scholarly journals Development and feasibility study of an app (Ladle) for weight loss and behaviour change

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6907
Author(s):  
Jane Ogden ◽  
Hazel Maxwell ◽  
Adrian Wong
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Behaviour Change ◽  
Health Care Professionals ◽  
Preliminary Analysis ◽  
Low Cost ◽  
Completion Rate ◽  
Evidence Based ◽  
Face To Face ◽  
Management Interventions

Background Weight management interventions involving behaviour change often utilise face to face interventions which include evidence based behaviour change strategies yet are costly and time intensive. In contrast, digital interventions cost less and have a wider reach yet tend to lack an evidence base and are less effective. Aims The present study therefore aimed to develop an evidence based behaviour change low cost app for weight management and to provide a preliminary analysis of its effectiveness. Methods The Ladle app was developed through evidence review and feedback from health care professionals and patients and consists of a 12 week course focusing on six habits and weight loss facilitated through 36 audio psychological lessons and 12 lessons specifically on the six habits. Each lesson was between 2–5 min (approx. 168 min of lessons). It was evaluated in terms of completion rate, weight loss, adoption of the six habits and participant feedback. Results The results showed a completion rate of 44%, that 52% of Completers showed weight loss of at least 5%, 79% showed weight loss of at least 3%, the median % weight lost was −5% and the median weight loss was −3.8 kg. Further, by the end of 12 weeks the majority (>80%) of participants had adopted four of the six habits for at least 5 days a week and nearly half (45%) had adopted the remaining two habits for at least 4 days out of 7. Feedback comments were mainly positive (n = 80) focusing mostly on the content of the lessons. Some comments were neutral (n = 56) and involved a statement of commitment or a description of a challenge and a minority were negative (n = 23) describing some technical issues which were addressed as the evaluation progressed. Conclusion The new Ladle app offers an evidenced based alternative to more intensive face to face interventions. On preliminary analysis it would seem to have lower completion rates than some more intensive interventions but comparable effectiveness for weight loss. It can also improve habits and is less time-intensive and costly to deliver. Participant feedback was generally positive.

scholarly journals The H2020 “NoHoW Project”: A Position Statement on Behavioural Approaches to Longer-Term Weight Management

Obesity Facts ◽  
2021 ◽  
pp. 1-13
Author(s):  
R. James Stubbs ◽  
Cristiana Duarte ◽  
Ruairi O’Driscoll ◽  
Jake Turicchi ◽  
Dominika Kwasnicka ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Weight Management ◽  
Behaviour Change ◽  
Weight Regain ◽  
Position Statement ◽  
Mechanisms Of Action ◽  
Evidence Based ◽  
Behavioural Interventions ◽  
Intervention Content

There is substantial evidence documenting the effects of behavioural interventions on weight loss (WL). However, behavioural approaches to initial WL are followed by some degree of longer-term weight regain, and large trials focusing on evidence-based approaches to weight loss maintenance (WLM) have generally only demonstrated small beneficial effects. The current state-of-the-art in behavioural interventions for WL and WLM raises questions of (i) how we define the relationship between WL and WLM, (ii) how energy balance (EB) systems respond to WL and influence behaviours that primarily drive weight regain, (iii) how intervention content, mode of delivery and intensity should be targeted to keep weight off, (iv) which mechanisms of action in complex interventions may prevent weight regain and (v) how to design studies and interventions to maximise effective longer-term weight management. In considering these issues a writing team within the NoHoW Consortium was convened to elaborate a position statement, and behaviour change and obesity experts were invited to discuss these positions and to refine them. At present the evidence suggests that developing the skills to self-manage EB behaviours leads to more effective WLM. However, the effects of behaviour change interventions for WL and WLM are still relatively modest and our understanding of the factors that disrupt and undermine self-management of eating and physical activity is limited. These factors include physiological resistance to weight loss, gradual compensatory changes in eating and physical activity and reactive processes related to stress, emotions, rewards and desires that meet psychological needs. Better matching of evidence-based intervention content to quantitatively tracked EB behaviours and the specific needs of individuals may improve outcomes. Improving objective longitudinal tracking of energy intake and energy expenditure over time would provide a quantitative framework in which to understand the dynamics of behaviour change, mechanisms of action of behaviour change interventions and user engagement with intervention components to potentially improve weight management intervention design and evaluation.

scholarly journals Evidence-Based Digital Tools for Weight Loss Maintenance: The NoHoW Project

Obesity Facts ◽  
2021 ◽  
pp. 1-14
Author(s):  
R. James Stubbs ◽  
Cristiana Duarte ◽  
António L. Palmeira ◽  
Falko F. Sniehotta ◽  
Graham Horgan ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behaviour Change ◽  
Digital Health ◽  
Self Regulation ◽  
Self Management ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Behavioural Science ◽  
Digital Architecture

<b><i>Background:</i></b> Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.g., provide choice). Stress management and emotion regulation techniques show potential for prevention of relapse and weight regain. Digital technologies (including networked-wireless tracking technologies, online tools and smartphone apps, multimedia resources, and internet-based support) offer attractive tools for teaching and supporting long-term behaviour change techniques. However, many digital offerings for weight management tend not to include evidence-based content and the evidence base is still limited. <b><i>The Project:</i></b> First, the project examined why, when, and how many European citizens make WL and WLM attempts and how successful they are. Second, the project employed the most up-to-date behavioural science research to develop a digital toolkit for WLM based on 2 key conditions, i.e., self-management (self-regulation and motivation) of behaviour and self-management of emotional responses for WLM. Then, the NoHoW trial tested the efficacy of this digital toolkit in adults who achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25). The primary outcome was change in weight (kg) at 12 months from baseline. Secondary outcomes included biological, psychological, and behavioural moderators and mediators of long-term energy balance (EB) behaviours, and user experience, acceptability, and cost-effectiveness. <b><i>Impact:</i></b> The project will directly feed results from studies on European consumer behaviour, design and evaluation of digital toolkits self-management of EB behaviours into development of new products and services for WLM and digital health. The project has developed a framework and digital architecture for interventions in the context of EB tracking and will generate results that will help inform the next generation of personalised interventions for effective self-management of weight and health.

scholarly journals SUN-543 Real World Evidence of Successful Weight Management for the Obese Population: Complete Reversal of Obesity Related Metabolic Co-Morbidities and Weight Loss in Patients Attending a Multidisciplinary Weight Management Clinic in Australia

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zoe Rock ◽  
Juliana Chen ◽  
Joanna Jaques ◽  
Bernard L Champion ◽  
Reginald V Lord ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Exercise Physiology ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Management Interventions ◽  
Co Morbidity ◽  
Total Body ◽  
Total Body Weight Loss

Abstract Over 2.5 billion people worldwide are overweight or obese. Multidisciplinary weight management interventions have evolved to address the complexity of weight loss for those with one or more chronic diseases, and the trend of weight regain. The aim of these interventions is to encourage sustainable lifestyle changes, resulting in weight loss and weight maintenance and improvements in comorbidities. While some prospective clinical trials have demonstrated efficacy, results are often not reported by real life practices. The aim of this study was to evaluate the effectiveness of a Sydney based multidisciplinary weight management clinic with endocrinology, dietetics, exercise physiology, psychology, and bariatric surgical domains. All patients who attended the clinic for weight loss purposes between March 2017 and April 2019 were included (n=220). A retrospective chart review was conducted. Patient data on weight, BMI, waist circumference, body composition measurements, and selected blood test results and co-morbidities were analysed. All patient therapy included endocrinological input for co-morbidity identification and management, lifestyle intervention (dietetic and exercise physiology input) with optional adjunct pharmacotherapy or psychological counselling. Of the 220 cohort, 20 of the patients had sleeve gastrectomy. Patient retention in the clinic after the first consultation was 85% (n=186), a high rate within the weight management community. 59% of patients achieved a minimum of 5% total body weight loss, including 18% who achieved greater than 10% total body weight loss. Additionally, 31% of patients lost enough weight to decrease their BMI class by up to 2 or more classes. Of the gastric sleeve cohort average excess body weight loss was 32kg (21-56kg) enhanced by multidisciplinary care in the lead up to surgery. Across the cohort some patients completely reversed co-morbidities; including dyslipidaemia (n=1), hypertension (n=3), NAFLD (n=1), pre-diabetes (n=8) and type 2 diabetes (n=3), OSA (n=1). These results demonstrate that obesity is a chronic condition that can be successfully managed. We have demonstrated significant durable weight loss and improvement in metabolic co-morbidities with holistic coordinated care. Future directions include translating this model of care into standard practice in Australia and other countries where obesity to date not received the same coordinated approach as other chronic conditions.

scholarly journals Do weight management interventions delivered by online social networks effectively improve body weight, body composition, and chronic disease risk factors? A systematic review

2016 ◽  
Vol 23 (2) ◽  
pp. 263-272 ◽  
Author(s):  
Erik A Willis ◽  
Amanda N Szabo-Reed ◽  
Lauren T Ptomey ◽  
Felicia L Steger ◽  
Jeffery J Honas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Networks ◽  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Online Social Networks ◽  
Disease Risk ◽  
Primary Source ◽  
Outcome Data ◽  
Management Interventions

Introduction Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990–November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results One-hundred percent of the studies ( n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion Using OSN for weight management is in its early stages of development and, while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.

scholarly journals GP-delivered brief weight loss interventions: a cohort study of patient responses and subsequent actions, using conversation analysis in UK primary care

2018 ◽  
Vol 68 (674) ◽  
pp. e646-e653 ◽  
Author(s):  
Charlotte Albury ◽  
Elizabeth Stokoe ◽  
Sue Ziebland ◽  
Helena Webb ◽  
Paul Aveyard
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Cohort Study ◽  
Conversation Analysis ◽  
Weight Management ◽  
Management Service ◽  
Management Interventions ◽  
Weight Management Programme ◽  
Patient Responses ◽  
Weight Loss Interventions

BackgroundGuidelines encourage GPs to make brief opportunistic interventions to support weight loss. However, GPs fear that starting these discussions will lead to lengthy consultations. Recognising that patients are committed to take action could allow GPs to shorten brief interventions.AimTo examine which patient responses indicated commitment to action, and the time saved if these had been recognised and the consultation closed sooner.Design and settingA mixed-method cohort study of UK primary care patients participating in a trial of opportunistic weight management interventions.MethodConversation analysis was applied to 226 consultation audiorecordings to identify types of responses from patients that indicated that an offer of referral to weight management was well received. Odds ratios (OR) were calculated to examine associations between response types and likelihood of weight management programme attendance.ResultsAffirmative responses, for example ‘yes’, displayed no conversational evidence that the referral was well received and showed no association with attendance: ‘yes’ (OR 1.2, 95% confidence interval [CI] = 0.37 to 3.95, P = 0.97). However, ‘oh’-prefaced responses and marked positive responses, for example ‘lovely’, showed conversational evidence of enthusiasm and were associated with higher odds of commercial weight management service attendance. Recognising these could have saved doctors a mean of 31 seconds per consultation.ConclusionWhen doctors make brief opportunistic interventions that incorporate the offer of help, ‘oh’-prefaced or marked positive responses indicate enthusiastic acceptance of the offer and a higher likelihood of take-up. Recognising these responses and moving swiftly to facilitate patient action would shorten the brief intervention in many cases.

scholarly journals Impact of adult weight management interventions on mental health: a systematic review and meta-analysis protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031857
Author(s):  
Rebecca A Jones ◽  
Emma R Lawlor ◽  
Simon J Griffin ◽  
Esther M F van Sluijs ◽  
Amy L Ahern
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Weight Loss ◽  
Weight Management ◽  
English Language ◽  
Meta Analysis ◽  
Overweight And Obesity ◽  
Primary Data ◽  
Management Interventions ◽  
The Impact

IntroductionThe effects of interventions targeting weight loss on physical health are well described, yet the evidence for mental health is less clear. It is essential to better understand the impact of weight management interventions on mental health to optimise care and minimise risk of harm. We will assess the effect of behavioural weight management interventions on mental health in adults with overweight and obesity.Methods and analysisThe systematic review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. We will include behavioural weight management interventions with a diet and/or physical activity component focusing on weight loss for adults with a body mass index ≥25 kg/m2. Randomised controlled trials (RCTs) and cluster RCTs will be the only eligible study designs. Outcomes of interest will be related to mental health. The following databases were searched from inception to 07 May 2019: MEDLINE, Embase, Cochrane database (CENTRAL), PsycINFO, ASSIA, AMED and CINAHL. The search strategy was based on four concepts: (1) adults, defined as ≥18 years, with overweight/obesity, defined as BMI ≥25kg/m², (2) weight management interventions, (3) mental health outcomes and (4) study design. The search was restricted to English-language published papers, with no other restrictions applied. Two stage screening for eligibility will be completed by two independent reviewers, with two independent reviewers completing data extraction and risk of bias assessment. Data permitting, a random-effects meta-analysis of outcomes, subgroup analyses and meta-regression will be conducted. If not appropriate, narrative synthesis and ‘levels of evidence’ assessment will be completed.Ethics and disseminationEthical approval is not required as primary data will not be collected. The completed systematic review will be disseminated in a peer-reviewed journal, at conferences and contribute towards the lead author’s PhD thesis.PROSPERO registration numberCRD42019131659.

Impact of a Weight Management Intervention on Eating Competence: Importance of Measurement Interval in Protocol Design

2017 ◽  
Vol 32 (3) ◽  
pp. 718-728 ◽  
Author(s):  
Barbara Lohse ◽  
Jodi Stotts Krall ◽  
Tricia Psota ◽  
Penny Kris-Etherton
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Repeated Measures ◽  
Cognitive Theory ◽  
Eating Attitudes ◽  
Exercise Session ◽  
Measurement Interval ◽  
Management Interventions ◽  
Supervised Exercise ◽  
Eating Competence

Purpose: To examine changes in eating competence (EC) in 12-month weight loss intervention. Design: Randomized, parallel-arm with weight loss phase (baseline to month 4) and weight-maintenance phase (months 4-12). Setting: Face-to-face in University classrooms, supervised and self-directed fitness sessions at University fitness center, and home. Participants: Premenopausal, mostly college-educated Pennsylvania women, body mass index >25 (n = 101). Intervention: Twenty-eight, 1-hour classes tailored for extremes of the Dietary Guidelines’ fat recommendations, based on social cognitive theory, problem-based learning delivery over 12 months. Exercise component included supervised and self-directed stretching, aerobics, and strength training. Measures: Anthropometrics, lipid profile, blood pressure, 24-hour dietary recalls, cognitive behavioral measures, Satter Eating Competence Inventory (ecSI). Analysis: General linear model repeated measures analysis of variance for outcome variables. Results: A total of 40% (n = 40) completed the ecSI. Overall, education and supervised exercise session attendance were 77% and 88%, respectively. Similar weight loss for lower and moderate fat groups (6.7 kg and 5.4 kg). The EC was unchanged baseline to month 4 but increased significantly from months 4 to 12, baseline to month 12 for both groups. The EC change baseline to month 12 was inversely associated with weight change from baseline to months 4 and 12. Conclusion: Weight management interventions, likely to introduce concerns with eating attitudes, behaviors, and foods, can reduce EC. Short-term measurement of EC change captures these consequent adjustments without opportunity to regain self-efficacy. Extending the measurement interval better reflects intervention impact on EC.

scholarly journals A Systematic Review of Methods to Predict Weight Trajectories in Health Economic Models of Behavioral Weight-Management Programs: The Potential Role of Psychosocial Factors

2019 ◽  
Vol 40 (1) ◽  
pp. 90-105
Author(s):  
Sarah Bates ◽  
Thomas Bayley ◽  
Paul Norman ◽  
Penny Breeze ◽  
Alan Brennan
Keyword(s):  
Health Economic ◽  
Weight Loss ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Weight Management ◽  
Psychosocial Factors ◽  
Economic Models ◽  
Psychosocial Variables ◽  
Management Interventions ◽  
Weight Trajectories

Objectives. There is limited evidence on the long-term effectiveness of behavioral weight-management interventions, and thus, when conducting health economic modeling, assumptions are made about weight trajectories. The aims of this review were to examine these assumptions made about weight trajectories, the evidence sources used to justify them, and the impact of assumptions on estimated cost-effectiveness. Given the evidence that some psychosocial variables are associated with weight-loss trajectories, we also aimed to examine the extent to which psychosocial variables have been used to estimate weight trajectories and whether psychosocial variables were measured within cited evidence sources. Methods. A search of databases (Medline, PubMed, Cochrane, NHS Economic Evaluation, Embase, PSYCinfo, CINAHL, EconLit) was conducted using keywords related to overweight, weight-management, and economic evaluation. Economic evaluations of weight-management interventions that included modeling beyond trial data were included. Results. Within the 38 eligible articles, 6 types of assumptions were reported (weight loss maintained, weight loss regained immediately, linear weight regain, subgroup-specific trajectories, exponential decay of effect, maintenance followed by regain). Fifteen articles cited at least 1 evidence source to support the assumption reported. The assumption used affected the assessment of cost-effectiveness in 9 of the 19 studies that tested this in sensitivity analyses. None of the articles reported using psychosocial factors to estimate weight trajectories. However, psychosocial factors were measured in evidence sources cited by 11 health economic models. Conclusions. Given the range of weight trajectories reported and the potential impact on funding decisions, further research is warranted to investigate how psychosocial variables measured in trials can be used within health economic models to simulate heterogeneous weight trajectories and potentially improve the accuracy of cost-effectiveness estimates.

scholarly journals Training physicians in motivational communication to improve behaviour change counselling competency: A behavioural medicine approach to NCD prevention and management

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Lavoie
Keyword(s):  
Behaviour Change ◽  
Skill Acquisition ◽  
Assessment Tool ◽  
Health Behaviours ◽  
Evidence Based ◽  
Training Dose ◽  
Face To Face ◽  
Behaviour Change Counselling ◽  
Communication Competencies ◽  
The Impact

Abstract Background Despite the importance of changing health behaviours in the context of preventing and managing non-communicable chronic diseases (NCD's), physician use of evidence-based behaviour change counselling (BCC) is low, and BCC skills competency is generally poor. Motivational communication (MC) is a patient-centred, evidence-based BCC approach used by healthcare providers, designed to increase patient motivation to adopt a healthy lifestyle. MC-based approaches improved a range of health behaviours (smoking, diet, physical activity) in patients with NCDs, leading to increased demand for physician training. Despite the widespread dissemination of training programs, data on their efficacy in achieving competency among physicians is limited. This is likely due to a lack of consensus on the core communication competencies to be achieved, and in the absence of acceptable, valid and reliable tools to measure skill acquisition. Results Using an integrated knowledge translation (iKT) approach that engaged 199 international physicians, behaviour change experts and health administrators, we have identified 11 core evidence-based communication competencies that physicians should acquire in the context of NCD prevention/management. They have been incorporated into a basic 4 hr face-to-face MC training program called “LEARN THE BASICs”. To assess MC competency, we have also developed a reliable, engaging, efficient, 'user-friendly' case-based digital assessment tool called the MC-Competency Assessment Test (MC-CAT). Conclusions Strategies for optimizing and tailoring this program, including finding the most cost-effective training dose, the impact of supplemental training components (e.g., in person vs. digital coaching; booster sessions), and delivery modes (e.g., face-to-face vs digital/online), will be discussed in the context of optimizing implementation success.

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