An examination of the integrated cognitive affective model and weight regain in obesity: a pilot study

Stabb, Katharine (2017) An examination of the integrated cognitive affective model and weight regain in obesity: a pilot study. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Obesity is a complex health issue that is widely considered to be an epidemic in North America. University-based weight loss programs produce weight loss in the shortterm, but obesity tends to be a chronic condition that is difficult to treat due to long-term weight regain. The majority of obese people who lose weight tend to regain a large proportion, if not all, of the lost weight within one year. Among non-regainers, long-term adherence to reduced-calorie diets and high levels of exercise are associated with better outcomes. However, weight regain is the norm. Preliminary evidence suggests that psychological factors may play into why some people regain weight. The Integrative Cognitive Affective Therapy [ICAT] model provides a framework for understanding how certain psychological factors may be associated with weight regain including selfdiscrepancy, mood states (i.e., depression, anxiety, and stress), emotion regulation, and emotional eating. The current study examined the application of the ICAT model to explain weight regain in obesity. A community sample of 71 obese adults who had recently lost at least 5% of their body weight were included in the analysis. At baseline, weight was measured, participants completed self-report questionnaires of psychological variables including: self-discrepancy, mood, difficulty in emotion regulation, emotional eating, and binge eating. Participants then provided self-reported weight at 3-month follow-up, and had their weight re-measured at 6-month follow-up. Results provided evidence that higher baseline self-discrepancy and difficulty in emotion regulation were related to worse baseline depression and anxiety. Higher baseline emotional eating was related to higher body mass index (BMI) at baseline, 3-, and 6-month follow-up. On average, BMI did not change significantly from baseline to 6- month follow-up. However, upon closer inspection, about one third of the sample regained weight (31.4%) while the remainder (68.6%) continued to lose weight between baseline and 6-months. Regression analyses revealed that none of the psychological variables measured at baseline significantly predicted BMI change from baseline to 6- months, and there were no significant differences between weight regainers and nonregainers on any of the baseline psychological variables including self-discrepancy, negative mood states, difficulties with emotion regulation, emotional eating, or binge eating. This research contributed to the literature by exploring the role of psychological factors in explaining weight regain in obesity, and provided an initial exploration of the ICAT model as a framework for understanding weight regain. The implications of the findings, directions for future research as well as study strengths and limitations are discussed.

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