Reductions in internal disinhibition during weight loss predict better weight loss maintenance

Abstract

The construct of disinhibition, as measured by the Eating Inventory, was recently found to have two factors: internal disinhibition (eating in response to cognitive and emotional cues) and external disinhibition (eating in response to environmental cues). This study examined whether early changes in disinhibition that occurred during a weight loss program predicted later weight loss maintenance. Participants were adults enrolled in a weight loss treatment study (n = 81, 16% men, BMI = 38.4 ± 6.5 kg/m2). Two-thirds of participants were African Americans. Participants received a uniform, al-replacement-based weight loss program in months 1-3 and one of four nutritionally focused programs for weight loss maintenance in months 4-12. Disinhibition and weight were assessed at clinic visits. Change in internal disinhibition from months 1-3 (i.e., the weight loss period) significantly predicted change in weight from month 4 to 12 (i.e., the weight maintenance period); this remained significant when treatment group, age, gender, thnicity, baseline weight, baseline depression, baseline internal disinhibition, and initial weight loss were controlled for (P = 0.03). A comparable analysis examining change in external disinhibition found that it was not a significant predictor of weight maintenance (P = 0.43). Participants who experienced the biggest decreases in internal disinhibition during the initial phase of treatment had the most success maintaining their weight loss in the next phase of treatment. Long-term weight loss outcomes may be improved by spending sufficient treatment time teaching strategies for reducing eating in response to internal cues.