Depression and Anxiety Changes Associated with Matched Increases in Physical Activity in Education-, Self-Regulation-, and Self-Regulation Plus Relaxation-Based Obesity Treatments in Women: A Pilot Study Investigating Implications for Controlling Emotional Eating

Abstract

Background/Objectives: Improvements in depression and anxiety, associated with moderate increases in physical activity, might induce reductions in emotional eating, especially in women with obesity, where emotion-driven eating is highly problematic. This pilot, field-based study sought to assess whether physical activity increase, itself, primarily predicts improved mood (biochemical theories) or if psychosocial factors associated with cognitive-behavioral treatment are principal correlates (behavioral theories). An aim was to inform improved treatment processes. Methods: Women with obesity participated in 6-month community-based behavioral obesity treatments emphasizing either: (a) standard education in weight-reduction methods (n = 28), (b) eating-related self-regulation methods (n = 24), or (c) self-regulation + relaxation training (n = 24). They completed a series of behavioral and psychological self-reports at baseline and Months 3 and 6. Results: Findings confirmed no significant difference in 3-month increases in physical activity, by group. There were significantly greater overall improvements in depression, emotional eating, self-regulation, and self-efficacy across the two self-regulation-focused groups (ps < 0.02), with anxiety improvement not reaching significance (p = 0.055). Separate significant paths from 3-month changes in depression and anxiety → self-efficacy change → emotional eating change were found. The same significant path was detected emanating from 6-month anxiety change; however, the hypothesized path of 6-month changes in depression → self-regulation → self-efficacy → emotional eating was, rather, significant. Weight reduction was considerably greater in the two self-regulation-based groups (~6% reduction), with simultaneously entered changes in self-regulation and self-efficacy significant predictors of those weight changes. Conclusions: Findings suggested viability in behavioral theory-driven explanations of the physical activity-mood improvement relationship. Future treatment foci on self-regulatory skills development leading to improvements in eating-related self-efficacy, emotional eating, and weight were suggested to extend the findings of this pilot study.

Keywords: anxiety; depression; emotional eating; obesity; physical activity; self-efficacy; self-regulation; treatment.

Figure 1

Mediation paths of 3-month changes in depression (A) and anxiety (B) scores toward emotional eating changes, through changes in self-regulation of eating leading to self-efficacy for controlling eating changes. Δ = change in score. Individual bootstrapped path data are given as B (SE_B) [95% confidence interval]. A heavy line indicates a significant path from mood change toward emotional eating change.

Figure 2

Mediation paths of 6-month changes in depression (A) and anxiety (B) scores toward emotional eating changes, through changes in self-regulation of eating leading to self-efficacy for controlling eating changes. Δ = change in score. Individual bootstrapped path data are given as B (SE_B) [95% confidence interval]. A heavy line indicates a significant path from mood change toward emotional eating change.