Impact of a Weight Management Intervention on Eating Competence: Importance of Measurement Interval in Protocol Design

Am J Health Promot. 2018 Mar;32(3):718-728. doi: 10.1177/0890117117692201. Epub 2017 Mar 7.


Purpose: To examine changes in eating competence (EC) in 12-month weight loss intervention.

Design: Randomized, parallel-arm with weight loss phase (baseline to month 4) and weight-maintenance phase (months 4-12).

Setting: Face-to-face in University classrooms, supervised and self-directed fitness sessions at University fitness center, and home.

Participants: Premenopausal, mostly college-educated Pennsylvania women, body mass index >25 (n = 101).

Intervention: Twenty-eight, 1-hour classes tailored for extremes of the Dietary Guidelines' fat recommendations, based on social cognitive theory, problem-based learning delivery over 12 months. Exercise component included supervised and self-directed stretching, aerobics, and strength training.

Measures: Anthropometrics, lipid profile, blood pressure, 24-hour dietary recalls, cognitive behavioral measures, Satter Eating Competence Inventory (ecSI).

Analysis: General linear model repeated measures analysis of variance for outcome variables.

Results: A total of 40% (n = 40) completed the ecSI. Overall, education and supervised exercise session attendance were 77% and 88%, respectively. Similar weight loss for lower and moderate fat groups (6.7 kg and 5.4 kg). The EC was unchanged baseline to month 4 but increased significantly from months 4 to 12, baseline to month 12 for both groups. The EC change baseline to month 12 was inversely associated with weight change from baseline to months 4 and 12.

Conclusion: Weight management interventions, likely to introduce concerns with eating attitudes, behaviors, and foods, can reduce EC. Short-term measurement of EC change captures these consequent adjustments without opportunity to regain self-efficacy. Extending the measurement interval better reflects intervention impact on EC.

Keywords: behavioral research; eating behavior; health impact assessment; lifestyle; weight reduction programs.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Blood Pressure
  • Body Image
  • Body Mass Index
  • Body Weight
  • Body Weights and Measures
  • Exercise / psychology*
  • Feeding Behavior / psychology*
  • Female
  • Health Behavior
  • Health Education / organization & administration*
  • Humans
  • Lipids / blood
  • Middle Aged
  • Pennsylvania
  • Self Efficacy
  • Socioeconomic Factors
  • Weight Reduction Programs / organization & administration*


  • Lipids