Lifestyle intervention has a beneficial effect on eating behavior and long-term weight loss in obese adults

• The change in eating behavior during 3-year lifestyle intervention
• Cognitive restraint of eating increased more in the intervention group.
• Motivation and tolerance to problems predicted the increment in cognitive restraint.
• Uncontrolled eating decreased among successful dieters.

ObjectiveTo investigate the change in eating behavior and the factors related with the change among successful dieters (maintained a weight loss of ≥ 5% of original weight).MethodsObese adult subjects (21 male, 55 female) were randomized into three-year lifestyle intervention (n = 59) and control groups (n = 17). Eating behavior (cognitive restraint of eating, uncontrolled eating and emotional eating) was evaluated by the TFEQ-18 and motivation to lose weight and tolerance to problems by a separate questionnaire. Weight, height and body mass index were measured.ResultsWeight decreased more in the intervention group than in the control group (5.0% vs 0.6%, p = 0.027). Cognitive restraint increased twice as much in the intervention group compared to the control group (16.0 vs. 7.0, p = 0.044). The increment in cognitive restraint was positively associated with weight loss and high baseline motivation and tolerance to problems. Cognitive restraint increased in both successful (n = 27) and unsuccessful dieters (n = 32), but only the successful dieters were able to decrease uncontrolled eating in the long term.ConclusionsOur results showed that intensive lifestyle counseling improved cognitive restraint which was associated with enhanced weight loss among obese adults. Successful dieters also showed a long-term improvement of uncontrolled eating. Eating behavior should be evaluated and followed before and during lifestyle interventions in order to support the change, e.g. by finding methods to control eating at risk situations and strengthening motivation and tolerance to problems.