A systematic review of self-regulation mediators of success in obesity interventions: the SPOTLIGHT project

Abstract

Background: This review examined individual self-regulation mediators of medium/ long-term weight control, physical activity, and energy intake in clinical and community behavior change obesity interventions. Methods: Studies were identified through electronic database searches. Studies reporting on experimental designs were eligible if: a) reported intervention effects in overweight/obese adults on at least one of the hypothesized mediators (self-regulation factors), and b) the association between these and outcomes of interest (weight change, physical activity, energy intake). Methodological quality and content of studies were extracted. Data was analyzed by means of narrative synthesis. Results: Thirty-five studies testing 42 putative mediators were included. Ten studies included formal tests of mediation. Identified mediators for medium/long-term weight control were higher levels of autonomous motivation, self-efficacy/barriers, self-regulation skills, flexible eating restraint, and positive body image. For physical activity, significant putative mediators were high autonomous motivation, self-efficacy, and use of self-regulation skills. For dietary intake, no consistent mediators were identified. Discussion: Despite limited evidence, this review identified important self-regulatory mediators of change in obesity-related behaviors in overweight/obese individuals that can contribute to improve future interventions’ design and efficacy.