Background: Little is known about which behavioral strategies are most important to target in weight loss interventions for men. Purpose: The aim of the current study was to identify behavioral mediators of weight loss in the male-only Self-Help, Exercise, and Diet using Information Technology (SHED-IT) community weight loss study. Methods: A randomized controlled trial with 159 overweight/obese men [mean (SD) age = 47.5 (11.0) years; body mass index = 32.7 (3.5) kg/m2] assessed at baseline, 3 months (post-test) and 6 months (follow-up). Results: In an intention-to-treat, multiple-mediator model, the significant intervention effect on weight at 6 months (-3.70 kg; p < 0.001) was mediated by increases in physical activity (steps/day) and decreases in takeaway meals (kJ/day) and portion size at 3 months. The largest mediation effect was for physical activity (-0.6 kg; 95% confidence interval -1.4, -0.1). Overall, the targeted mediators accounted for 47.0% of the intervention's effect on weight. Conclusion: Step counts, takeaway food consumption, and portion sizes may be key areas to target in future weight loss programs for men (ACTRN12610000699066).
Annals of Behavioral Medicine Vol. 49, Issue 2, p. 286-292