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A sample of 94 obese men and women treated with a very low calorie diet (VLCD) and behavior modification were chosen to examine the effects of emotion-related events (ERE), food-related environmental events (FREE), and dysphoric mood (anxiety and depression) on adherence. Sixty-eight (72%) of the subjects completed this 10-week study. Subjects completed food diaries documenting any deviations from the diet. The number of ERE, FREE, and levels of anxiety and depression were assessed weekly. Results indicate that anxiety and number of ERE were positively correlated with nonadherence, but only during the last 3 weeks of the study despite no increase in absolute levels of the variables. The results are interpreted as providing evidence for a “fatiguing” effect around the eighth week of partial fasting when significantly more extradiet eating occurs. The nature of this effect is an increase in vulnerability to the disrupting effects of ERE and anxiety. The results are discussed in light of their importance for the management of obese patients on VLCD.
David J. LaPorte (1990) studied this question.