Episodic future thinking, delay discounting, and exercise during weight loss maintenance: The PACE trial

Area of Science:

• Behavioral science
• Obesity research
• Health psychology

Background:

• Weight loss maintenance (WLM) is challenging, with common weight regain despite intentions.
• Self-regulation capacity, including delay discounting (DD), influences intention-behavior consistency.
• Episodic Future Thinking (EFT) may enhance DD and promote sustained behavior change.

Purpose of the Study:

• To examine if EFT improves DD in the context of WLM.
• To investigate the potential of EFT as a tool for enhancing self-regulatory capacity.
• To explore the role of DD in mediating the relationship between interventions and physical activity.

Main Methods:

• Randomized controlled trial comparing standard WLM (WLM-STD) with WLM plus daily EFT (WLM + EFT).
• Participants achieving ≥5% weight loss were assigned to either WLM-STD or WLM + EFT.
• Daily smartphone-based EFT training for WLM + EFT; daily Healthy Thinking for WLM-STD to control for contact.

Main Results:

• The primary hypothesis is that WLM + EFT will show greater improvements in DD than WLM-STD.
• Secondary outcomes include exploring the mediating role of DD on physical activity.
• Exploration of weight and contextual variables will be conducted.

Conclusions:

• This study pioneers the investigation of EFT's impact on DD for WLM.
• Findings could illuminate the interplay between EFT, DD, and sustained behavior change in obesity.
• Results may inform novel therapeutic strategies for long-term weight management.