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Predicting Weight Loss Using Psychological and Behavioral Factors: The POUNDSLOST Trial.

CONTEXT
Eating habits and food craving are strongly correlated with weight status. It is currently not well understood how psychological and behavioral factors influence both weight loss and weight regain.


OBJECTIVE
To examine the associations between psychological and behavioral predictors with weight changes and energy intake in a randomized controlled trial on weight loss.


DESIGN AND SETTING
The Prevention of Obesity Using Novel Dietary Strategies (POUNDSLOST) is a dietary intervention trial, which examined the efficacy of four diets on weight loss over 2 years. Participants were 811 overweight (BMI: 25-40.9 kg/m2, age: 30-70 years) otherwise healthy adults.


RESULTS
Every 1-point increase in craving score for high-fat foods at baseline was associated with greater weight loss (-1.62kg, P=0.0004) and a decrease in energy intake (r = -0.10, P =0.01) and fat intake (r = -0.16, P <0.0001) during the weight loss period. In contrast, craving for carbohydrates/starches was associated with both less weight loss (P <0.0001) and more weight regain (P =0.04).Greater cognitive restraint of eating at baseline was associated with both less weight loss (0.23kg, P <0.0001) and more weight regain (0.14kg, P =0.0027) whereas greater disinhibition of eating was only associated with more weight regain (0.12kg, P =0.01).


CONCLUSIONS
Craving for high-fat foods is predictive of greater weight loss while craving for carbohydrates is predictive of less weight loss. Cognitive restraint is predictive of less weight loss and more weight regain. Interventions targeting different psychological and behavioral factors can lead to greater success in weight loss.