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Behavioral failure in the process of weight regain: a data driven protocol

Ma, Qianheng (2016) Behavioral failure in the process of weight regain: a data driven protocol. Master's Thesis, University of Pittsburgh. (Unpublished)

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Background: The prevalence of obesity is still an issue of high public health significance. Dietary self-monitoring (DSM) has been identified as the key component in standard behavioral treatment (SBT) for obesity that supports weight loss maintenance. However, little is known about the process of the weight regain in interventions using SBT. Previous research showed the temporal trend of adherence to DSM which preceded weight regain. We hypothesized that participants experienced the failure in adherence to DSM before the onset of weight regain. We then hypothesized that the adherence to daily time-contingent surveys in ecological momentary assessments (EMA) would protect people from behavioral failure and weight regain.
Methods: In this study, we provided a data-driven protocol to define and analyze the weight regain and behavioral failure. With the self-weighing data, we used piecewise linear model to detect the onset of weight regain and classified participants as maintainers and regainers. We used Bai-Perron’s test to detect the failure in DSM adherence before weight regain and classified participants as collapsers and sustainers. Group-based trajectory modeling was used to cluster the longitudinal patterns of adherence to the time-contingent EMA surveys into two groups (the consistent group and the decline group). We constructed a three-state Markov transition model for the process of weight regain via a behavioral failure and used Cox models to explore the group effect on the transition intensities among states.
Results: According to the self-weighing trajectories, 148 participants were classified as regainers (66.89%) and maintainers (25.68%). Among the regainers and maintainers (N=137), 62.04% was classified as collapsers versus sustainers (37.96%) for adherence to DSM. of the participants were organized as the consistent group (73.8%) versus the decline group for adherence to EMA surveys. Being consistently adherent to EMA surveys significantly was related to: (1) greater amount of percent weight loss before weight regain; (2) longer duration of weight loss and maintenance before weight regain; (3) longer duration without behavioral failure and weight regain; and (4) lower hazard of behavioral failure in DSM adherence.
Conclusions: Failure in the adherence of DSM was a more hazardous state for weight regain. Consistent adherence to time-contingent EMA surveys was associated with lower hazard of failure in the adherence to DSM.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Ma, QianhengQim9@pitt.eduQIM9
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairMarsh, Gary Mgmarsh@pitt.eduGMARSH
Committee MemberBurke, Lora Elbu100@pitt.eduLBU100
Committee MemberSereika, Susan Mssereika@pitt.eduSSEREIKA
Date: 1 June 2016
Date Type: Completion
Defense Date: 9 June 2016
Approval Date: 9 September 2016
Submission Date: 1 June 2016
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 79
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: No
Uncontrolled Keywords: weight regain;weight loss relapse;behavioral treatment;self-monitoring;Markov transition model;time series
Date Deposited: 09 Sep 2016 17:26
Last Modified: 15 Nov 2016 14:33


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