Predictors of Psychological Well-Being during Behavioral Obesity Treatment in Women

Relationships Between IKIGAI Well-Being and Motivation for Autonomous Regulation of Eating and Exercise for Health - Included the Relevance Between Sense of Coherence and Social Support

BACKGROUND

Self-regulated motivation is associated with better behavior change, health, and hedonic well-being in the health domain. Meanwhile, there are evidences that eudaemonic well-being contributes to health. As well as reducing lifestyle diseases, the promotion of IKIGAI well-being (encompassing hedonic and eudaemonic well-being) has been targeted in Japan. However, little is known about the impact of IKIGAI well-being on the motivation for health. This study explored the relationships between autonomous motivation for eating and exercise for health, IKIGAI well-being, sense of coherence, and social support.

METHODS

The participants were 622 Japanese (269 males and 353 females, aged 20 to 59 years). They completed a questionnaire on motivation for healthy eating (MHE), exercise motivation for health (EMH), sense of coherence, social support, and IKIGAI well-being.

RESULTS

IKIGAI well-being was positively associated to the relative autonomy index (RAI)-MHE and RAI-EMH. Social support exerted a positive effect on sense of coherence and IKIGAI well-being; sense of coherence positively affected IKIGAI well-being. The invariances of the model across groups, such as gender, age, and subjective economic status, were verified using multiple-group structural equation models.

CONCLUSION

With IKIGAI well-being as a mediating factor, social support and sense of coherence play important roles in promoting autonomous motivation for healthy eating and exercise.

Changes over time in the relationship between weight, body fat, motivation, impulsivity and eating behaviour

BACKGROUND

University students are at a greater risk of gaining weight compared to others. We explored associations between changes in weight and a set of dispositional constructs related to eating behaviour: motivation, impulsivity, social comparison, and eating styles. We predicted that increases in controlled motivation, impulsivity, uncontrolled eating, emotional eating, and physical appearance comparison would be related to increased weight and body fat.

METHODS

First year students at a British university completed baseline (n = 196) and three-month (n = 163) measures of impulsivity, physical appearance comparison, motivation for following a healthy diet, eating styles, weight and body fat. Baseline-follow-up changes in these constructs were computed and subjected to cluster analysis.

RESULTS

Four participant groups were identified according to similarities in the way these constructs evolved over time. The Losing and Gaining groups tended to show opposing changes in key variables (physical appearance comparison, uncontrolled eating, motivation, weight, and percentage of body fat). Interestingly, two groups showed no change in weight and body fat but evidenced unique changes in key variables, indicating that individuals can have different psychological profiles but still maintain their weight.

CONCLUSIONS

The study highlighted how stable weight maintenance arises from sets of interdependent constructs rather than variables in isolation, as well as emphasizing a need to take a person-centred approach to examining those at risk of weight gain and in developing interventions.

Effect of exercise training on psychological outcomes in adults with overweight or obesity: A systematic review and meta-analysis

This study systematically identified the effects of exercise on multiple psychological outcomes among adults with overweight/obesity, also assessing whether these effects differed across exercise types, genders, age, and body mass index (BMI) categories. Pubmed, Web of Science, PsychInfo, and SportDiscus were searched up to October 2019 for peer-reviewed papers assessing exercise training effects on psychosocial outcomes in adults with overweight/obesity. Thirty-six articles, 32 randomized controlled trials (RCTs), were included in this review. Most interventions were supervised (65%), ranging between 6 and 76 weeks (median = 12). Sixteen psychological outcomes were studied. Exercise induced positive changes in quality of life but did not reduce depression. Large effect sizes were observed on quality of life's physical component, but exercise was also able to improve vitality and mental health. Most psychological outcomes (e.g., body image, anxiety, and perceived stress) are poorly studied, evidencing either conflicting or null exercise effects. Exercise self-efficacy and autonomous motivations were also consistently improved. Exercise types and gender seem to moderate exercise psychological effects. Exercise training programs might lead to positive changes in some psychological outcomes, especially in quality of life, in adults with overweight and obesity, but more studies, with greater systematization in program characteristics, and longer follow-ups are still required to allow more solid conclusions.

A Telerehabilitation Approach to Enhance Quality of Life Through Exercise Among Adults With Paraplegia: Study Protocol

Background

Despite compelling evidence linking physical activity and quality of life among adults with spinal cord injury (SCI), exercise participation rates are extremely low in this population. Unfortunately, a lack of behavioral exercise interventions, in particular theory-based randomized controlled trials (RCT), exists within the SCI literature. A pilot RCT is needed to first examine the feasibility to conduct such interventions and determine the appropriate effect size to inform future full-scale interventions.

Objective

The overall goal of this pilot RCT is to test an 8-week innovative, video-based telerehabilitation intervention based on self-determination theory and aimed at enhancing the basic psychological needs, motivation, exercise participation, and quality of life‒related outcomes of adults with paraplegia. The objectives are to (1) determine if individuals in the intervention group have greater increases in their basic psychological needs and autonomous motivation and a decrease in controlled motivation compared to the control group, (2) determine whether the intervention group reports greater increases in exercise participation and quality of life‒related variables (eg, life satisfaction, participation in daily/social activities, depressive symptoms) compared to the control group, and (3) examine if adults with paraplegia who received the intervention report improved scores on psychosocial predictors of exercise (eg, action planning) and well-being (eg, positive affect) compared to the control group. We also aimed to examine the implementation characteristics of the intervention (eg, satisfaction with the technology, counselor’s ability to foster the psychological needs).

Methods

Adults with paraplegia (N=24) living in the community will be recruited. All participants will be invited to complete assessments of their psychological needs, motivation, exercise, and quality of life‒related variables at three time points (baseline, 6, and 10 weeks). Following the baseline assessment, participants will be randomly assigned to the intervention or control group. Participants in the intervention group will participate in 8 weekly, 1-hour video-based telerehabilitation sessions with a trained physical activity counselor, while participants in the control group will be asked to continue with their regular routine.

Results

We expect higher ratings of the basic psychological needs and autonomous motivation and lower scores for controlled motivation for the intervention group compared to the control group (Objective 1). We also expect that our video-based intervention will have moderate effects on exercise participation, as well as small-to-moderate positive effects on the quality of life‒related variables (Objective 2). Finally, we expect the intervention to have a small positive effect on psychosocial predictors of physical activity and well-being (Objective 3).

Conclusions

We anticipate that the results will show that the intervention is appropriate for adults with paraplegia and feasible to test in a full-scale RCT.

Trial Registration

ClinicalTrials.gov NCT02833935; https://clinicaltrials.gov/ct2/show/NCT02833935 (Archived by WebCite at http://www.webcitation.org/6u8U9x2yt)

The Norwegian Healthy Life Study: protocol for a pragmatic RCT with longitudinal follow-up on physical activity and diet for adults

BACKGROUND

The Norwegian Directorate of Health recommends that Healthy Life Centres (HLCs) be established in primary health care to support behaviour change and reduce the risk of non-communicable diseases. The aim of the present study protocol is to present the rationale, design and methods of a combined pragmatic randomized controlled trial (RCT) and longitudinal cohort study of the effects of attending HLCs concerning physical activity, sedentary behaviour and diet and to explore how psychological well-being and motivational factors may mediate short- and long-term effects.

METHODS

The present study will combine a 6-month RCT with a longitudinal cohort study (24 months from baseline) conducted at six HLCs from June 2014 to Sept 2017. Participants are randomized to behavioural change interventions or a 6-month waiting list control group.

DISCUSSION

A randomized trial of interventions in HLCs has the potential to influence the development of policy and practice for behaviour change interventions and patient education programmes in Norway. We discuss some of the important preconditions for obtaining valid results from a complex intervention and outline some of the characteristics of ecological approaches in health care research that can enable a pragmatic intervention study.

TRIAL REGISTRATION

The study was retrospectively registered on September 19, 2014 and is available online at ClinicalTrials.gov (ID: NCT02247219 ).

The Impact of Social and Cultural Engagement and Dieting on Well-Being and Resilience in a Group of Residents in the Metropolitan Area of Naples

Social isolation and exclusion are associated with poor health status and premature death. A number of related isolation factors, inadequate transportation system and restrictions in individuals' life space, have been associated with malnutrition in older adults. Since eating is a social event, isolation can have a negative effect on nutrition. Cultural involvement and participation in interactive activities are essential tools to fight social isolation, and they can counteract the detrimental effects of social isolation on health. To provide data supporting the hypothesis that encouraging participation might represent an innovative preventive and health promoting strategy for healthy living and aging, we developed an ad hoc questionnaire to investigate the relationship between cultural participation, well-being, and resilience in a sample of residents in the metropolitan area of Naples. The questionnaire includes a question on adherence to diet or to a special nutritional regimen; in addition, the participants are asked to mention their height and weight. We investigated the relationship between BMI, adherence to diet, and perceived well-being (PWB) and resilience in a sample of 571 subjects over 60 years of age. Here, we present evidence that engagement into social and cultural activities is associated with higher well-being and resilience, in particular in females over 60 years of age.

The moderating role of authoritarian leadership on the relationship between the internalization of emotional regulation and the well-being of employees

This study explores whether the internalization of emotional regulation affects well-being and examines further whether authoritarian leadership can moderate the relationship between such internalization of emotional regulation and employee well-being. A total of 271 working adults who were employed by Chinese enterprises in Taiwan participated in this study. All hypotheses were tested using hierarchical regression analyses. The study showed that controlled emotional regulation through external regulation is significantly negatively associated with such indicators of well-being as mental and physical health, whereas autonomous emotional regulation through integrated regulation is significantly positively associated with such indicators of well-being as mental and physical health. The study also found that authoritarian leadership may moderate the relationship between autonomous emotional regulation through identified or integrated regulation and the well-being indicators.

Predictors of quality of life in Portuguese obese patients: a structural equation modeling application

Living with obesity is an experience that may affect multiple aspects of an individual's life. Obesity is considered a relevant public health problem in modern societies. To determine the comparative efficacy of different treatments and to assess their impact on patients' everyday life, it is important to identify factors that are relevant to the quality of life of obese patients. The present study aims to evaluate, in Portuguese obese patients, the simultaneous impact of several psychosocial factors on quality of life. This study also explores the mediating role of stigma in the relationship between positive/negative affect and quality of life. A sample of 215 obese patients selected from the main hospitals in Portugal completed self-report questionnaires to assess sociodemographic, clinical, psychosocial, and quality of life variables. Data were analysed using structural equation modeling. The model fitted the data reasonably well, CFI = 0.9, RMSEA = 0.06. More enthusiastic and more active patients had a better quality of life. Those who reflect lower perception of stigma had a better physical and mental health. Partial mediation effects of stigma between positive affect and mental health and between negative affect and physical health were found. The stigma is pervasive and causes consequences for psychological and physical health.

Exercise, physical activity, and self-determination theory: a systematic review

BACKGROUND

Motivation is a critical factor in supporting sustained exercise, which in turn is associated with important health outcomes. Accordingly, research on exercise motivation from the perspective of self-determination theory (SDT) has grown considerably in recent years. Previous reviews have been mostly narrative and theoretical. Aiming at a more comprehensive review of empirical data, this article examines the empirical literature on the relations between key SDT-based constructs and exercise and physical activity behavioral outcomes.

METHODS

This systematic review includes 66 empirical studies published up to June 2011, including experimental, cross-sectional, and prospective studies that have measured exercise causality orientations, autonomy/need support and need satisfaction, exercise motives (or goal contents), and exercise self-regulations and motivation. We also studied SDT-based interventions aimed at increasing exercise behavior. In all studies, actual or self-reported exercise/physical activity, including attendance, was analyzed as the dependent variable. Findings are summarized based on quantitative analysis of the evidence.

RESULTS

The results show consistent support for a positive relation between more autonomous forms of motivation and exercise, with a trend towards identified regulation predicting initial/short-term adoption more strongly than intrinsic motivation, and intrinsic motivation being more predictive of long-term exercise adherence. The literature is also consistent in that competence satisfaction and more intrinsic motives positively predict exercise participation across a range of samples and settings. Mixed evidence was found concerning the role of other types of motives (e.g., health/fitness and body-related), and also the specific nature and consequences of introjected regulation. The majority of studies have employed descriptive (i.e., non-experimental) designs but similar results are found across cross-sectional, prospective, and experimental designs.

CONCLUSION

Overall, the literature provides good evidence for the value of SDT in understanding exercise behavior, demonstrating the importance of autonomous (identified and intrinsic) regulations in fostering physical activity. Nevertheless, there remain some inconsistencies and mixed evidence with regard to the relations between specific SDT constructs and exercise. Particular limitations concerning the different associations explored in the literature are discussed in the context of refining the application of SDT to exercise and physical activity promotion, and integrating these with avenues for future research.

Motivational dynamics of eating regulation: a self-determination theory perspective

Within Western society, many people have difficulties adequately regulating their eating behaviors and weight. Although the literature on eating regulation is vast, little attention has been given to motivational dynamics involved in eating regulation. Grounded in Self-Determination Theory (SDT), the present contribution aims to provide a motivational perspective on eating regulation. The role of satisfaction and thwarting of the basic psychological needs for autonomy, competence, and relatedness is introduced as a mechanism to (a) explain the etiology of body image concerns and disordered eating and (b) understand the optimal regulation of ongoing eating behavior for healthy weight maintenance. An overview of empirical studies on these two research lines is provided. In a final section, the potential relevance and value of SDT in relation to prevailing theoretical models in the domain of eating regulation is discussed. Although research on SDT in the domain of eating regulation is still in its early stages and more research is clearly needed, this review suggests that the SDT represents a promising framework to more thoroughly study and understand the motivational processes involved in eating regulation and associated problems.

Motivation, self-determination, and long-term weight control

This article explores the topics of motivation and self-regulation in the context of weight management and related behaviors. We focus on the role of a qualitative approach to address motivation--not only considering the level but also type of motivation--in weight control and related behaviors. We critically discuss the operationalization of motivation in current weight control programs, present a complementary approach to understanding motivation based on self-determination theory, and review empirical findings from weight control studies that have used self-determination theory measures and assessed their association with weight outcomes. Weight loss studies which used Motivational Interviewing (MI) are also reviewed, considering MI's focus on enhancing internal motivation. We hypothesize that current weight control interventions may have been less successful with weight maintenance in part due to their relative disregard of qualitative dimensions of motivation, such as level of perceived autonomy, often resulting in a motivational disconnect between weight loss and weight-related behaviors. We suggest that if individuals fully endorse weight loss-related behavioral goals and feel not just competent but also autonomous about reaching them, as suggested by self-determination theory, their efforts are more likely to result in long-lasting behavior change.

The Basic Psychological Needs at Work Scale: Measurement Invariance between Canada and France

The purpose of this study is to develop and validate the Basic Psychological Needs at Work Scale (BPNWS) in French, but items are also provided in English in the article. The BPNWS is a work-related self-report instrument designed to measure the degree to which the needs for autonomy, competence, and relatedness, as identified by Self-Determination Theory (Deci & Ryan, 2000), are satisfied at work. Using exploratory and confirmatory factor analysis, the first study examines the structure of the BPNWS in a group of 271 workers. The second study tests the measurement invariance of the scale in a group of 851 teachers from two different cultures, Canada and France. Results support the three-factor structure and show adequate internal consistency, as well as nomological validity across samples.

Situational motivation and perceived intensity: their interaction in predicting changes in positive affect from physical activity

There is evidence that affective experiences surrounding physical activity can contribute to the proper self-regulation of an active lifestyle. Motivation toward physical activity, as portrayed by self-determination theory, has been linked to positive affect, as has the intensity of physical activity, especially of a preferred nature. The purpose of this experimental study was to examine the interaction between situational motivation and intensity [i.e., ratings of perceived exertion (RPE)] in predicting changes in positive affect following an acute bout of preferred physical activity, namely, running. Fourty-one female runners engaged in a 30-minute self-paced treadmill run in a laboratory context. Situational motivation for running, pre- and post-running positive affect, and RPE were assessed via validated self-report questionnaires. Hierarchical regression analyses revealed a significant interaction effect between RPE and introjection (P < .05) but not between RPE and identified regulation or intrinsic motivation. At low levels of introjection, the influence of RPE on the change in positive affect was considerable, with higher RPE ratings being associated with greater increases in positive affect. The implications of the findings in light of SDT principles as well as the potential contingencies between the regulations and RPE in predicting positive affect among women are discussed.

Usefulness of standard BMI cut-offs for quality of life and psychological well-being in women

OBJECTIVE

We examined BMI-based obesity categories and risk for poor health-related quality of life (HRQOL) and psychological well-being (PWB).

METHODS

Participants were 1,795 women aged 35.3 ± 10.2 years with a mean BMI of 26.6 kg/m(2), not seeking treatment (55%) or upon entry into a weight control program. Assessments included general HRQOL, weight-related HRQOL, self-esteem, and body image.

RESULTS

All variables, except general HRQOL, were different (p < 0.001) between normal-weight and overweight/obese women. For weight-related HRQOL and body image, worse psychosocial scores were observed linearly with higher obesity levels. Self-esteem was lower in overweight and obese women in comparison with normal-weight women, with no difference between class I and class II obesity. Participants entering a clinical program reported higher physical HRQOL, but lower self-esteem and poorer body image than community-dwelling women of equal weight.

CONCLUSIONS

BMI categories are useful for identifying increased impairment in PWB and HRQOL in overweight and obese (class I or II) women. Women with a BMI under 25 kg/m(2) reported improved well-being and HRQOL in comparison to overweight or obese women. However, this relation may not be linear across all psychosocial outcomes, with unique patterns emerging for the association of obesity level with specific dimensions of PWB and HRQOL.

Physical activity advertisements that feature daily well-being improve autonomy and body image in overweight women but not men

The reasons for exercising that are featured in health communications brand exercise and socialize individuals about why they should be physically active. Discovering which reasons for exercising are associated with high-quality motivation and behavioral regulation is essential to promoting physical activity and weight control that can be sustained over time. This study investigates whether framing physical activity in advertisements featuring distinct types of goals differentially influences body image and behavioral regulations based on self-determination theory among overweight and obese individuals. Using a three-arm randomized trial, overweight and obese women and men (aged 40-60 yr, n = 1690) read one of three ads framing physical activity as a way to achieve (1) better health, (2) weight loss, or (3) daily well-being. Framing effects were estimated in an ANOVA model with pairwise comparisons using the Bonferroni correction. This study showed that there are immediate framing effects on physical activity behavioral regulations and body image from reading a one-page advertisement about physical activity and that gender and BMI moderate these effects. Framing physical activity as a way to enhance daily well-being positively influenced participants' perceptions about the experience of being physically active and enhanced body image among overweight women, but not men. The experiment had less impact among the obese study participants compared to those who were overweight. These findings support a growing body of research suggesting that, compared to weight loss, framing physical activity for daily well-being is a better gain-frame message for overweight women in midlife.