficacy theory, such induced increases might promote favorable behavioral changes.