We have emphasized the role of self-efficacy in prompting people to perform self-management skills. The oft-cited message has been that if people believe they can do a given thing, they will; if they don’t have self-efficacy believes, however, they are less likely to do whatever they need to do to solve a particular problem. Findings are often inconsistent with respect to an individual’s performance, however. Warziski and coworkers looked at self-efficacy specific to changing eating behaviors in the PREFER trial, an 18-month behavioral weight-loss study, to determine if self-efficacy and dietary adherence were associated with weight change, and what impact self-efficacy had on weight change after controlling for adherence. Measurements included the weight efficacy lifestyle questionnaire, body weight, self-reported fat gram intake, calorie intake, and adherence to calorie and fat gram goals at baseline, 6, 12, and 18 months. The sample (N = 170) included 88.2% female and 70.0% Caucasian; the mean age was 44.1 years. Mean weight loss at 18 months was 4.64% of baseline body weight and the mean increase in self-efficacy was 11.70%. Self-efficacy improved significantly over time and was associated with weight loss. Adherence to the fat gram goal was associated with weight loss, and self-efficacy remained associated with weight loss after controlling for fat gram adherence. Consistent with self-efficacy theory, improvement in self-efficacy over time supported greater weight loss. Adherence to the fat gram goal also influenced weight loss.

VALUE OF STUDY TO READER: This study nicely showed the relation between self-efficacy and weight loss. These findings were maintained at 18 months. Thus, both the positive outcomes and the long-term follow-up of patients make the PREFER program particularly noteworthy as an example of a self-management program for losing weight and maintaining the gains.

MT Warziski et al. Changes in self-efficacy and dietary adherence: the impact on weight loss in the PREFER study. Journal of Behavioral Medicine, October 26, 2007.