Triggers of Lapse and Relapse of Diet and Exercise in Behavioral Weight Loss

Objective This study aimed to (1) develop instruments to evaluate situations that lead to lapse and relapse in diet and exercise and (2) prospectively investigate when and which psychosocial situations predict failure to lose weight in a clinical trial of intentional weight loss. Methods Participants were 469 individuals with overweight or obesity participating in a behavioral weight loss program (age: mean = 53.6 years, SD = 11.4; BMI: mean = 35.7 kg/m(2), SD = 6.5). Results The Cronbach alphas for the Diet Lapse and Relapse Triggers Scale and the Exercise Lapse and Relapse Triggers Scale were 0.93 and 0.91, respectively. Subscale alphas ranged from 0.60 to 0.96. Lapse and relapse were assessed at 3 and 9 months for associations with weight loss at 12 months. At 9 months, diet triggers were negative emotional states (beta = 0.11, P = 0.02) and urges (beta = 0.14, P = 0.01). Predicted social situations showed the opposite (beta = -0.09, P = 0.02). Exercise subscales were all nonsignificant. Conclusions Findings suggest the ongoing importance of addressing negative emotional states and the contributing influence of urges. The novel finding that participants whose difficulties arise in social situations may do better over time requires further study.