Does Behavioral Bootstrapping Boost Weight Control Confidence? A Pilot Study

Background: Since confidence is an important predictor of ability to lose weight, methods for increasing weight-control confidence are important. The purpose of this study was to test the relationship between short-term behavior changes ('behavioral bootstrapping') and change in weight-control confidence in a small prospective weight-loss project. Methods: Data were available from 38 patients who received an initial motivational interview and a follow-up visit. Body mass index at baseline ranged from 25.5 kg/m(2) to 50.4 kg/m(2) (mean = 35.8, median = 34.4). Independent variables were change in weight (measured in kilograms in the clinic), self-reported change in minutes of physical activity, age, sex, and marital status. Minutes of physical activity were assessed at baseline and after 30 days, using the following question, "How many minutes do you exercise per week (e.g. fast walking, biking, treadmill)?" Weights were measured in the clinic. Results: Weight change was inversely correlated with change in confidence (p = 0.01). An increase in physical activity was associated with an increase in confidence (p = 0.01). Age, sex, and marital status were not related to change in confidence. Independent effects of weight change and physical activity were estimated using multiple linear regression analysis: b = -0.44, p = 0.04 for change in weight, and b = 0.02, p = 0.03 for change in physical activity (r(2) = 0.28). Conclusions: Short-term changes in behavior (losing weight and exercising more) lead to increased weight-control confidence in primary-care patients.