Obesity remains a medical issue of great concern. Behavioural methods attempting to induce weight loss have largely failed because of a minimal understanding of stress- and depression-associated psychosocial correlates. This study extended research into the effects of exercise on weight loss through psychological pathways to improve treatments. Women with obesity (N = 108), participating in an original theory-driven cognitive-behavioural treatment within community-based health promotion centres, were evaluated over 24 months. Their mean scores on anxiety, depression, and anger at baseline were significantly higher than normative data from a general sample of United States women. Three serial mediation models were specified assessing mediation of the significant exercise→dietary change relationship. These yielded two significant paths: changes in exercise→anxiety→anxiety-associated emotional eating→self-efficacy→diet, and changes in exercise→depression→depression-associated emotional eating→self-efficacy→diet; and one non-significant path: changes in exercise→anger→anger-associated emotional eating→self-efficacy→diet. In a subsequent moderated moderation model, change in eating-related self-regulation moderated the relationship between changes in anxiety and anxiety-associated emotional eating, where exercise-associated self-regulation moderated effects from eating-related self-regulation. Dietary improvement was significantly related to weight loss over 6 (β = −0.40), 12 (β = −0.42), and 24 (β = −0.33) months. Findings indicated an increased treatment focus on the completion of moderate amounts of exercise for weight loss and, following that, attention to improvements in anxiety, depression, anxiety- and depression-associated emotional eating, self-efficacy for controlled eating, and the transfer of exercise-related self-regulation to eating-related self-regulation. Given the scope of the obesity problem, extensions of this research within field settings are warranted to accelerate application opportunities.

中文翻译：

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心血管运动对饮食行为的影响：解释对肥胖女性压力、抑郁和愤怒相关情绪饮食的影响

肥胖仍然是一个备受关注的医学问题。由于对压力和抑郁相关心理社会关系的了解很少，试图诱导减肥的行为方法基本上失败了。这项研究通过心理途径扩展了运动对减肥效果的研究，以改善治疗。肥胖女性（N  = 108）在社区健康促进中心参加了原创理论驱动的认知行为治疗，并接受了为期 24 个月的评估。她们的基线焦虑、抑郁和愤怒平均得分显着高于美国女性一般样本的标准数据。指定了三个系列中介模型来评估显着运动→饮食变化关系的中介。这些产生了两条重要路径：运动的变化→焦虑→焦虑相关的情绪饮食→自我效能→饮食，以及运动的变化→抑郁→抑郁相关的情绪饮食→自我效能→饮食；一条不显着的路径：运动变化→愤怒→与愤怒相关的情绪化饮食→自我效能→饮食。在随后的调节模型中，与饮食相关的自我调节的变化调节了焦虑变化与焦虑相关的情绪饮食之间的关系，其中与运动相关的自我调节调节了与饮食相关的自我调节的影响。饮食改善与 6 ( β  = -0.40)、12 ( β  = -0.42) 和 24 ( β = -0.33) 个月内的体重减轻显着相关 。研究结果表明，治疗重点更多地关注完成适量运动以减轻体重，然后关注改善焦虑、抑郁、焦虑和抑郁相关的情绪化饮食、控制饮食的自我效能以及转移与运动相关的自我调节到与饮食相关的自我调节。考虑到肥胖问题的范围，有必要在现场环境中扩展这项研究，以加速应用机会。