The Journal of Primary Prevention

, Volume 36, Issue 5, pp 311–321 | Cite as

Changes in Self-Efficacy for Exercise and Improved Nutrition Fostered by Increased Self-Regulation Among Adults With Obesity

  • James J. Annesi
  • Ping H. Johnson
  • Kristin L. McEwen
Original Paper


Behavioral theory suggests that treatments that increase participants’ use of self-regulatory skills and/or their feelings of ability (self-efficacy) will improve exercise and nutrition behaviors. In addition, psychosocial factors associated with increased exercise may carry over to improved eating. Self-regulation might enhance self-efficacy through feelings of ability to manage barriers to maintaining weight-loss behaviors. Sedentary adults with severe or morbid obesity (M age = 43 years; M BMI = 40.1 kg/m2) participated in a 6-month study within a community-based YMCA center. We randomly assigned participants to one of the two groups that incorporated the same cognitive-behavioral support of exercise paired with methods for controlled, healthy eating emphasizing either (a) self-efficacy (n = 138), or (b) self-regulation (n = 136) methods. Mixed model repeated measures ANOVAs indicated significant improvements in exercise- and eating-related self-regulation over 3 months, and exercise- and eating-related self-efficacy over 6 months. The Self-Regulation Treatment Group demonstrated greater improvements in self-regulation for eating and fruit and vegetable intake than the Self-Efficacy Group. Regression analyses indicated that for both exercise and eating, self-regulation change significantly predicted self-efficacy change. In separate equations, changes in exercise and fruit and vegetable intake mediated those relationships, and change in self-efficacy and the corresponding behavioral changes demonstrated reciprocal, mutually reinforcing, relationships. There was evidence of carry-over, or generalization, of both self-regulation and self-efficacy changes from an exercise context to an eating context. We discussed findings in terms of leveraging self-regulation to improve self-efficacy, and provide a rationale for why exercise is the strongest predictor of success with weight loss. Results may be used to inform future behavioral weight-management treatments through improved knowledge of relationships among theoretically derived psychosocial factors.


Obesity Self-regulation Self-efficacy Exercise Nutrition Treatment 


Compliance With Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Appropriate institutional review board approval was received.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • James J. Annesi
    • 1
    • 2
  • Ping H. Johnson
    • 1
  • Kristin L. McEwen
    • 2
  1. 1.Kennesaw State UniversityKennesawUSA
  2. 2.YMCA of Metro AtlantaAtlantaUSA

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