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Dyadic Dynamics in a Randomized Weight Loss Intervention

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Despite health and economic burdens associated with overweight and obesity, long-term weight loss intervention efforts have been largely unsuccessful. Observations that weight status tends to cluster in social groups, and findings showing “ripple” effects of weight change within social clusters, raise questions about the impact of social relationships on weight loss.

Purpose

Through a reanalysis of data from a randomized weight loss intervention, this study compared dyadic dynamics in intervention participants and in-home partners.

Methods

Over the course of 18 months, data was collected from 201 pairs enrolled in either behavioral weight loss treatment (BWL) or treatment including partners and providing items to facilitate healthy choices at home (BWL + H). Using a dyadic growth curve model, covariance between baseline BMI, BMI change trajectories, and starting BMI and BMI trajectory for both the self and the other were examined.

Results

There were strong indicators of dependence in the data. Baseline BMI was positively correlated for both treatment groups. In the BWL + H condition, BMI change trajectories were positively correlated. In the BWL condition, this reversed: Change trajectories were negatively correlated. Additionally, partner BMI and primary participant BMI change were positively correlated, indicating that a heavier partner at baseline related to less weight loss.

Conclusions

Social relationships exert a significant influence on weight loss outcomes. Depending on the intervention group, these influences may help (BWL + H) or hinder (BWL). It may be that home intervention changed social support and interaction in important ways and that these effects could be effectively harnessed to implement more effective interventions (NCT00200330).

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Author information

Authors and Affiliations

  1. Department of Psychology, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA

    Talea Cornelius M.A., M.S.W., Katelyn Gettens M.A. & Amy A. Gorin Ph.D.

Authors
  1. Talea Cornelius M.A., M.S.W.
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  2. Katelyn Gettens M.A.
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  3. Amy A. Gorin Ph.D.
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Corresponding author

Correspondence to Talea Cornelius M.A., M.S.W..

Ethics declarations

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Talea Cornelius is funded on an NIH T-32 training grant. Katelyn Gettens is funded on an NIH grant (HL125157). Amy Gorin has received external grant funding from NIH, NHLBI (R21 HL125157; R01 HL77082), NICHD (R21 HD073966; R21 HD065185), Weight Watchers, NIAAA (R01AA021471), NIDDK (R01DK092374; U01 DK067861; R01 DK 57413; DK066787 S1), NINR (R01 NR07960), Science Applications International Corporation, Community Health Network of Connecticut, Aetna Foundation, National Cancer Institute, National Library of Medicine, and Obesity Society New Investigator Grant, and has consulted on NHLBI grants (R01 HL090864; R01 HL118208), NIDDK grants (R03 DK095959), NICHD grants (K23 HD057957), and NIMHD grants (R03 MH083987). She holds a secondary appointment as adjunct assistant professor at Brown Medical School in Providence, RI. She has also served as co-chair for the Society of Behavioral Medicine, Obesity and Eating Disorders Special Interest Group, and as a consultant for the Obesity Program at Connecticut Children’s Medical Center, in Hartford, CT. 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.

All participants provided informed consent. Procedures were approved by the Miriam Hospital Institutional Review Board.

Funding

The original study was funded by NHLBI (HL77082).

Appendix

Appendix

*Unconditional growth model

**REML

MIXED BMI_A WITH Primary_A Partner_A CBMI_P CTime GROUP_BL Primary_Partner_BL_A SEX_0_1_A

/CRITERIA = CIN(95) MXITER(100) MXSTEP(65) SCORING(1) SINGULAR(0.000000000001) HCONVERGE(0,

ABSOLUTE) LCONVERGE(0, ABSOLUTE) PCONVERGE(0.000001, ABSOLUTE)

/FIXED = Primary_Partner_BL_A CTime Primary_Partner_BL_A*CTime | SSTYPE(3)

/METHOD = REML

/PRINT = SOLUTION TESTCOV

/RANDOM = Primary_A Partner_A Primary_A*CTime Partner_A*CTime | SUBJECT(CoupleID) COVTYPE(UNR)

/REPEATED = Primary_Partner_BL_A | SUBJECT(CoupleID*CTime) COVTYPE(CSH).

**ML for chi square comparison

MIXED BMI_A WITH Primary_A Partner_A CBMI_P CTime GROUP_BL Primary_Partner_BL_A SEX_0_1_A

/CRITERIA = CIN(95) MXITER(100) MXSTEP(65) SCORING(1) SINGULAR(0.000000000001) HCONVERGE(0,

ABSOLUTE) LCONVERGE(0, ABSOLUTE) PCONVERGE(0.000001, ABSOLUTE)

/FIXED = Primary_Partner_BL_A CTime Primary_Partner_BL_A*CTime | SSTYPE(3)

/METHOD = ML

/PRINT = SOLUTION TESTCOV

/RANDOM = Primary_A Partner_A Primary_A*CTime Partner_A*CTime | SUBJECT(CoupleID) COVTYPE(UNR)

/REPEATED = Primary_Partner_BL_A | SUBJECT(CoupleID*CTime) COVTYPE(CSH).

*Conditional Model

**REML

MIXED BMI_A WITH Primary_A Partner_A CBMI_P CTime GROUP_BL Primary_Partner_BL_A SEX_0_1_A

/CRITERIA = CIN(95) MXITER(100) MXSTEP(65) SCORING(1) SINGULAR(0.000000000001) HCONVERGE(0,

ABSOLUTE) LCONVERGE(0, ABSOLUTE) PCONVERGE(0.000001, ABSOLUTE)

/FIXED = GROUP_BL CTime SEX_0_1_A Primary_Partner_BL_A CTime*GROUP_BL CTime*Primary_Partner_BL_A

CTime*SEX_0_1_A GROUP_BL*Primary_Partner_BL_A GROUP_BL*SEX_0_1_A Primary_Partner_BL_A*SEX_0_1_A

CTime*GROUP_BL*Primary_Partner_BL_A CTime*GROUP_BL*SEX_0_1_A CTime*Primary_Partner_BL_A*SEX_0_1_A

GROUP_BL*Primary_Partner_BL_A*SEX_0_1_A GROUP_BL*Primary_Partner_BL_A*SEX_0_1_A*CTime | SSTYPE(3)

/METHOD = REML

/PRINT = SOLUTION TESTCOV

/RANDOM = Primary_A Partner_A Primary_A*CTime Partner_A*CTime | SUBJECT(CoupleID) COVTYPE(UNR)

/REPEATED = Primary_Partner_BL_A | SUBJECT(CoupleID*CTime) COVTYPE(CSH).

**ML

MIXED BMI_A WITH Primary_A Partner_A CBMI_P CTime GROUP_BL Primary_Partner_BL_A SEX_0_1_A

/CRITERIA = CIN(95) MXITER(100) MXSTEP(65) SCORING(1) SINGULAR(0.000000000001) HCONVERGE(0,

ABSOLUTE) LCONVERGE(0, ABSOLUTE) PCONVERGE(0.000001, ABSOLUTE)

/FIXED = GROUP_BL CTime SEX_0_1_A Primary_Partner_BL_A CTime*GROUP_BL CTime*Primary_Partner_BL_A

CTime*SEX_0_1_A GROUP_BL*Primary_Partner_BL_A GROUP_BL*SEX_0_1_A Primary_Partner_BL_A*SEX_0_1_A

CTime*GROUP_BL*Primary_Partner_BL_A CTime*GROUP_BL*SEX_0_1_A CTime*Primary_Partner_BL_A*SEX_0_1_A

GROUP_BL*Primary_Partner_BL_A*SEX_0_1_A GROUP_BL*Primary_Partner_BL_A*SEX_0_1_A*CTime | SSTYPE(3)

/METHOD = ML

/PRINT = SOLUTION TESTCOV

/RANDOM = Primary_A Partner_A Primary_A*CTime Partner_A*CTime | SUBJECT(CoupleID) COVTYPE(UNR)

/REPEATED = Primary_Partner_BL_A | SUBJECT(CoupleID*CTime) COVTYPE(CSH).

*Final Model

**REML

MIXED BMI_A WITH Primary_A Partner_A CBMI_P CTime GROUP_BL Primary_Partner_BL_A SEX_0_1_A CTimeSq

/CRITERIA = CIN(95) MXITER(100) MXSTEP(65) SCORING(1) SINGULAR(0.000000000001) HCONVERGE(0,

ABSOLUTE) LCONVERGE(0, ABSOLUTE) PCONVERGE(0.000001, ABSOLUTE)

/FIXED = GROUP_BL CTime Primary_Partner_BL_A SEX_0_1_A CTimeSq CTime*GROUP_BL

CTime*Primary_Partner_BL_A CTime*SEX_0_1_A CTimeSq*Primary_Partner_BL_A

GROUP_BL*Primary_Partner_BL_A GROUP_BL*SEX_0_1_A Primary_Partner_BL_A*SEX_0_1_A

CTime*GROUP_BL*Primary_Partner_BL_A CTime*GROUP_BL*SEX_0_1_A CTime*Primary_Partner_BL_A*SEX_0_1_A

GROUP_BL*Primary_Partner_BL_A*SEX_0_1_A

CTime*GROUP_BL*Primary_Partner_BL_A*SEX_0_1_A | SSTYPE(3)

/METHOD = REML

/PRINT = SOLUTION TESTCOV

/RANDOM = Primary_A Partner_A Primary_A*CTime Partner_A*CTime | SUBJECT(CoupleID) COVTYPE(UNR)

/REPEATED = Primary_Partner_BL_A | SUBJECT(CoupleID*CTime) COVTYPE(CSH).

**ML

MIXED BMI_A WITH Primary_A Partner_A CBMI_P CTime GROUP_BL Primary_Partner_BL_A SEX_0_1_A CTimeSq

/CRITERIA = CIN(95) MXITER(100) MXSTEP(65) SCORING(1) SINGULAR(0.000000000001) HCONVERGE(0,

ABSOLUTE) LCONVERGE(0, ABSOLUTE) PCONVERGE(0.000001, ABSOLUTE)

/FIXED = GROUP_BL CTime Primary_Partner_BL_A SEX_0_1_A CTimeSq CTime*GROUP_BL

CTime*Primary_Partner_BL_A CTime*SEX_0_1_A CTimeSq*Primary_Partner_BL_A

GROUP_BL*Primary_Partner_BL_A GROUP_BL*SEX_0_1_A Primary_Partner_BL_A*SEX_0_1_A

CTime*GROUP_BL*Primary_Partner_BL_A CTime*GROUP_BL*SEX_0_1_A CTime*Primary_Partner_BL_A*SEX_0_1_A

GROUP_BL*Primary_Partner_BL_A*SEX_0_1_A

CTime*GROUP_BL*Primary_Partner_BL_A*SEX_0_1_A | SSTYPE(3)

/METHOD = ML

/PRINT = SOLUTION TESTCOV

/RANDOM = Primary_A Partner_A Primary_A*CTime Partner_A*CTime | SUBJECT(CoupleID) COVTYPE(UNR)

/REPEATED = Primary_Partner_BL_A | SUBJECT(CoupleID*CTime) COVTYPE(CSH).

*Split by condition - quadratic

MIXED BMI_A WITH Primary_A Partner_A CBMI_P CTime Primary_Partner_BL_A SEX_0_1_A CTimeSq

/CRITERIA = CIN(95) MXITER(100) MXSTEP(65) SCORING(1) SINGULAR(0.000000000001) HCONVERGE(0,

ABSOLUTE) LCONVERGE(0, ABSOLUTE) PCONVERGE(0.000001, ABSOLUTE)

/FIXED = CTime Primary_Partner_BL_A SEX_0_1_A CTimeSq

CTime*Primary_Partner_BL_A CTime*SEX_0_1_A CTimeSq*Primary_Partner_BL_A Primary_Partner_BL_A*SEX_0_1_A

CTime*Primary_Partner_BL_A*SEX_0_1_A | SSTYPE(3)

/METHOD = REML

/PRINT = SOLUTION TESTCOV

/RANDOM = Primary_A Partner_A Primary_A*CTime Partner_A*CTime | SUBJECT(CoupleID) COVTYPE(UNR)

/REPEATED = Primary_Partner_BL_A | SUBJECT(CoupleID*CTime) COVTYPE(CSH).

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Cornelius, T., Gettens, K. & Gorin, A.A. Dyadic Dynamics in a Randomized Weight Loss Intervention. ann. behav. med. 50, 506–515 (2016). https://doi.org/10.1007/s12160-016-9778-8

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  • DOI: https://doi.org/10.1007/s12160-016-9778-8

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