Journal of Behavioral Medicine

, Volume 33, Issue 2, pp 110–122 | Cite as

Using self-determination theory to promote physical activity and weight control: a randomized controlled trial in women

  • Marlene N. Silva
  • Paulo N. Vieira
  • Sílvia R. Coutinho
  • Cláudia S. Minderico
  • Margarida G. Matos
  • Luís B. Sardinha
  • Pedro J. Teixeira
Article

Abstract

Behavior change interventions are effective to the extent that they affect appropriately-measured outcomes, especially in experimental controlled trials. The primary goal of this study was to analyze the impact of a 1-year weight management intervention based on self-determination theory (SDT) on theory-based psychosocial mediators, physical activity/exercise, and body weight and composition. Participants were 239 women (37.6 ± 7.1 years; 31.5 ± 4.1 kg/m2) who received either an intervention focused on promoting autonomous forms of exercise regulation and intrinsic motivation, or a general health education program (controls). At 12 months, the intervention group showed increased weight loss (−7.29%,) and higher levels of physical activity/exercise (+138 ± 26 min/day of moderate plus vigorous exercise; +2,049 ± 571 steps/day), compared to controls (P < 0.001). Main intervention targets such as more autonomous self-regulation (for treatment and for exercise) and a more autonomous perceived treatment climate revealed large effect sizes (between 0.80 and .96), favoring intervention (P < 0.001). Results suggest that interventions grounded in SDT can be successfully implemented in the context of weight management, enhancing the internalization of more autonomous forms of behavioral regulation, and facilitating exercise adherence, while producing clinically-significant weight reduction, when compared to a control condition. Findings are fully consistent with previous studies conducted within this theoretical framework in other areas of health behavior change.

Keywords

Theory-based intervention Randomized controlled trial Weight management Autonomy promotion Self-regulation Intrinsic motivation 

References

  1. Blair, S. N., Haskell, W. L., Ho, P., Paffenbarger, R. S., Jr., Vranizan, K. M., Farquhar, J. W., et al. (1985). Assessment of habitual physical activity by a 7-day recall in a community survey and controlled experiments. American Journal of Epidemiology, 122(5), 794–804.PubMedGoogle Scholar
  2. Catenacci, V. A., & Wyatt, H. R. (2007). The role of physical activity in producing and maintaining weight loss. Nature Clinical Practice Endocrinology & Metabolism, 3(7), 518–529.CrossRefGoogle Scholar
  3. Chatzisarantis, N., & Hagger, M. (2009). Effects of an intervention based on self-determination theory on self-reported leisure-time physical activity participation. Psychology and Health, 24(1), 29–48.CrossRefPubMedGoogle Scholar
  4. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Earlbaum Associates.Google Scholar
  5. Cooper, Z., & Fairburn, C. G. (2001). A new cognitive behavioural approach to the treatment of obesity. Behaviour Research and Therapy, 39(5), 499–511.CrossRefPubMedGoogle Scholar
  6. Deci, E. L., Eghrari, H., Patrick, B. C., & Leone, D. R. (1994). Facilitating internalization: the self-determination theory perspective. Journal of Personality, 62(1), 119–142.CrossRefPubMedGoogle Scholar
  7. Deci, E., & Ryan, R. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum.Google Scholar
  8. Deci, E., & Ryan, R. (2008). Self-determination theory: A macrotheory of human motivation, development, and health. Canadian Psychology, 49(3), 182–185.Google Scholar
  9. Donnelly, J. E., Blair, S. N., Jakicic, J. M., Manore, M. M., Rankin, J. W., & Smith, B. K. (2009). American college of sports medicine position stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Medicine and Science in Sports and Exercise, 41(2), 459–471.CrossRefPubMedGoogle Scholar
  10. Donnelly, J. E., Smith, B., Jacobsen, D. J., Kirk, E., Dubose, K., Hyder, M., et al. (2004). The role of exercise for weight loss and maintenance. Best Practice & Research Clinical Gastroenterology, 18(6), 1009–1029.Google Scholar
  11. Edmunds, J., Ntoumanis, N., & Duda, J. (2008). Testing a selfdetermination theory-based teaching style intervention in the exercise Domain. European Journal of Social Psychology, 38, 375–388.CrossRefGoogle Scholar
  12. Fortier, M. S., Sweet, S. N., O’Sullivan, T. L., & Williams, G. (2007). A self-determination process model of physical activity adoption in the context of a randomized controlled trial. Psychology of Sport and Exercise, 8, 741–757.CrossRefGoogle Scholar
  13. Hayden-Wade, H. A., Coleman, K. J., Sallis, J. F., & Armstrong, C. (2003). Validation of the telephone and in-person interview versions of the 7-day PAR. Medicine and Science in Sports and Exercise, 35(5), 801–809.CrossRefPubMedGoogle Scholar
  14. Jakicic, J. M., Marcus, B. H., Gallagher, K. I., Napolitano, M., & Lang, W. (2003). Effect of exercise duration and intensity on weight loss in overweight, sedentary women: A randomized trial. Jama, 290(10), 1323–1330.CrossRefPubMedGoogle Scholar
  15. Le Masurier, G. C., & Tudor-Locke, C. (2003). Comparison of pedometer and accelerometer accuracy under controlled conditions. Medicine and Science in Sports and Exercise, 35(5), 867–871.CrossRefPubMedGoogle Scholar
  16. Markland, D. (1999). Self-Determination moderates the effects of perceived competence on intrinsic motivation in an exercise setting. Journal of Sport and Exercise Psychology, 21, 351–361.Google Scholar
  17. Markland, D., & Hardy, L. (1997). On the factorial and construct validity of the intrinsic motivation inventory: conceptual and operational concerns. Research Quarterly for Exercise and Sport, 68(1), 20–32.PubMedGoogle Scholar
  18. Markland, D., & Ingledew, D. (1997). The measurement of exercise motives: factorial validity and Invariance across gender of a revised exercise motivation inventory. British Journal of Health Psychology, 2, 361–376.Google Scholar
  19. Martinez-Gonzalez, M. A., Varo, J. J., Santos, J. L., De Irala, J., Gibney, M., Kearney, J., et al. (2001). Prevalence of physical activity during leisure time in the European Union. Medicine and Science in Sports and Exercise, 33(7), 1142–1146.CrossRefPubMedGoogle Scholar
  20. Mata, J., Silva, M. N., Vieira, P. N., Carraca, E. V., Andrade, A. M., Coutinho, S. R., et al. (2009). Motivational “spill-over” during weight control: Increased self-determination and exercise intrinsic motivation predict eating self-regulation. Health Psychology, 28(6), 709–716.CrossRefPubMedGoogle Scholar
  21. Mcauley, E., Duncan, T., & Tammen, V. V. (1989). Psychometric properties of the intrinsic motivation inventory in a competitive sport setting: a confirmatory factor analysis. Research Quarterly for Exercise and Sport, 60(1), 48–58.PubMedGoogle Scholar
  22. Mcbride, P. E., Einerson, J. A., Grant, H., Sargent, C., Underbakke, G., Vitcenda, M., et al. (2008). Putting the diabetes prevention program into practice: A program for weight loss and cardiovascular risk reduction for patients with metabolic syndrome or type 2 diabetes mellitus. The Journal Of Nutrition, Health & Aging, 12(10), 745s–749s.Google Scholar
  23. Michie, S., & Abraham, C. (2004). Interventions to change health behaviours: evidence-based or evidence-inspired? Psychology and Health, 19, 29–49.CrossRefGoogle Scholar
  24. Rose, E., Parfitt, G., & Williams, G. (2005). Exercise causality orientations, behavioral regulation for exercise and stage of change for exercise: Exploring their relationships. Psychology Sport Exercise, 6, 399–414.CrossRefGoogle Scholar
  25. Rutten, A., & Abu-Omar, K. (2004). Prevalence of physical activity in the European Union. Preventive Medicine, 49(4), 281–289.Google Scholar
  26. Ryan, R., & Connell, J. (1989). Perceived locus of causality and internalization: Examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57, 749–761.CrossRefPubMedGoogle Scholar
  27. Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78.CrossRefPubMedGoogle Scholar
  28. Ryan, R., Frederick, C., Lepes, D., Rubio, N., & Sheldon, K. (1997). Intrinsic motivation and exercise adherence. International Journal of Psychology, 28, 335–354.Google Scholar
  29. Saris, W. H., Blair, S. N., Van Baak, M. A., Eaton, S. B., Davies, P. S., Di Pietro, L., et al. (2003). How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st stock conference and consensus statement. Obesity Reviews, 4(2), 101–114.CrossRefPubMedGoogle Scholar
  30. Sharma, M. (2007). Behavioural interventions for preventing and treating obesity in adults. Obesity Reviews, 8(5), 441–449.CrossRefPubMedGoogle Scholar
  31. Shaw, K., Gennat, H., O’rourke, P. & Del Mar, C. (2006). Exercise for overweight or obesity. Cochrane Database Syst Rev(4):CD003817.Google Scholar
  32. Sheldon, K., Ryan, R., & Reis, H. (1996). What makes for a good day? Personality and Social Psychology Bulletin, 22, 1270–1279.CrossRefGoogle Scholar
  33. Sheldon, G., Williams, G., & Joiner, T. (2003). Self-determination theory in the clinic: Motivating physical and mental health. New Haven: Yale University Press.Google Scholar
  34. Silva, M. N., Markland, D. A., Minderico, C. S., Vieira, P. N., Castro, M. M., Coutinho, S. R., et al. (2008). A randomized controlled trial to evaluate self-determination theory for exercise adherence and weight control: Rationale and intervention description. BMC Public Health, 8(1), 234.CrossRefPubMedGoogle Scholar
  35. Spiegel, A. M., & Alving, B. M. (2005). Executive summary of the strategic plan for national institutes of health obesity research. American Journal of Clinical Nutrition, 82(1 Suppl), 211S–214S.PubMedGoogle Scholar
  36. Teixeira, P. J., Going, S. B., Houtkooper, L. B., Cussler, E. C., Metcalfe, L. L., Blew, R. M., et al. (2006). Exercise motivation, eating, and body image variables as predictors of weight control. Medicine and Science in Sports and Exercise, 38(1), 179–188.CrossRefPubMedGoogle Scholar
  37. Teixeira, P. J., Silva, M. N., Coutinho, S. R., Palmeira, A. L., Mata, J., Vieira, P. N., et al. (2009). Mediators of weight loss and weight loss maintenance in middle-aged women. Obesity (Silver Spring) Aug 20 [Epub ahead of print].Google Scholar
  38. Thogersen-Ntoumani, C., & Ntoumanis, N. (2006). The role of self-determined motivation in the understanding of exercise-related behaviours, cognitions and physical self-evaluations. Journal of Sports Sciences, 24(4), 393–404.CrossRefPubMedGoogle Scholar
  39. Tudor-Locke, C., & Bassett, D. R., Jr. (2004). How many steps/day are enough? Preliminary pedometer indices for public health. Sports Medicine, 34(1), 1–8.CrossRefPubMedGoogle Scholar
  40. Tuomilehto, J., Lindstrom, J., Eriksson, J. G., Valle, T. T., Hamalainen, H., Ilanne-Parikka, P., et al. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine, 344(18), 1343–1350.CrossRefPubMedGoogle Scholar
  41. Varo, J. J., Martinez-Gonzalez, M. A., De Irala-Estevez, J., Kearney, J., Gibney, M., & Martinez, J. A. (2003). Distribution and determinants of sedentary lifestyles in the European Union. International Journal of Epidemiology, 32(1), 138–146.CrossRefPubMedGoogle Scholar
  42. Ware, J. H. (2003). Interpreting incomplete data in studies of diet and weight loss. New England Journal of Medicine, 348(21), 2136–2137.CrossRefPubMedGoogle Scholar
  43. Washburn, R. A., Jacobsen, D. J., Sonko, B. J., Hill, J. O., & Donnelly, J. E. (2003). The validity of the Stanford 7-day physical activity recall in young adults. Medicine and Science in Sports and Exercise, 35(8), 1374–1380.CrossRefPubMedGoogle Scholar
  44. Welk, G. J., Differding, J. A., Thompson, R. W., Blair, S. N., Dziura, J., & Hart, P. (2000). The utility of the Digi-walker step counter to assess daily physical activity patterns. Medicine and Science in Sports and Exercise, 32(9 Suppl), S481–S488.PubMedGoogle Scholar
  45. Williams, G. C., Freedman, Z. R., & Deci, E. L. (1998). Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care, 21(10), 1644–1651.CrossRefPubMedGoogle Scholar
  46. Williams, G. C., Gagne, M., Ryan, R. M., & Deci, E. L. (2002a). Facilitating autonomous motivation for smoking cessation. Health Psychology, 21(1), 40–50.CrossRefPubMedGoogle Scholar
  47. Williams, G. C., Grow, V. M., Freedman, Z. R., Ryan, R. M., & Deci, E. L. (1996). Motivational predictors of weight loss and weight-loss maintenance. Journal of Personality and Social Psychology, 70(1), 115–126.CrossRefPubMedGoogle Scholar
  48. Williams, G. C., Mcgregor, H. A., Sharp, D., Levesque, C., Kouides, R. W., Ryan, R. M., et al. (2006). Testing a self-determination theory intervention for motivating tobacco cessation: Supporting autonomy and competence in a clinical trial. Health Psychology, 25(1), 91–101.CrossRefPubMedGoogle Scholar
  49. Williams, G. C., Mcgregor, H. A., Zeldman, A., Freedman, Z. R., & Deci, E. L. (2004). Testing a self-determination theory process model for promoting glycemic control through diabetes self-management. Health Psychology, 23(1), 58–66.CrossRefPubMedGoogle Scholar
  50. Williams, G. C., Minicucci, D. S., Kouides, R. W., Levesque, C. S., Chirkov, V. I., Ryan, R. M., et al. (2002b). Self-determination, smoking, diet and health. Health Education Research, 17(5), 512–521.CrossRefPubMedGoogle Scholar
  51. Wilson, D. K., Evans, A. E., Williams, J., Mixon, G., Sirard, J. R., & Pate, R. (2005). A preliminary test of a student-centered intervention on increasing physical activity in underserved adolescents. Annals of Behavioral Medicine, 30(2), 119–124.CrossRefPubMedGoogle Scholar
  52. Wilson, P., & Rodgers, W. (2003). The relationship between perceived autonomy support exercise regulations and behavioural intentions in women. Psychology of Sport and Exercise, 5, 229–242.CrossRefGoogle Scholar
  53. Wilson, P. M., Rodgers, W. M., Fraser, S. N., & Murray, T. C. (2004). Relationships between exercise regulations and motivational consequences in university students. Research Quarterly for Exercise and Sport, 75(1), 81–91.PubMedGoogle Scholar
  54. Wing, R., & Hill, J. (2001). Successful weight loss maintenance. Annual Review Nutrition, 21, 323–341.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Marlene N. Silva
    • 1
  • Paulo N. Vieira
    • 1
  • Sílvia R. Coutinho
    • 1
  • Cláudia S. Minderico
    • 1
  • Margarida G. Matos
    • 1
  • Luís B. Sardinha
    • 1
  • Pedro J. Teixeira
    • 1
  1. 1.Faculty of Human KineticsTechnical University of Lisbon, Estrada da Costa, Cruz QuebradaLisbonPortugal

Personalised recommendations