Effect of Age and Gender on the Efficacy of a 12-Month Body Weight Reduction Program Conducted Online—A Prospective Cohort Study

Woźniak, Jakub; Woźniak, Katarzyna; Wojciechowska, Olga; Wrzosek, Michał; Włodarek, Dariusz

doi:10.3390/ijerph191912009

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…Recent studies have highlighted the importance of analyzing sex weight loss patterns separately [52][53][54][55], and sex differences are important factors in interpreting program efficacy. Due to societal norms, it has been observed that males tend to desire weight gain whereas females desire weight loss [52].…”

Section: Plos Medicinementioning

confidence: 99%

An SMS chatbot digital educational program to increase healthy eating behaviors in adolescence: A multifactorial randomized controlled trial among 7,890 participants in the Danish National Birth Cohort

Bjerregaard,

Zoughbie,

Hansen

et al. 2024

PLoS Med

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Background Few cost-effective strategies to shift dietary habits of populations in a healthier direction have been identified. We examined if participating in a chatbot health education program transmitted by Short Messages Service (“SMS-program”) could improve adolescent dietary behaviors and body weight trajectories. We also explored possible added effects of maternal or peer involvement. Methods and findings We conducted a randomized controlled trial (RCT) among adolescents from the Danish National Birth Cohort (DNBC). Eligible were adolescents who during 2015 to 2016 at age 14 years had completed a questionnaire assessing height, weight, and dietary habits. Two thirds were offered participation in an SMS-program, whereas 1/3 (“non-SMS group”) received no offer. The SMS program aimed to improve 3 key dietary intake behaviors: sugar-sweetened beverages (SSBs), fruit and vegetables (FV), and fish. The offered programs had 3 factorially randomized schemes; the aims of these were to test effect of asking the mother or a friend to also participate in the health promotion program, and to test the effect of a 4-week individually tailored SMS program against the full 12-week SMS program targeting all 3 dietary factors. Height and weight and intakes of SSB, FV, and fish were assessed twice by a smartphone-based abbreviated dietary questionnaire completed at 6 months (m) and 18 m follow-up. Main outcome measures were (1) body mass index (BMI) z-score; and (2) an abbreviated Healthy Eating Index (mini-HEI, 1 m window, as mean of z-scores for SSB, FV, and fish). Among the 7,890 randomized adolescents, 5,260 were assigned to any SMS program; 63% (3,338) joined the offered program. Among the 7,890 randomized, 74% (5,853) and 68% (5,370) responded to follow-ups at 6 m and 18 m, respectively. Effects were estimated by intention-to-treat (ITT) analyses and inverse probability weighted per-protocol (IPW-PP) analyses excluding adolescents who did not join the program. Mean (standard deviation (SD)) mini-HEI at baseline, 6 m and 18 m was −0.01 (0.64), 0.01 (0.59), and −0.01 (0.59), respectively. In ITT-analyses, no effects were observed, at any time point, in those who had received any SMS program compared to the non-SMS group, on BMI z-score (6 m: −0.010 [95% confidence interval (CI) −0.035, 0.015]; p = 0.442, 18 m: 0.002 [95% CI −0.029, 0.033]; p = 0.901) or mini-HEI (6 m: 0.016 [95% CI −0.011, 0.043]; p = 0.253, 18m: −0.016 [95% CI −0.045, 0.013]; p = 0.286). In IPW-PP analyses, at 6 m, a small decrease in BMI z-score (−0.030 [95% CI −0.057, −0.003]; p = 0.032) was observed, whereas no significant effect was observed in mini-HEI (0.027 [95% CI −0.002, 0.056]; p = 0.072), among those who had received any SMS program compared to the non-SMS group. At 18 m, no associations were observed (BMI z-score: −0.006 [95% CI −0.039, 0.027]; p = 0.724, and mini-HEI: −0.005 [95% CI −0.036, 0.026]; p = 0.755). The main limitations of the study were that DNBC participants, though derived from the general population, tend to have higher socioeconomic status than average, and that outcome measures were self-reported. Conclusions In this study, a chatbot health education program delivered through an SMS program had no effect on dietary habits or weight trajectories in ITT analyses. However, IPW-PP-analyses, based on those 63% who had joined the offered SMS program, suggested modest improvements in weight development at 6 m, which had faded at 18 m. Future research should focus on developing gender-specific messaging programs including “booster” messages to obtain sustained engagement. Clinical Trial Registration ClinicalTrials.gov Identifier: NCT02809196 https://clinicaltrials.gov/study/NCT02809196.

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Section: Plos Medicinementioning

confidence: 99%

An SMS chatbot digital educational program to increase healthy eating behaviors in adolescence: A multifactorial randomized controlled trial among 7,890 participants in the Danish National Birth Cohort

Bjerregaard,

Zoughbie,

Hansen

et al. 2024

PLoS Med

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“…Previous studies also found that gender is a factor in weight-loss interventions. For example, one prospective cohort study found that while men and women can achieve weight loss following weight loss therapy, women are more likely to achieve better results [ 39 ]. This might be explained by the report by another study that men were discouraged from engaging with or continuously attending sessions due to gender imbalance and attitudes toward existing weight loss services [ 40 ].…”

Section: Reviewmentioning

confidence: 99%

Barriers and Motivators to Weight Loss in People With Obesity

Binsaeed,

Aljohani,

Alsobiai

et al. 2023

Cureus

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Introduction: Obesity has become a global public health challenge with associated health risks. Effective weight-loss interventions are crucial to mitigating these risks and improving overall well-being. However, individuals with obesity often encounter various barriers that hinder their weight loss efforts, while specific motivators can drive them towards successful outcomes. This systematic review aimed to explore the barriers and motivators to weight loss in people with obesity. Methods: A literature search was conducted using relevant keywords in electronic databases such as PubMed, Medline, PsycINFO, and Google Scholar. Studies published in peer-reviewed journals during the last 10 years were considered for inclusion. We included studies investigating both barriers and/or motivators to weight loss published in English. Results: The findings showed that motivators for weight loss include health concerns, body satisfaction, family support, normalcy restoration, emotional encouragement, self-determination, and mindful food choices. Motivators involve exercise facilities, balanced diets, and assistance from healthcare providers, peers, friends, or family. Gender influences healthcare providers’ influence on weight loss, with women trusting providers more while men lean towards medication options. Healthcare providers play a role in impacting weight loss through discussions and educating patients. Age also influences motivators; adolescents emphasize health, self-esteem, and bullying avoidance, while young women focus on lifestyle influence, resources, and joy. Barriers include insufficient self-control, physical pain, time constraints, dietary restrictions, and a lack of support. Logistical issues, patient readiness, healthcare providers' views, resource scarcity, and social dynamics are also barriers. Dietary barriers involve triggers, emotional states, and limited healthy options. School-aged children with obesity face curriculum challenges and resource scarcity. Conclusion: These findings show the intricate interplay between motivators and barriers, underscoring the multifaceted nature of weight loss in people with obesity. Targeted interventions that address these factors holistically are essential for successful weight management.

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Effect of Age and Gender on the Efficacy of a 12-Month Body Weight Reduction Program Conducted Online—A Prospective Cohort Study

Cited by 2 publications

References 23 publications

An SMS chatbot digital educational program to increase healthy eating behaviors in adolescence: A multifactorial randomized controlled trial among 7,890 participants in the Danish National Birth Cohort

An SMS chatbot digital educational program to increase healthy eating behaviors in adolescence: A multifactorial randomized controlled trial among 7,890 participants in the Danish National Birth Cohort

Barriers and Motivators to Weight Loss in People With Obesity

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