Factors associated with early non‐response within an Internet‐based behavioural weight loss program

Abstract

Summary Objective While behavioural weight loss interventions are effective overall, many individuals fail to achieve a clinically significant weight loss. Given that 4‐week weight loss has been shown to predict longer term outcomes, one potential strategy for improving rates of success is to provide additional support to early non‐responders. To inform these early rescue efforts, it is important to first identify how they may differ from their more successful peers. Methods At week 4 of a 12‐week Internet‐delivered weight loss program, 130 adults (age: 49.8 ± 9.8 years, body mass index: 31.2 ± 4.6 kg m −2 ) were asked to complete an 11‐item survey assessing mood and weight‐related cognitions and behaviours. Participants were then categorized as early non‐responders (4‐week weight loss <2%) or initial responders (4‐week weight loss ≥2%), and groups were compared on intervention adherence during weeks 1–4 and week 4 survey question responses. Results Early non‐responders and initial responders did not differ on any intervention adherence variables ( p s > 0.05). Compared to initial responders, early non‐responders reported less positive mood ( p = 0.011), greater boredom with weight loss efforts ( p = 0.036), greater temptation to eat foods not consistent with their goals ( p = 0.023), and that their eating choices were less consistent with their goals ( p < 0.001). Conclusions These findings identify important differences between early non‐responders and initial responders, offering potential intervention targets for rescuing early non‐responders (i.e. making it easier for individuals to choose healthier foods, reducing boredom in Internet‐delivered weight loss programs and providing strategies to limit exposure to dietary temptations).

Describing Transitions in Adherence to Physical Activity Self-monitoring and Goal Attainment in an Online Behavioral Weight Loss Program: Secondary Analysis of a Randomized Controlled Trial

“…Intriguingly, the likelihood of long-term adherence increased 2-fold if a participant remained adherent through the graded goal phase. Our findings substantiate previous studies that demonstrate that the first 2 months of program initiation serve as a critical juncture associated with better long-term program adherence, weight loss, and health-related outcomes [ 16 , 27 - 30 ]. From a theoretical perspective, successful adoption of PA recommendations may be attributed to an increase in self-efficacy and mastery experiences during program initiation from frequent, intentional exposure to self-monitoring and goal attainment [ 31 - 33 ].…”

The Behavioral Intervention with Technology for E-Weight Loss Study (BITES): Incorporating Energy Balance Models and the Bite Counter into an Online Behavioral Weight Loss Program

“…It is important to note that there is insufficient statistical power to justify inferential statistics to compare these differences, so larger sample sizes should be a priority in future studies. On average, participants completed approximately 60% of the online lessons, which is similar to previous studies ( Unick et al 2019 ). Previous studies using this online system have set a benchmark of at least 7 of 12 lessons completed to be considered good adherence ( Wing et al 2010 ), which was the average lesson completion rate in this study across groups.…”

Detailed Versus Simplified Dietary Self-monitoring in a Digital Weight Loss Intervention Among Racial and Ethnic Minority Adults: Fully Remote, Randomized Pilot Study

“…Weight change from baseline to 1 and 3 months was assessed separately for each treatment arm. We also examined the proportion of participants who achieved clinically significant weight loss of ≥3% or ≥5% from baseline by 3 months [ 2 , 79 ], as well as the proportion of participants who achieved ≥2% weight loss by 1 month, which has been considered an indicator of early success in past research [ 80 - 82 ].…”