In Their Own Words: Topic Analysis of the Motivations and Strategies of over 6,000 Long-term Weight-loss Maintainers

Overview

Journal Obesity (Silver Spring)

Specialties Endocrinology
Nutritional Sciences
Physiology

Date 2022 Feb 9

PMID 35137557

Authors

Suzanne Phelan

James Roake

Noemi Alarcon

Sarah M Ng

Hunter Glanz

Michelle I Cardel

Gary D Foster

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to identify major themes of a large cohort experiencing long-term weight-loss maintenance who answered open-ended questions about weight-loss triggers, current motivations, strategies, and experiences.

Methods: Machine learning and topic modeling were used to analyze responses to six open-ended questions among 6,139 WW International, Inc., (formerly Weight Watchers) members with weight-loss maintenance; inclusion criteria included ≥9.1-kg loss with weight-loss maintenance for ≥1 year.

Results: Participants (mean age = 53.6 years; 94.3% White; mean BMI = 27.8 kg/m ) had lost 24.5 kg and maintained the loss for 3.4 years. Descriptions of factors triggering weight loss coalesced into five topics: medical status, appearance, mobility, social prompts, and change needed. Factors currently motivating weight-loss maintenance yielded two topics: looking back at experiences at higher weight and health/appearance concerns. Advice for others to succeed in weight-loss maintenance coalesced on two recommendations: perseverance in the face of setbacks and consistency in tracking. Rewards for weight management included improved confidence, pain, mobility, fitness, body image, medical status, and affect. Two thematic negative consequences were clothing costs and sagging skin.

Conclusions: Future weight-maintenance research should include more diverse populations and investigate weight-loss maintenance as a journey with highs and lows, perseverance in the face of setbacks, sustained tracking, and making changes in medical status more salient during the weight-maintenance journey.

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References

Wing R, Phelan S . Long-term weight loss maintenance. Am J Clin Nutr. 2005; 82(1 Suppl):222S-225S. DOI: 10.1093/ajcn/82.1.222S. View

Greaves C, Poltawski L, Garside R, Briscoe S . Understanding the challenge of weight loss maintenance: a systematic review and synthesis of qualitative research on weight loss maintenance. Health Psychol Rev. 2017; 11(2):145-163. DOI: 10.1080/17437199.2017.1299583. View

LaRose J, Leahey T, Hill J, Wing R . Differences in motivations and weight loss behaviors in young adults and older adults in the National Weight Control Registry. Obesity (Silver Spring). 2013; 21(3):449-53. PMC: 3630273. DOI: 10.1002/oby.20053. View

Weiss E, Galuska D, Khan L, Gillespie C, Serdula M . Weight regain in U.S. adults who experienced substantial weight loss, 1999-2002. Am J Prev Med. 2007; 33(1):34-40. DOI: 10.1016/j.amepre.2007.02.040. View

Frederick D, Saguy A, Sandhu G, Mann T . Effects of competing news media frames of weight on antifat stigma, beliefs about weight and support for obesity-related public policies. Int J Obes (Lond). 2015; 40(3):543-9. DOI: 10.1038/ijo.2015.195. View

Gudzune K, Doshi R, Mehta A, Chaudhry Z, Jacobs D, Vakil R . Efficacy of commercial weight-loss programs: an updated systematic review. Ann Intern Med. 2015; 162(7):501-12. PMC: 4446719. DOI: 10.7326/M14-2238. View

Klem M, Wing R, McGuire M, Seagle H, Hill J . A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr. 1997; 66(2):239-46. DOI: 10.1093/ajcn/66.2.239. View

Wing R, Tate D, Gorin A, Raynor H, Fava J . A self-regulation program for maintenance of weight loss. N Engl J Med. 2006; 355(15):1563-71. DOI: 10.1056/NEJMoa061883. View

Jolly K, Lewis A, Beach J, Denley J, Adab P, Deeks J . Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten Up randomised controlled trial. BMJ. 2011; 343:d6500. PMC: 3208022. DOI: 10.1136/bmj.d6500. View

10.

Ahern A, Wheeler G, Aveyard P, Boyland E, Halford J, Mander A . Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial. Lancet. 2017; 389(10085):2214-2225. PMC: 5459752. DOI: 10.1016/S0140-6736(17)30647-5. View

11.

McGuire M, Wing R, Klem M, Lang W, Hill J . What predicts weight regain in a group of successful weight losers? . J Consult Clin Psychol. 1999; 67(2):177-85. DOI: 10.1037//0022-006x.67.2.177. View

12.

Field A, Wing R, Manson J, Spiegelman D, Willett W . Relationship of a large weight loss to long-term weight change among young and middle-aged US women. Int J Obes Relat Metab Disord. 2001; 25(8):1113-21. DOI: 10.1038/sj.ijo.0801643. View

13.

Teixeira P, Carraca E, Marques M, Rutter H, Oppert J, De Bourdeaudhuij I . Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators. BMC Med. 2015; 13:84. PMC: 4408562. DOI: 10.1186/s12916-015-0323-6. View

14.

Tate D, Jeffery R, Sherwood N, Wing R . Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain?. Am J Clin Nutr. 2007; 85(4):954-9. DOI: 10.1093/ajcn/85.4.954. View

15.

Borgatti A, Tang Z, Tan F, Salvy S, Dutton G . Predicting program attendance and weight loss in obesity interventions: Do triggering events help?. J Health Psychol. 2019; 26(11):2056-2061. PMC: 8074571. DOI: 10.1177/1359105319887800. View

16.

Puhl R, Suh Y, Li X . Legislating for weight-based equality: national trends in public support for laws to prohibit weight discrimination. Int J Obes (Lond). 2016; 40(8):1320-4. DOI: 10.1038/ijo.2016.49. View

17.

Santos I, Vieira P, Silva M, Sardinha L, Teixeira P . Weight control behaviors of highly successful weight loss maintainers: the Portuguese Weight Control Registry. J Behav Med. 2016; 40(2):366-371. DOI: 10.1007/s10865-016-9786-y. View

18.

Gorin A, Raynor H, Fava J, Maguire K, Robichaud E, Trautvetter J . Randomized controlled trial of a comprehensive home environment-focused weight-loss program for adults. Health Psychol. 2012; 32(2):128-37. PMC: 3393797. DOI: 10.1037/a0026959. View

19.

Pascual R, Phelan S, La Frano M, Pilolla K, Griffiths Z, Foster G . Diet Quality and Micronutrient Intake among Long-Term Weight Loss Maintainers. Nutrients. 2019; 11(12). PMC: 6950482. DOI: 10.3390/nu11123046. View

20.

Vo L, Albrecht S, Kershaw K . Multilevel interventions to prevent and reduce obesity. Curr Opin Endocr Metab Res. 2019; 4:62-69. PMC: 6752740. DOI: 10.1016/j.coemr.2018.11.002. View