Psychosocial Characteristics by Weight Loss and Engagement in a Digital Intervention Supporting Self-Management of Weight

Abstract

There is substantial variability in weight loss outcomes. Psychosocial characteristics underlying outcomes require better understanding, particularly on self-managed digital programs. This cross-sectional study examines differences in psychosocial characteristics by weight loss and engagement outcome, and which characteristics are most associated with weight loss, on a self-managed digital weight loss program. Some underexplored psychosocial characteristics are included, such as flourishing, or a sense of meaning and purpose in life. A questionnaire was emailed to a random sample of 10,000 current users at week 5 in the program and 10,000 current users at week 17. The questionnaire was completed by 2225 users, and their self-reported weight and recorded program engagement data were extracted from the program’s database. Multiple comparison tests indicated that mental health quality of life, depression, anxiety, work-life balance, and flourishing differed by weight loss outcome at program end (week 17; ≥5%, 2–5%, below 2%) and by engagement tertile at program beginning and end (weeks 5 and 17). Only anxiety was associated with weight loss in a backward stepwise regression controlling for engagement and sociodemographic characteristics. Flourishing did not predict weight loss overall but predicted the weight loss outcome group. Our findings have implications for creating more effective interventions for individuals based on psychosocial characteristics and highlight the potential importance of anxiety in underexplored self-managed digital programs.

The Relationship Between Weight Loss Outcomes and Engagement in a Mobile Behavioral Change Intervention: Retrospective Analysis

“…It is possible that the factors driving individuals to successfully achieve certain levels of weight loss influence their engagement as well. We previously demonstrated that 5% or more weight loss on Noom was associated with psychosocial characteristics such as mental health quality of life and perceived work-life balance [ 33 ], and a systematic review reported that weight loss is associated with the expectations individuals have for their weight loss [ 14 ]. Future research should separate out the individual components involved in losing certain amounts of weight loss and investigate how each relates to engagement.…”

Self-Reported Nutritional Factors Are Associated with Weight Loss at 18 Months in a Self-Managed Commercial Program with Food Categorization System: Observational Study

“…However, there could be other variables that we did not capture, such as socioeconomic factors, that may be associated with 18-month weight loss. In a previous study, socioeconomic factors such as income and education did not emerge in a stepwise regression as important factors associated with weight loss at 4 months on Noom [6]. However, one study found that socioeconomic factors are associated with maintenance of long-term weight loss [70].…”

“…Body weight loss of 5-10% can reduce the risk of these conditions [4]. It is estimated that many individuals use commercial programs, but there is little knowledge on how dietary quality or nutrition knowledge is impacted via these programs [5,6]. Most studies on nutritional factors in weight loss have taken place in non-commercial settings, such as clinical trials or free-living settings [7][8][9][10][11][12][13][14].…”

Men’s Weight Loss Outcomes, Behaviors, and Perceptions in a Self-Directed Commercial Mobile Program: Retrospective Analysis

“…It is important to note that men are not a homogeneous group; their constructions of masculinity are shaped by a variety of sociodemographic factors, which create and reflect disparities in outcomes (Bridges & Pascoe, 2014; Galdas, 2009; Thorpe et al, 2015). However, we focus here on hegemonic masculinity given that it likely influences the Western, middle-aged users on this type of program (Evans et al, 2011; Mitchell et al, 2021). It is unclear what men would find most effective in a self-directed commercial program.…”