Advertisement

Motivation and Its Relationship to Adherence to Self-monitoring and Weight Loss in a 16-week Internet Behavioral Weight Loss Intervention

Published:February 08, 2010DOI:https://doi.org/10.1016/j.jneb.2009.03.001

      Abstract

      Objective

      To examine changes in motivation and the relationship of motivation to adherence to self-monitoring and weight loss in a 16-week Internet behavioral weight-loss intervention.

      Design

      Two-group randomized design.

      Setting

      This study was conducted over the Internet.

      Participants

      Sixty-six women, ages 22-65, with a body mass index (BMI) between 25 and 40, and with a home computer with Internet access, participated.

      Intervention

      These data are from an Internet behavioral weight-loss program in which all participants received a face-to-face initial session followed by the 16-week Internet program.

      Main Outcome Measures

      Adherence to self-monitoring and weight loss were the main outcome measures.

      Analysis

      Linear regression and mediation analysis using the Baron and Kenny method were conducted.

      Results

      Autonomous motivation increased initially and remained high for those who ultimately achieved a 5% weight loss, but declined over time for participants who did not achieve a 5% weight loss. Autonomous motivation at 4 weeks was a predictor of adherence to self-monitoring and 16-week weight loss. Adherence mediated the relationship between autonomous motivation and weight loss.

      Conclusions and Implications

      These results suggest that autonomous motivation may be a promising intervention target for promoting program procedure adherence and weight loss.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access

      SNEB Member Login

      SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.

      Subscribe:

      Subscribe to Journal of Nutrition Education and Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ogden C.
        • Carroll M.D.
        • Curtin L.
        • McDowell M.
        • Tabak C.J.
        • Flegal K.M.
        Prevalence of overweight and obesity in the United States, 1999-2004.
        JAMA. 2006; 295: 1549-1555
      1. National Center for Health Statistics (NCHS). Prevalence of Overweight and Obesity Among Adults: United States, 2003-2004. http://www.cdc.gov/nchs/data/hestat/overweight/overwght_adult_03.htm. Accessed September 15, 2009.

        • National Heart Lung and Blood Institute (NHLBI)
        Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The evidence report.
        Obes Res. 1998; 6: S51-S210
        • Wolf A.M.
        • Colditz G.A.
        Current estimates of the economic costs of obesity in the United States.
        Obes Res. 1998; 6: 97-106
        • Teixeira P.J.
        • Going S.B.
        • Sardinha L.B.
        • Lohman T.G.
        A review of psychosocial pre-treatment predictors of weight control.
        Obes Rev. 2005; 6: 43-65
        • Elfhag K.
        • Rossner S.
        Who succeeds at maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain.
        Obes Rev. 2005; 6: 67-85
        • Teixeira P.J.
        • Going S.B.
        • Houtkooper L.B.
        • et al.
        Pretreatment predictors of attrition and successful weight management in women.
        Int J Obes Relat Metab Disord. 2004; 28: 1124-1133
        • Teixeira P.J.
        • Palmeira A.L.
        • Branco T.L.
        • et al.
        Who will lose weight? A reexamination of predictors of weight loss in women.
        Int J Behav Nutr Phys Act. 2004; 1: 12
        • Dishman R.K.
        • Ickes W.
        Self-motivation and adherence to therapeutic exercise.
        J Behav Med. 1981; 4: 421-438
        • Williams G.C.
        • Grow V.M.
        • Freedman Z.R.
        • Ryan R.M.
        • Deci E.L.
        Motivational predictors of weight loss and weight-loss maintenance.
        J Pers Soc Psychol. 1996; 70: 115-126
        • Palmeira A.L.
        • Teixeira P.J.
        • Branco T.L.
        • et al.
        Predicting short-term weight loss using four leading health behavior change theories.
        Int J Behav Nutr Phys Act. 2007; 4: 14
        • Vitolins M.
        • Naughton M.J.
        The value of session attendance in a weight-loss intervention.
        Am J Health Behav. 2000; 24: 413-421
        • Jeffery R.W.
        • Bjornson-Benson W.M.
        • Rosenthal B.S.
        Correlates of weight loss and its maintenance over two years of follow-up among middle-aged men.
        Prev Med. 1984; 13: 155-168
        • Stevens V.J.
        • Rossner J.
        • Greenlick M.
        • Stevens N.
        • Frankel H.M.
        • Craddick S.
        Freedom from fat: a contemporary multi-component weight loss program for the general population of obese adults.
        J Am Diet Assoc. 1989; 89: 1254-1258
        • Streit K.J.
        • Stevens N.
        • Stevens V.J.
        • Rossner J.
        Food records: a predictor and modifier of weight change in long-term weight loss programs.
        J Am Diet Assoc. 1991; 91: 213-216
        • Tate D.F.
        • Win R.R.
        • Winett R.A.
        Using Internet technology to deliver a behavioral weight loss program.
        JAMA. 2001; 285: 1172-1177
        • Tate D.F.
        • Jackvony E.H.
        • Wing R.R.
        Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial.
        JAMA. 2003; 289: 1833-1836
        • Tate D.F.
        • Jackvony E.H.
        • Wing R.R.
        A randomized trial comparing human e-mail counseling, computer-animated tailored counseling, and no counseling in an Internet weight loss program.
        Arch Intern Med. 2006; 166: 1620-1625
        • Miller W.R.
        • Rollnick S.
        Motivational Interviewing: Preparing People for Change.
        2nd ed. Guilford Press, New York, NY2002
        • Resnicow K.
        • Jackson A.
        • Wang T.
        • De A.K.
        • McCarty F.
        • Dudley W.N.
        A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: results of the Eat for Life trial.
        Am J Public Health. 2001; 91: 1686-1693
        • Bowen D.
        • Ehret C.
        • Pederson M.
        • et al.
        Results of an adjunct dietary intervention program in the Women's Health Intitiative.
        J Am Diet Assoc. 2002; 102: 1631-1637
        • Smith D.E.
        • Kratt P.P.
        • Heckemeyer C.M.
        • Mason D.A.
        Motivational interviewing to improve adherence to a behavioral weight-control program for older obese women with NIDDM.
        Diabetes Care. 1997; 20: 52-54
        • Goldberg J.H.
        • Kiernan M.
        Innovative techniques to address retention in a behavioral weight-loss trial.
        Health Educ Res. 2005; 20: 439-447
        • West D.
        • DiLillo V.
        • Bursac V.
        • Gore S.A.
        • Greene P.G.
        Motivational interviewing improves weight loss in women with type 2 diabetes.
        Diabetes Care. 2007; 30: 1081-1087
        • Webber K.H.
        • Tate D.F.
        • Quintiliani L.M.
        Motivational interviewing in Internet groups: A pilot study for weight loss.
        J Am Diet Assoc. 2008; 108: 1029-1032
        • Shephard R.J.
        • Cox M.H.
        • Simper K.
        An analysis of “Par-Q” responses in an office population.
        Can J Pub Health. 1981; 72: 37-40
        • Shephard R.J.
        PAR-Q, Canadian Home Fitness Test and exercise screening alternatives.
        Sports Med. 1988; 5: 185-195
        • Webber K.H.
        • Tate D.F.
        • Bowling J.M.
        A randomized comparison of two motivationally enhanced Internet weight loss programs.
        Behav Res Ther. 2008; 46: 1090-1095
        • Williams G.C.
        • Cox E.M.
        • Kouides R.
        • Deci E.L.
        Presenting the facts about smoking to adolescents: the effects of an autonomy supportive style.
        Arch Ped Adol Med. 1999; 153: 959-964
        • Ryan R.M.
        • Plant R.W.
        • O'Malley S.
        Initial motivations for alcohol treatment: relations with patient characteristics, treatment involvement, and dropout.
        Addict Behav. 1995; 20: 279-297
      2. Deci EL, Ryan RM. Self Determination Theory. http://www.psych.rochester.edu/SDT/. Accessed September 15, 2009.

        • Barron R.M.
        • Kenny D.A.
        The moderator-mediator variables distinction in social psychological research: Conceptual, strategic, and statistical considerations.
        J Pers Soc Psych. 1986; 51: 1173-1182
        • Goldstein D.J.
        Beneficial health effects of modest weight loss.
        Int J Obes Rel Metab Disord. 1992; 16: 397-415
        • Knowler W.C.
        • Barrett-Conner E.
        • Fowler S.E.
        • Hamman R.F.
        • Lachin J.M.
        • Walker E.A.
        Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.
        New Engl J Med. 2002; 346: 393-403
        • Deci E.L.
        • Ryan R.M.
        Self-Determination Theory: A macrotheory of human motivation, development, and health.
        Can Psych. 2008; 49: 182-185
        • Carels R.A.
        • Cacciapaglia H.M.
        • Douglass O.M.
        • Rydin S.
        • O'Brien W.H.
        The early identification of poor treatment outcome in a women's weight loss program.
        Eat Behav. 2003; 4: 265-282