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BackgroundClinic-based behavioral weight loss programs are effective in producing significant weight loss. A one-size-fits-all approach is often taken with these programs. It may be beneficial to tailor programs based on participants' baseline characteristics. Type and level of motivation may be an important factor to consider. Previous research has found that, in general, higher levels of controlled motivation are detrimental to behavior change while higher levels of autonomous motivation improve the likelihood of behavior modification.MethodsThis study assessed the outcomes of two internet behavioral weight loss interventions and assessed the effect of baseline motivation levels on program success. Eighty females (M (SD) age 48.7 (10.6) years; BMI 32.0 (3.7) kg/m2; 91% Caucasian) were randomized to one of two groups, a standard group or a motivation-enhanced group. Both received a 16-week internet behavioral weight loss program and attended an initial and a four-week group session. Weight and motivation were measured at baseline, four and 16 weeks. Hierarchical regression analysis was conducted to test for moderation.ResultsThere was significant weight loss at 16-weeks in both groups (p < 0.001); however there were no between group differences (p = 0.57) (standard group 3.4 (3.6) kg; motivation-enhanced group 3.9 (3.4) kg).Further analysis was conducted to examine predictors of weight loss. Baseline controlled motivation level was negatively correlated with weight loss in the entire sample (r = -0.30; p = 0.01). Statistical analysis revealed an interaction between study group assignment and baseline level of controlled motivation. Weight loss was not predicted by baseline level of controlled motivation in the motivation-enhanced group, but was significantly predicted by controlled motivation in the standard group. Baseline autonomous motivation did not predict weight change in either group.ConclusionsThis research found that, in participants with high levels of baseline controlled motivation for weight loss, an intervention designed to enhance motivation for weight loss produced significantly greater weight loss than a standard behavioral weight loss intervention.

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Although obesity rates are high in Appalachian Kentucky, few interventions have been developed for this population. The purpose of this study was to survey adults in the region about their needs and interest for a weight loss program. A telephone survey was conducted with 404 adults in Appalachian Kentucky. Sixty‐nine percent (69%) of respondents were overweight or obese. Nearly half (48%) of respondents reported a diagnosis of a chronic health condition. The most frequently mentioned barriers to weight loss were current eating habits, time, and current physical condition. The most frequently mentioned motivators for losing weight were health, appearance, and feeling better. Sixty‐eight percent (68%) of respondents were interested in losing weight. Women were more likely than men to have an accurate perception of their weight and a greater interest in losing weight.

Participation in a 16-week behavioural weight-loss programme significantly improved diet quality and reduced dietary energy density and energy intake in adult women. However, despite the overall increase in diet quality score, there were deficiencies in key micronutrients in the diets of most women at the conclusion of the 16-week study.

This study elicits community-identified barriers to healthy behaviors and provides foundational data to inform future place-based obesity reduction interventions.

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