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A randomized controlled trial of a theory-based weight-loss program for couples.

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Spousal autonomy support, not the intervention type, predicted weight loss in couples. An SDT-informed approach improved autonomy support for couples with low initial support.

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Area of Science:

  • Behavioral science
  • Psychology
  • Health and wellness

Background:

  • Weight gain is common during marriage, yet obesity treatments often overlook couples' dynamics.
  • Interpersonal factors and spousal interdependence significantly influence weight management outcomes.
  • Self-determination theory (SDT) highlights the role of autonomy-supportive environments in improving health behaviors.

Purpose of the Study:

  • To test an SDT-informed weight-loss intervention designed to enhance autonomy support within couples.
  • To compare the effectiveness of an SDT-informed intervention against standard behavioral weight loss (BWL) for couples.
  • To examine the relationship between autonomy support (AS) and weight loss in a couples-based intervention.

Main Methods:

  • Sixty-four couples were randomized into either a standard BWL group or an SDT-informed weight-loss (SDT-WL) group.
  • Interventions involved weekly sessions for six months, with assessments at baseline, 3, 6, and 12 months.
  • Key outcome measures included percent weight loss and changes in autonomy support.

Main Results:

  • No significant differences in percent weight loss or autonomy support (AS) changes were found between the SDT-WL and BWL conditions.
  • Higher baseline AS consistently predicted greater weight loss at both 6 and 12 months across all participants.
  • Increases in AS over time also correlated with greater weight loss.
  • A post hoc analysis revealed that SDT-WL was more effective in increasing AS for couples with initially low baseline AS.

Conclusions:

  • While direct intervention differences in weight loss were not observed, spousal autonomy support emerged as a key predictor of weight loss in both couples-based approaches.
  • The SDT-informed intervention demonstrated efficacy in enhancing autonomy support specifically for couples starting with lower levels of AS.
  • These findings underscore the importance of fostering autonomy support within marital relationships for successful weight management.