Uncovering Barriers and Facilitators of Weight Loss and Weight Loss Maintenance: Insights from Qualitative Research

Abstract

Long-term weight loss maintenance is often difficult to achieve. This review analysed qualitative data on self-perceived barriers and facilitators of weight loss and weight loss maintenance among weight loss intervention participants. A literature search was conducted using electronic databases. Qualitative studies written in English and published between 2011–2021 were eligible for inclusion if they explored the perspectives and experiences of individuals who received standardised dietary and behavioural support for weight loss. Studies were excluded if weight loss was achieved through self-directed methods, only increasing physical activity, or surgical or pharmacological interventions. Fourteen studies were included, totaling 501 participants from six countries. Thematic analysis was used to identify four aggregate themes: internal factors (i.e., motivation and self-efficacy), programme-specific factors (i.e., the intervention diet), social factors (i.e., supporters and saboteurs), and environmental factors (i.e., an obesogenic environment). Our findings demonstrate that internal, social, and environmental factors all influence weight loss success, as well as the acceptability of the weight loss intervention. Future interventions may be more successful if they prioritise participant acceptability and engagement by, for example, providing tailored interventions, a structured relapse management plan, strategies to enhance autonomous motivation and emotional self-regulation, and extended contact during weight loss maintenance.

Can Digital Technologies Be Useful for Weight Loss in Individuals with Overweight or Obesity? A Systematic Review

“…However, some considerations are needed in this regard. In general, internal (i.e., motivation and self-efficacy), social (i.e., supporters and saboteurs) and environmental (i.e., an obesogenic environment) factors have been shown to influence the outcomes of a weight loss program, as well as the acceptability of the intervention [ 81 ]. Considering the barriers to exercise and PA that people with overweight or obesity may encounter, digital solutions have the potential to provide convenient and equitable support in weight loss based on behavior change [ 70 ].…”

Practical strategies to manage obesity in type 2 diabetes

“…137 Preventing weight regain after a successful weight-loss intervention is one of the greatest challenges in weight management, as it often marks a transition from clearly defined behavioural rules and professional supervision to independent meal and exercise planning, which can be overwhelming for an individual. 138 In addition, the neurometabolic circuits that regulate appetite may still be imbalanced. 139 Therefore, it is crucial to support people at this stage with continued monitoring and care, through either face-to-face or virtual contacts.…”

“…Support from family and friends and from other participants in weight-loss interventions can have a significant impact on weight outcomes. 138 It may also be worthwhile to prescribe commercial weight-loss programmes with peer-reviewed efficacy and safety. 136,145 Although currently based on a few short-term trials, there is also evidence for improved efficacy of weight loss by means of eHealth weight management interventions, including web-, smartphone-or telephone-based support for people with overweight or obesity.…”

“…Nevertheless, it is crucial to provide continuous support to individuals not only during initial weight‐loss interventions but also during the weight‐loss maintenance phase 137 . Preventing weight regain after a successful weight‐loss intervention is one of the greatest challenges in weight management, as it often marks a transition from clearly defined behavioural rules and professional supervision to independent meal and exercise planning, which can be overwhelming for an individual 138 . In addition, the neurometabolic circuits that regulate appetite may still be imbalanced 139 .…”

“…In addition, community resources and digital health tools can also support people with obesity and/or T2D in a weight‐loss or weight‐loss maintenance programme to overcome barriers such as distance, time and costs. Support from family and friends and from other participants in weight‐loss interventions can have a significant impact on weight outcomes 138 . It may also be worthwhile to prescribe commercial weight‐loss programmes with peer‐reviewed efficacy and safety 136,145 .…”