Experiential or behavioral processes: Which one is prominent in physical activity? Examining the processes of change 1 year after an intervention of therapeutic education among adults with obesity

• Whether processes of change predict transition through stages of change in obesity is unknown.
• Three processes of change (out of five) predict the transition across stages of change.
• Weight loss was predicted by a hybrid behavioral process of change.
• Effect sizes were larger for behavioral processes of change.

ObjectiveAlthough physical activity (PA) is essential, most obese people will not engage in its practice. The transtheoretical model (TTM) and its processes of change (POC) contribute to the understanding of behavior change regarding PA. The present study aimed to test how POC are associated with a progression through the stages of change (SOC) and whether they predict BMI change.MethodsInterventional study. A total of 134 subjects participated in an education program, were called at 1 year and 62 of them provided follow-up data. Participants completed the SOC and POC questionnaires at baseline, at 1 year and were classified according to their SOC progression.ResultsParticipants who progressed through SOC lost more weight (p < 0.001). Significant interactions were found for three out of five POC (p < 0.05). Progression through SOC was associated with an increased use of POC. Weight loss was predicted by two behavioral POC.ConclusionResults support the previous cross-sectional studies showing that physically active people use more frequently POC.Practice implicationsThe present findings support the development of TTM-grounded behavioral interventions targeted to obese patients. Identifying methods to promote POC use to improve adherence to weight guidelines may lead to improved clinical outcomes and quality of life.