All ETDs from UAB

Advisory Committee Chair

Gary R Hunter

Advisory Committee Members

Kristi Menear

Dorothy Pekmezi

Scott Snyder

Document Type

Thesis

Date of Award

2023

Degree Name by School

Master of Science (MS) School of Education

Abstract

Although people can lose weight by restricting calories and increasing energy ex-penditure, only a small percentage are successful at maintaining the loss. PURPOSE: Therefore, the purpose of this study is to identify factors that may predict who is more likely to gain weight and visceral fat back after weight loss, and to evaluate the efficacy of a weight maintenance support group (EatRight) during 12 months of weight mainte-nance. METHODS: Subjects (n=85) were healthy, overweight [body mass index (BMI) 27–30 kg/m2, mean weight 77.6 kg] premenopausal women (age 34). Data were collect-ed at baseline, immediately after weight loss, and 1-year post-weight loss. Women lost an average of 12 kilograms during the intervention. Visceral fat was determined by com-puted tomography. Energy expenditure was evaluated using doubly labeled water (DLW). Adherence to the diet (resulting in faster weight loss) was calculated by sub-tracting daily energy lost (baseline minus post-weight loss/days on diet) from daily ener-gy expenditure (minus 800 kcal). The Weight Efficacy Lifestyle Questionnaire (WEL) was administered at baseline and follow-up to determine self-efficacy for control of eat-ing. Overall WEL score was used to assess confidence in abstaining from eating. After weight loss was achieved, subjects were expected to attend free weight management sup-port group classes (EatRight) monthly throughout one-year post weight loss. The focus of the sessions was to develop lifestyle strategies that included good nutrition and physical activity. Subjects were expected to attend a total of six sessions. RESULTS: After 1 year of weight maintenance, the average weight regain was 5.3±3.8 kg, visceral fat gain was 7.9± 22.1 cm2, and attendance to EatRight was 56±32%. Greater dietary non-adherence (r = 0.40, p < 0.01), WEL (r = - 0.21, p < 0.06), and lower attendance with EatRight (r = - 0.24, p < 0.05) were related to increased weight gain. Regression analysis indicates that dietary non-adherence and attendance to EatRight were independently related to weight and visceral fat gain, but WEL was not. CONCLUSION: These results suggest that non-adherence to diet and low confidence in the ability to restrain from eating contribute to weight and visceral fat gain. However, adherence to a weight maintenance support group slows weight and visceral fat gain.

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