Neurocognitive and psychological predictors of early weight loss in behavioral treatment

Le résumé fourni par la source

Response to behavioral weight loss (BWL) interventions varies substantially. Early weight loss (EWL; [greater than or equal to] 2.5% weight loss by Week 3) is among the strongest predictors of long-term outcomes, yet its baseline determinants remain poorly understood. This secondary analysis examined whether baseline executive functioning (EF), hedonic hunger, and eating-related disinhibition predicted EWL in adults with obesity enrolled in a BWL intervention (n = 449). EF was assessed via the D-KEFS Tower Test; eating-related traits via validated self-report measures. Multivariable logistic regression examined baseline predictors, and bootstrapped mediation and moderated mediation analyses tested early dietary self-monitoring as a mediator and sex as a moderator. Men achieved EWL at significantly higher rates than women (57.9% vs. 32.3%; OR = 2.83, p < .001). Greater EF and lower hedonic hunger predicted EWL, consistent with hypotheses. Contrary to hypotheses, greater eating-related disinhibition also predicted EWL. Greater EF predicted more consistent dietary self-monitoring, which in turn predicted EWL, yielding a significant indirect effect (b = 0.024, 95% CI [0.006, 0.052]). Hedonic hunger and disinhibition were not associated with self-monitoring, and sex did not moderate any tested associations. The unexpected disinhibition finding may reflect a suppression effect given its strong correlation with hedonic hunger (r = .69). To our knowledge, this is the first study to formally test dietary self-monitoring as a mechanism linking baseline traits to EWL. Findings identify EF and dietary self-monitoring as promising targets for improving early response to BWL treatment.

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