Habit-based interventions for weight loss maintenance in adults with overweight and obesity: a randomized controlled trial

Background/Objectives: Unhealthy lifestyle is often related to overweight and obesity and thus to chronic diseases. Web-based programs might be an option for a comprehensive approach to improving long-term weight management. Data from a randomized controlled trial (RCT) evaluating the impact of a lifestyle program on weight reduction were used for a secondary analysis. The objectives were (a) to identify potential predictors for marked weight loss, (b) to explore associations of weight reduction with changes in health-related variables, and (c) to evaluate whether self-monitoring of the daily lifestyle is associated with weight loss. Methods: 67 subjects with a body mass index of 28-35 who underwent the 1-year ‘Individual Health Management' (IHM) program were included in the analysis (mean age 49.8 years, 79% female). Two subgroups (high response: ≥7.5% weight reduction vs. low response: <7.5%) were compared in terms of sociodemographic data, baseline values, and pre-post changes of various risk and protective factors. A logistic regression was performed to identify potential predictors of weight loss. Results: 70% of the subjects fulfilled the criterion of high response. There were no statistically significant differences between the two subgroups with respect to sociodemographic and baseline data. Regression analysis failed to identify any predictors for the amount of weight reduction. Subjects with high response showed a more distinct improvement in life satisfaction and neurovegetative stability. The findings indicated an association between the level of self-monitoring and weight loss. Conclusions: More research is needed to establish optimal strategies for maximizing the longer-term maintenance of weight loss and prevention effects. For weight reduction, support strategies like feedback learning through self-monitoring, reporting systems, and self-performance measurement with questionnaires might ameliorate high-intensity lifestyle modification programs.

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Meal replacements, reduced energy density eating, and weight loss maintenance in primary care patients: A randomized controlled trial

Obesity ◽

10.1002/oby.20582 ◽

2013 ◽

Vol 22 (1) ◽

pp. 94-100 ◽

Cited By ~ 17

Author(s):

Michael R. Lowe ◽

Meghan L. Butryn ◽

J. Graham Thomas ◽

Maria Coletta

Keyword(s):

Primary Care ◽

Weight Loss ◽

Randomized Controlled Trial ◽

Energy Density ◽

Controlled Trial ◽

Weight Loss Maintenance ◽

Randomized Controlled ◽

Primary Care Patients ◽

Meal Replacements

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A Self-Directed Mobile Intervention (WaznApp) to Promote Weight Control Among Employees at a Lebanese University: Protocol for a Feasibility Pilot Randomized Controlled Trial (Preprint)

10.2196/preprints.9793 ◽

2018 ◽

Author(s):

Marco Bardus ◽

Ghassan Hamadeh ◽

Bouchra Hayek ◽

Rawan Al Kherfan

Keyword(s):

Weight Loss ◽

Randomized Controlled Trial ◽

Weight Management ◽

Weight Control ◽

Mobile Apps ◽

Controlled Trial ◽

Overweight And Obesity ◽

Randomized Controlled ◽

Obesity And Overweight ◽

And Control

BACKGROUND Overweight and obesity have become major health problems globally with more than 1.9 billion overweight adults. In Lebanon, the prevalence of obesity and overweight is 65.4% combined. Risk factors of obesity and overweight are preventable and can be addressed by modifications in the environment and in an individual’s lifestyle. Mobile technologies are increasingly used in behavioral, self-directed weight management interventions, providing users with additional opportunities to attain weight control (weight loss, weight gain prevention, etc). Mobile apps may allow for the delivery of Just-in-Time Adaptive Interventions (JITAIs), which provide support through skill building, emotional support, and instrumental support, following the participants’ progress. A few commercially available apps offer JITAI features, but no studies have tested their efficacy. OBJECTIVE The primary objective of this study is to examine the feasibility of a self-directed weight loss intervention, targeting employees of an academic institution, using a virtual coaching app with JITAI features (Lark) and a self-help calorie-counting app (MyFitnessPal). The secondary objective is to estimate the effects of the intervention on main study outcomes. METHODS This study is a single-center, parallel, randomized controlled trial with 2 study arms (intervention and control). Participants will be randomly allocated in equal proportions to the intervention (Lark) and control groups (MyFitnessPal). To be eligible for this study, participants must be employed full- or part-time at the university or its medical center, able to read English, have a smartphone, and be interested in controlling their weight. Recruitment strategies entail email invitations, printed posters, and social media postings. We will assess quantitative rates of recruitment, adherence, and retention, self-reported app quality using the user version of the Mobile App Rating Scale. We will also assess changes in weight-related outcomes (absolute weight and waist circumference), behavioral outcomes (physical activity and diet), and cognitive factors (motivation to participate in the trial and to manage weight). RESULTS WaznApp was funded in June 2017, and recruitment started in March 2018. CONCLUSIONS This study will provide information as to whether the selected mobile apps offer a feasible solution for promoting weight management in an academic workplace. The results will inform a larger trial whose results might be replicated in similar workplaces in Lebanon and the Middle East and North Africa region, and will be used as a benchmark for further investigations in other settings and similar target groups. CLINICALTRIAL ClinicalTrials.gov NCT03321331; https://clinicaltrials.gov/ct2/show/NCT03321331 (Archived by WebCite at http://www.webcitation.org/6ys9NOLo5) REGISTERED REPORT IDENTIFIER RR1-10.2196/9793

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Faculty Opinions recommendation of Comparison of 3 ad libitum diets for weight-loss maintenance, risk of cardiovascular disease, and diabetes: a 6-mo randomized, controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1129830.586915 ◽

2008 ◽

Author(s):

Ian Macdonald

Keyword(s):

Cardiovascular Disease ◽

Weight Loss ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Weight Loss Maintenance ◽

Randomized Controlled ◽

Ad Libitum

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NoHoW web-based toolkit with weight and activity tracking for weight-loss maintenance: long-term user experience results from a randomized controlled trial (Preprint)

10.2196/preprints.29302 ◽

2021 ◽

Author(s):

Elina Mattila ◽

Susanne Hansen ◽

Lise Bundgaard ◽

Lauren Ramsay ◽

Alice Dunning ◽

...

Keyword(s):

Weight Loss ◽

Randomized Controlled Trial ◽

User Experience ◽

Controlled Trial ◽

Weight Loss Maintenance ◽

External Factors ◽

Factors Affecting ◽

Randomized Controlled ◽

Objectively Measured

BACKGROUND Digital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience of the technologies largely determines user engagement, which is necessary for their effectiveness. OBJECTIVE To evaluate user experiences with the NoHoW Toolkit (TK), a DBCI targeting weight loss maintenance (WLM), over a 12-month period using mixed methodology and to identify the main strengths and weaknesses of the TK as well as external factors affecting its adoption. Secondly, the objective was to describe objectively measured usage of the TK and its association with user experience. METHODS An 18-month, 2 x 2 factorial randomized controlled trial was delivered, including three intervention arms receiving an 18-week active intervention and a control arm. User experience of the TK was assessed quantitatively through electronic questionnaires after 1, 3, 6 and 12 months of use, including also thematically analyzed open-ended items. Focus group interviews were conducted at month 6 and thematically analyzed to gather deeper insight into user experience. Usage logs of the TK were used to evaluate the number of visits to the TK, the total duration spent in the TK, and intervention completion. RESULTS The level of usability of the TK was rated as satisfactory. User acceptance was rated as modest, declining during the trial in all arms, as did the objectively measured usage of the TK. The most appreciated features were weekly emails, graphs, goal setting, and interactive exercises. Four themes were identified in the qualitative data: 1) engagement with features, 2) usage decline, 3) external factors affecting the user experience, and 4) suggestions for improvements. CONCLUSIONS The long-term user experience of the TK highlighted the need to optimize the technical functioning, appearance and content of a DBCI before and during the trial, in a way a commercial app would. The users should be made aware of how they should use the intervention and what the use requires, especially in the case of more intensive intervention content. CLINICALTRIAL ISRCTN88405328 INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2019-029425

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