Monitoring your weight-loss process online: prior weight-loss experiences, online social support and subsequent weight-loss success (Preprint)

BACKGROUND Online weight-loss communities (OWCs) have been becoming increasingly popular for weight management, which enable individuals to monitor (i.e. self-monitoring) and discuss (i.e. social interaction) their weight-loss experiences. However, there has been limited understanding of the role of individuals’ prior weight-loss experiences in subsequent weight-loss success, especially in online settings. OBJECTIVE To address the significant literature gap, this study investigates the relationship between prior weight-loss experiences (success or failure), online social support and subsequent weight-loss success in the contexts of OWCs based on self-determination theory. METHODS The data of 1650 users from one popular OWC is collected using a python crawler procedure, including individuals’ characteristics (e.g. gender, age, friends, posts, membership duration) and weight-loss diary information. Two logit regression models are deployed to estimate the effects of prior weight-loss experiences and social support on subsequent weight-loss success, as well as the moderation effect of social support. RESULTS The results reveal that prior successful weight-loss experiences are positively related to subsequent weight-loss success (β=0.376,p<0.01) while the relationship between prior failed weight-loss experiences and subsequent weight-loss success is negative (β=-0.225,p<0.05). Meanwhile, online social support can not only influence positively subsequent weight-loss success directly (β=0.441,p<0.01) but also undermine the negative effect of prior failed weight-loss experiences (β=0.025,p<). Nevertheless, social support has no significant moderating effect on the relationship between prior successful weight-loss experiences and subsequent weight-loss success (β=0.104,p>0.1). CONCLUSIONS This study contributes to literature on prior experiences and online social support in the context of OWCs, and provides valuable insights for OWCs’ designs to improve users’ engagement and their weight-loss success.

Long-term weight loss success and the health behaviours of adults in the USA: findings from a nationally representative cross-sectional study

ObjectiveTo describe the relationship between long-term weight loss (LTWL) success and lifestyle behaviours among US adults.DesignSerial cross-sectional data from National Health and Nutrition Examination Survey cycles 2007–2014.Setting and participantsPopulation-based nationally representative sample. The analytic sample included 3040 adults aged 20–64 years who tried to lose weight in the past year.MeasuresParticipants were grouped into five LTWL categories (<5%, 5%–9.9%, 10%–14.9%, 15%–19.9% and ≥20%). Lifestyle-related behaviours included the following: alcohol intake, physical activity, smoking, fast-food consumption, dietary quality (Healthy Eating Index (HEI)) and caloric intake. Multivariable regression was employed adjusting for age, sex, race/ethnicity, marital status, education, household income and size, current body mass index and self-reported health status.ResultsIndividuals in the 15%–19.9% LTWL group differed significantly from the reference group (<5% LTWL) in their physical activity and dietary quality (HEI) but not caloric intake. Specifically, they had a higher HEI score (β=3.19; 95% CI 0.39 to 5.99) and were more likely to meet physical activity guidelines (OR=1.99; 95% CI 1.11 to 3.55). In comparison, the ≥20% LTWL group was significantly more likely to smoke (OR=1.63; 95% CI 1.03 to 2.57) and to consume lower daily calories (β=−202.91; 95% CI –345.57 to –60.25) than the reference group; however, dietary quality and physical activity did not significantly differ.ConclusionAmong a national sample of adults, a higher level of LTWL success does not necessarily equate to healthy weight loss behaviours. Future research should attempt to design interventions aimed at facilitating weight loss success while encouraging healthy lifestyle behaviours.

Physical Activity, Sleep, and Sedentary Behavior among Successful Long-Term Weight Loss Maintainers: Findings from a U.S. National Study

Despite adults’ desire to reduce body mass (weight) for numerous health benefits, few are able to successfully lose at least 5% of their starting weight. There is evidence on the independent associations of physical activity, sedentary behaviors, and sleep with weight loss; however, this study provided insight on the combined effects of these behaviors on long-term body weight loss success. Hence, the purpose of this cross-sectional study was to evaluate the joint relations of sleep, physical activity, and sedentary behaviors with successful long-term weight loss. Data are from the 2005–2006 wave of the National Health and Examination Survey (NHANES). Physical activity and sedentary behavior were measured with an accelerometer, whereas sleep time was self-reported. Physical activity and sleep were dichotomized into meeting guidelines (active/not active, ideal sleep/short sleep), and sedentary time was categorized into prolonged sedentary time (4th quartile) compared to low sedentary time (1st–3rd quartiles). The dichotomized behaviors were combined to form 12 unique behavioral combinations. Two-step multivariable regression models were used to determine the associations between the behavioral combinations with (1) long-term weight loss success (≥5% body mass reduction for ≥12-months) and (2) the amount of body mass reduction among those who were successful. After adjustment for relevant factors, there were no significant associations between any of the independent body weight loss behaviors (physical activity, sedentary time, and sleep) and successful long-term weight loss. However, after combining the behaviors, those who were active (≥150 min MVPA weekly), regardless of their sedentary time, were significantly (p < 0.05) more likely to have long-term weight loss success compared to the inactive and sedentary referent group. These results should be confirmed in longitudinal analyses, including investigation of characteristics of waking (type, domain, and context) and sleep (quality metrics) behaviors for their association with long-term weight loss success.

Identifying the Factors That Hinder Sustainable Dietary Modification and Successful Weight Loss in Obese Adult

Objectives The Individualized Diet Improvement Program (iDip) is a year-long, group session-based weight loss program to help participants experiment and discover a sustainable dietary modification. We observed a large difference among participants in weight loss success. The objective is to identify factors that explain the difference in weight loss magnitude among participants. Methods 30 participants (25–70y) enrolled in an ongoing iDip study. A self-reflection survey was designed and administrated at eight months to determine the factors that could account for the differential weight loss outcome. The survey consisted of 19 dietary implementation statements and 19 behavior change statements. A degree of dietary implementation was scored from 0 (Have not tried) to 3 (Well implemented). Difficulty in a behavior change was scored from 0 (Strongly agree) to 4 (Strongly disagree). The survey scores were compared between top and bottom tertile groups in weight loss success. Two-tailed t-test was used for statistical analysis. Results 21 out of 24 remaining participants returned the survey. Mean weight loss of the top, middle, and bottom tertiles (n = 7 each) was −14.8 ± 2.9, −5.2 ± 0.6 and −1.3 ± 0.6 kg (mean ± SEM) at eight months, respectively. The sum of dietary implementation statement scores in the bottom tertile group (14.5 ± 1.2) was significantly lower (P &lt; 0.05) than that of the top tertile group (17.7 ± 1.1). The score of the bottom tertile group was also significantly lower than that of the top tertile group in the following statements: exchanging protein sources for leaner options (2.00 vs.2.86), selecting higher protein and fiber density foods (1.71 vs. 2.43), making meals high in protein and fiber (1.57 vs. 2.29), and finding staple food high in protein and fiber (1.86 vs.2.57). No difference was observed in the sum of behavioral statement scores between the two groups. Only one statement, “it is demotivating when seeing others losing weight”, was found significant among individual behavioral statements (bottom and top tertile groups, 3.1 and 3.7, respectively. Conclusions The survey indicates that the main obstacles to successful weight loss are difficulty in establishing meal routine and selecting foods high in protein and fiber per energy. In addition, lack of success in weight loss is likely to decrease motivation. Funding Sources USDA NIFA; NIBIB NIH (CA).

Predictors of weight loss outcomes in obesity care: results of the national ACTION study

Background A key objective of this study was to examine obesity care attitudes and behaviors of people with obesity (PwO) and determine independent factors associated with a self-reported sustained weight loss success outcome. Methods An online survey was conducted in 2015 among 3008 U.S. adult PwO (BMI > 30 through self-reported height and weight). Multivariate logistic models explained variation in weight loss success, defined as ≥ 10% weight loss in previous 3 years and maintained for > 1 year. Results Controlling for weight changes over time, we found significant associations between self-reported weight history and weight loss success. PwO who had personal motivation to lose weight, were willing to talk to a diabetes educator about their weight, who had their weight loss attempts recognized by a healthcare provider, and were diagnosed with “obesity” or “overweight” were more likely to report having success losing weight. Conclusions This study does not determine causality, but suggests motivation and engagement with PwO may impact weight loss, and presents a basis for assessing the mechanism involved. Determining such mechanisms may identify important targets to improve obesity treatment outcomes. Trial registration This study is registered with ClinicalTrials.gov, number NCT03223493, https://clinicaltrials.gov/ct2/show/NCT03223493. Registered July 17, 2017 (retrospectively registered).