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Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 5/2017

01-10-2017 | Original Article

Ecological Momentary Assessment of Dietary Lapses Across Behavioral Weight Loss Treatment: Characteristics, Predictors, and Relationships with Weight Change

Authors: Evan M. Forman, PhD, Leah M. Schumacher, MS, Ross Crosby, PhD, Stephanie M. Manasse, MS, Stephanie P. Goldstein, MS, Meghan L. Butryn, PhD, Emily P. Wyckoff, BA, J. Graham Thomas, PhD

Published in: Annals of Behavioral Medicine | Issue 5/2017

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Abstract

Background

Adherence to dietary prescriptions is critical for successful weight loss and weight loss maintenance. However, research on specific instances of inadherence (lapses) is limited, and findings regarding the frequency, nature, and causes of lapses are mixed. Additionally, no studies have examined lapses over the course of a weight loss program.

Purpose

In the context of a reduced calorie diet prescribed as part of a behavioral treatment, we aimed to characterize lapse occurrence, examine lapse frequency across treatment, examine predictors of lapses, and assess the relationship between lapses and weight loss.

Methods

Adults (n = 189) enrolled in a 12-month behavioral weight loss program completed ecological momentary assessment (EMA) at baseline, mid-treatment, and end of treatment. At each EMA survey, participants indicated whether a lapse had occurred, and responded to questions assessing situational, environmental, and affective states.

Results

Lapse frequency showed a curvilinear relationship over time, such that frequency first decreased and then increased. Lapse frequency at baseline was negatively associated with early and overall weight loss. Lapses most often occurred at home, in the evenings, on the weekends, and entailed eating a forbidden food. Greater overall levels of assessed affective and environmental triggers predicted lapses, and greater momentary hunger and deprivation, and the presence of palatable food, also prospectively predicted lapses.

Conclusions

In addition to characterizing lapse frequency, the current study identified prospective predictors of lapses across treatment. These findings support the importance of lapses to weight control and provide insight for potential targets of intervention to prevent lapse occurrence.
Literature
1.
2.
Yaemsiri S, Slining MM, Agarwal SK: Perceived weight status, overweight diagnosis, and weight control among US adults: the NHANES 2003–2008 Study. International Journal of Obesity. 2011, 35:1063–1070.CrossRefPubMed
3.
Weinsier RL, Nagy TR, Hunter GR, et al.: Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the set-point theory. The American journal of clinical nutrition. 2000, 72:1088–1094.PubMed
4.
Lowe MR: Self-regulation of energy intake in the prevention and treatment of obesity: is it feasible? Obesity research. 2003, 11:44S–59S.CrossRefPubMed
5.
Brownell KD, Jeffery RW: Improving long-term weight loss: pushing the limits of treatment. Behavior Therapy. 1987, 18:353–374.CrossRef
6.
Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO: A descriptive study of individuals successful at long-term maintenance of substantial weight loss. The American journal of clinical nutrition. 1997, 66:239–246.PubMed
7.
Wilson GT: Behavioral treatment of obesity: thirty years and counting. Advances in Behaviour Research and Therapy. 1994, 16:31–75.CrossRef
8.
Carels RA, Douglass OM, Cacciapaglia HM, O'Brien WH: An ecological momentary assessment of relapse crises in dieting. Journal of consulting and clinical psychology. 2004, 72:341.CrossRefPubMed
9.
Carels RA, Hoffman J, Collins A, et al.: Ecological momentary assessment of temptation and lapse in dieting. Eating Behaviors. 2002, 2:307–321.CrossRef
10.
Stroebe W, Mensink W, Aarts H, Schut H, Kruglanski AW: Why dieters fail: testing the goal conflict model of eating. Journal of Experimental Social Psychology. 2008, 44:26–36.CrossRef
11.
Forman EM, Butryn ML: A new look at the science of weight control: how acceptance and commitment strategies can address the challenge of self-regulation. Appetite. 2015, 84:171–180.CrossRefPubMed
12.
Grilo CM, Shiffman S, Wing RR: Relapse crises and coping among dieters. Journal of consulting and clinical psychology. 1989, 57:488.CrossRefPubMed
13.
Wing RR: Changing diet and exercise behaviors in individuals at risk for weight gain. Obesity research. 1995, 3:277s–282s.CrossRefPubMed
14.
Schwarz N, Sudman S, Schuman H, et al.: Context effects in social and psychological research. 1992.CrossRef
15.
Shiffman S, Stone AA, Hufford MR: Ecological momentary assessment. Annual review of clinical psychology. 2008, 4:1–32.CrossRefPubMed
16.
Stone AA, Shiffman S: Ecological momentary assessment (EMA) in behavorial medicine. Annals of Behavioral Medicine. 1994, 16:199–202.
17.
McKee HC, Ntoumanis N, Taylor IM: An ecological momentary assessment of lapse occurrences in dieters. Annals of Behavioral Medicine. 2014, 48:300–310.CrossRefPubMed
18.
19.
Shiffman S, Stone AA: Ecological momentary assessment: a new tool for behavioral medicine research. Technology and methods in behavioral medicine. 1998:117-131.
20.
Engel SG, Crosby RD, Thomas G, Bond D, Lavender JM, Mason T, ... & Wonderlich SA: Ecological momentary assessment in eating disorder and obesity research: a review of the recent literature. Current Psychiatry Reports.2016, 18(4):1-9.
21.
An R: Weekend-weekday differences in diet among US adults, 2003–2012. Annals of epidemiology. 2016, 26:57–65.CrossRefPubMed
22.
Wadden TA, Butryn ML, Sarwer DB, et al.: Comparison of psychosocial status in treatment-seeking women with class III vs. class I–II obesity. Obesity. 2006, 14:90S–98S.CrossRefPubMed
23.
Carels RA, Cacciapaglia HM, Douglass OM, Rydin S, O'Brien WH: The early identification of poor treatment outcome in a women’s weight loss program. Eating Behaviors. 2003, 4:265–282.CrossRefPubMed
24.
Stotland S, Larocque M: Early treatment response as a predictor of ongoing weight loss in obesity treatment. British journal of health psychology. 2005, 10:601–614.CrossRefPubMed
25.
Nackers LM, Ross KM, Perri MG: The association between rate of initial weight loss and long-term success in obesity treatment: does slow and steady win the race? International journal of behavioral medicine. 2010, 17:161–167.CrossRefPubMedPubMedCentral
26.
Lowe M, Annunziato R, Riddell L, et al.: Reduced energy density eating and weight loss maintenance: 18-month follow-lip results from a randomized controlled trial. Obesity research: 2003.
27.
Lowe MR, Butryn ML, Didie ER, et al.: The power of food scale. A new measure of the psychological influence of the food environment. Appetite. 2009, 53:114–118.CrossRefPubMed
28.
Drapkin RG, Wing RR, Shiffman S: Responses to hypothetical high risk situations: do they predict weight loss in a behavioral treatment program or the context of dietary lapses? Health Psychology. 1995, 14:427.CrossRefPubMed
29.
Forman EM, Butryn ML, Manasse SM, et al.: Acceptance-based versus standard behavioral treatment for obesity: results from the mind your health randomized controlled trial. Obesity. 2016, 24:2050–2056.CrossRefPubMed
30.
Smyth JM, Wonderlich SA, Heron KE, et al.: Daily and momentary mood and stress are associated with binge eating and vomiting in bulimia nervosa patients in the natural environment. Journal of consulting and clinical psychology. 2007, 75:629.CrossRefPubMed
31.
Thomas JG, Doshi S, Crosby RD, Lowe MR: Ecological momentary assessment of obesogenic eating behavior: combining person-specific and environmental predictors. Obesity. 2011, 19:1574–1579.CrossRefPubMed
32.
Watson D, Clark LA, Tellegen A: Development of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988, 54:1063–1070.CrossRefPubMed
33.
Wadden TA, Butryn ML, Byrne KJ: Efficacy of lifestyle modification for long-term weight control. Obesity research. 2004, 12:151S–162S.CrossRefPubMed
34.
Byrne SM, Cooper Z, Fairburn CG: Psychological predictors of weight regain in obesity. Behaviour research and therapy. 2004, 42:1341–1356.CrossRefPubMed
35.
Forman EM, Butryn ML, Hoffman KL, Herbert JD: An open trial of an acceptance-based behavioral intervention for weight loss. Cognitive and Behavioral Practice. 2009, 16:223–235.CrossRef
36.
Webber KH, Tate DF, Ward DS, Bowling JM: Motivation and its relationship to adherence to self-monitoring and weight loss in a 16-week Internet behavioral weight loss intervention. Journal of nutrition education and behavior. 2010, 42:161–167.CrossRefPubMed
37.
Perri MG, Corsica JA: Improving the maintenance of weight lost in behavioral treatment of obesity. Handbook of obesity treatment. 2002, 1:357–379.
38.
Wing RR: Behavioral weight control. Handbook of obesity treatment. 2002, 2:301–317.
39.
West DS, Gorin AA, Subak LL, et al.: A motivation-focused weight loss maintenance program is an effective alternative to a skill-based approach. International Journal of Obesity. 2011, 35:259–269.CrossRefPubMed
40.
Teixeira PJ, Silva MN, Mata J, Palmeira AL, Markland D: Motivation, self-determination, and long-term weight control. International Journal of Behavioral Nutrition and Physical Activity. 2012, 9:22.CrossRefPubMedPubMedCentral
41.
42.
Hofmann W, Vohs KD, Baumeister RF: What people desire, feel conflicted about, and try to resist in everyday life. Psychological Science. 2012, 23:582–588.CrossRefPubMed
43.
Carels RA, Young KM, Koball A, et al.: Transforming your life: an environmental modification approach to weight loss. Journal of health psychology. 2011, 16:430–438.CrossRefPubMed
44.
Gorin AA, Raynor HA, Fava J, et al.: Randomized controlled trial of a comprehensive home environment-focused weight-loss program for adults. Health Psychology. 2013, 32:128.CrossRefPubMed
45.
Redman L, Heilbronn L, Martin C, et al.: Metabolic and behavioral compensations in response to caloric restriction: implications for the maintenance of weight loss. PloS one. 2008, 4:e4377-e4377.CrossRef
46.
Friese M, Hofmann W, Wänke M: When impulses take over: moderated predictive validity of explicit and implicit attitude measures in predicting food choice and consumption behaviour. British Journal of Social Psychology. 2008, 47:397–419.CrossRefPubMed
47.
Houben K, Roefs A, Jansen A: Guilty pleasures. Implicit preferences for high calorie food in restrained eating. Appetite. 2010, 55:18–24.CrossRefPubMed
48.
Richetin J, Perugini M, Adjali I, Hurling R: The moderator role of intuitive versus deliberative decision making for the predictive validity of implicit and explicit measures. European Journal of Personality. 2007, 21:529–546.CrossRef
49.
Nahum-Shani I, Hekler EB, Spruijt-Metz D: Building health behavior models to guide the development of just-in-time adaptive interventions: a pragmatic framework. Health Psychology. 2015, 34:1209.CrossRefPubMedCentral
50.
Heron KE, Smyth JM: Ecological momentary interventions: incorporating mobile technology into psychosocial and health behaviour treatments. British journal of health psychology. 2010, 15:1–39.CrossRefPubMed
51.
Geliebter A, Aversa A: Emotional eating in overweight, normal weight, and underweight individuals. Eating Behaviors. 2003, 3:341–347.CrossRefPubMed
52.
Faith M, Allison D, Geliebter A, Dalton S: Emotional eating and obesity: theoretical considerations and practical recommendations. Overweight and weight management: the health professional's guide to understanding and practice. 1997:439-465.
53.
Lowe MR, Fisher Jr EB: Emotional reactivity, emotional eating, and obesity: a naturalistic study. Journal of behavioral medicine. 1983, 6:135–149.CrossRefPubMed
54.
Wansink B: Environmental factors that increase the food intake and consumption volume of unknowing consumers*. Annu. Rev. Nutr. 2004, 24:455–479.CrossRefPubMed
Metadata
Title
Ecological Momentary Assessment of Dietary Lapses Across Behavioral Weight Loss Treatment: Characteristics, Predictors, and Relationships with Weight Change
Authors
Evan M. Forman, PhD
Leah M. Schumacher, MS
Ross Crosby, PhD
Stephanie M. Manasse, MS
Stephanie P. Goldstein, MS
Meghan L. Butryn, PhD
Emily P. Wyckoff, BA
J. Graham Thomas, PhD
Publication date
01-10-2017
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 5/2017
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-017-9897-x

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