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The clinical obesity maintenance model: a structural equation model

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Purpose

Theoretical research on the psychological underpinnings of weight management is limited. Recently, the clinical obesity maintenance model (COMM) proposed a theoretical conceptualisation of salient psychological and neuropsychological mechanisms maintaining weight management issues. The current study aimed to empirically test the COMM and elucidate the results in the context of recent empirical findings.

Methods

Participants (N = 165) were recruited from university and community settings in Australia. The sample consisted of adults with normal weight (n = 41), overweight (n = 40), and obesity (n = 84). Participants completed self-report questionnaires and a brief neuropsychological test. Structural equation modelling was used to estimate the associations between the hypothesised variables of the COMM and evaluate the model fit.

Results

Findings suggested acceptable to good model fit. Furthermore, several direct effects were found. First, cognitive flexibility directly affected eating habit strength. Second, eating habit strength directly affected eating beliefs. Third, eating beliefs directly affected emotion dysregulation. Fourth, emotion dysregulation directly affected depression and binge eating with depression partially mediating this relationship. Finally, depression directly affected binge eating.

Conclusion

This was the first study to empirically test the COMM. Overall, findings provide preliminary support for the COMM as a psychological model of weight management and highlight the underlying psychological and neuropsychological mechanisms that may contribute to weight management issues. As this study examined a simplified version of the COMM, future research should continue evaluating this model and consider incorporating these components into more holistic weight management models to improve long-term treatment outcomes.

Level of evidence

V, cross-sectional descriptive study

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Availability of data and material

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This research is supported by an Australian Government Research Training Program Scholarship.

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Authors and Affiliations

  1. Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia

    Dean Spirou, Katie Wood & Jayanthi Raman

  2. School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia

    Evelyn Smith

  3. Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia

    Evelyn Smith

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  1. Dean Spirou
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  4. Jayanthi Raman
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Correspondence to Jayanthi Raman.

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The authors declare that they have no conflict of interest.

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This study was approved by the University of Technology Sydney Human Research Ethics Committee (ETH19-4065; ETH19-4404). All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Spirou, D., Smith, E., Wood, K. et al. The clinical obesity maintenance model: a structural equation model. Eat Weight Disord 26, 1927–1937 (2021). https://doi.org/10.1007/s40519-020-01034-y

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