Daily weight monitoring as a method of weight gain prevention in healthy weight and overweight young adult women

Patient perceptions of three-dimensional (3D) surface imaging technology and traditional methods used to assess anthropometry

Background

Obesity and overweight are commonplace, yet attrition rates in weight management clinics are high. Traditional methods of body measurement may be a deterrent due to invasive and time-consuming measurements and negative experiences of how data are presented back to individuals. Emerging new technologies, such as three-dimensional (3D) surface imaging technology, might provide a suitable alternative. This study aimed to understand acceptability of traditional and 3D surface imaging-based body measures, and whether perceptions differ between population groups.

Methods

This study used a questionnaire to explore body image, body measurement and shape, followed by a qualitative semi-structured interview and first-hand experience of traditional and 3D surface imaging-based body measures.

Results

49 participants responded to the questionnaire and 26 participants attended for the body measurements and interview over a 2-month period. There were 3 main themes from the qualitative data 1) Use of technology, 2) Participant experience, expectations and perceptions and 3) Perceived benefits and uses.

Conclusion

From this study, 3D-surface imaging appeared to be acceptable to patients as a method for anthropometric measurements, which may reduce anxiety and improve attrition rates in some populations. Further work is required to understand the scalability, and the role and implications of these technologies in weight management practice. (University Research Ethics Committee reference number ER41719941).

Recruiting and retaining young adults: what can we learn from behavioural interventions targeting nutrition, physical activity and/or obesity? A systematic review of the literature

OBJECTIVE

To describe strategies used to recruit and retain young adults in nutrition, physical activity and/or obesity intervention studies, and quantify the success and efficiency of these strategies.

DESIGN

A systematic review was conducted. The search included six electronic databases to identify randomised controlled trials (RCT) published up to 6 December 2019 that evaluated nutrition, physical activity and/or obesity interventions in young adults (17-35 years). Recruitment was considered successful if the pre-determined sample size goal was met. Retention was considered acceptable if ≥80 % retained for ≤6-month follow-up or ≥70 % for >6-month follow-up.

RESULTS

From 21 582 manuscripts identified, 107 RCT were included. Universities were the most common recruitment setting used in eighty-four studies (79 %). Less than half (46 %) of the studies provided sufficient information to evaluate whether individual recruitment strategies met sample size goals, with 77 % successfully achieving recruitment targets. Reporting for retention was slightly better with 69 % of studies providing sufficient information to determine whether individual retention strategies achieved adequate retention rates. Of these, 65 % had adequate retention.

CONCLUSIONS

This review highlights poor reporting of recruitment and retention information across trials. Findings may not be applicable outside a university setting. Guidance on how to improve reporting practices to optimise recruitment and retention strategies within young adults could assist researchers in improving outcomes.

Which behaviour change techniques within interventions to prevent weight gain and/or initiate weight loss improve adiposity outcomes in young adults? A systematic review and meta-analysis of randomized controlled trials

Young adulthood is associated with the highest rate of weight gain compared with any other adult age group. This review evaluates the effectiveness of interventions with adiposity outcomes among young adults and identifies which behaviour change techniques (BCTs) are most effective. BCT utilization was assessed using Michie's 93-item BCT Taxonomy v1. Six electronic databases were searched for randomized controlled trials assessing change in adiposity in young adults (17-35 years) until December 2019; identifying 21,582 articles. Fifty-one studies were included. Meta-analyses for weight (n=19 studies), body mass index (BMI) (n=20 studies), and waist circumference (n=10 studies) demonstrated no significant between-group differences at ≤3 or >3 months. There were no differences between interventions focusing on weight loss or weight-gain prevention. Narrative synthesis showed significant between-group differences in weight change, favouring the intervention in 14/43 (33%) studies. In studies assessing BMI and waist circumference, this was 31% (11/36) and 25% (4/16). Two BCTs had a percentage effectiveness ratio >50% in weight loss interventions; social support (unspecified) and self-monitoring behaviour, and one in weight-gain prevention interventions; and goal-setting (outcome). Findings demonstrate initial potential for these types of BCTs and can help build cumulative evidence towards delivering effective, cost-efficient, and replicable interventions.

A brief behavioural intervention to promote regular self-weighing to prevent weight regain after weight loss: a RCT

Background

Although behavioural weight loss treatments can be effective, long-term maintenance of this weight loss remains a critical challenge because the vast majority of people will regain their lost weight over time. The period after initial weight loss is the time when people are at the highest risk of weight regain.

Objective

The primary aim of this study was to evaluate the effectiveness and cost-effectiveness of a brief behavioural intervention delivered by non-specialist call centre staff to promote regular self-weighing to prevent weight regain after intentional weight loss.

Design

Randomised controlled trial.

Setting

West Midlands, UK.

Participants

Adults were recruited if they had attended a local authority-funded weight management programme and had lost ≥ 5% of their starting weight by the end of their weight loss programme.

Interventions

The intervention group received three brief support telephone calls, delivered by non-specialist call centre staff (from a third-sector community organisation), that encouraged setting a weight maintenance target of ≤ 1 kg of weight gain from current weight, which was to be assessed by daily self-weighing and recording weight on a record card, together with regular text messages. Participants were asked to return to their weight loss plan if they gained > 1 kg above their target weight. The usual-care group received a standard weight maintenance leaflet, the infographic EatWell Plate and a list of useful websites pertaining to weight management.

Main outcome measures

The primary outcome was the difference between the groups in mean weight change (kg) from baseline to 12 months. The secondary outcomes included the proportion of participants in each group who had regained < 1 kg in weight at the 3- and 12-month follow-up points.

Results

A total of 813 potential participants were screened, 583 of whom were eligible and randomised (usual care,n = 292; intervention,n = 291). A total of 94% and 89% of participants completed follow-up at 3 and 12 months, respectively. At 12 months, the mean unadjusted weight change was +0.39 kg for the intervention group and –0.17 kg for the usual-care group, an adjusted difference of 0.53 kg [95% confidence interval (CI) –0.64 to 1.71 kg]. At 12 months, 134 (45.9%) and 130 (44.7%) participants regained ≤ 1 kg of their baseline weight in the usual-care and intervention groups, respectively (odds ratio 0.96, 95% CI 0.69 to 1.33). As the intervention was ineffective, we did not pursue a cost-effectiveness analysis.

Conclusions

Brief behavioural telephone support delivered by non-specialist workers to promote target-setting and daily self-weighing and recording of weight does not prevent weight regain after intentional weight loss. Specifically, as target-setting and daily self-weighing did not increase conscious cognitive restraint, people may need more intensive interventions to promote the use of behavioural techniques that help people maintain lost weight.

Trial registration

Current Controlled Trials ISRCTN52341938.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 7, No. 7. See the NIHR Journals Library website for further project information.

Eating pathology and psychological outcomes in young adults in self-regulation interventions using daily self-weighing

OBJECTIVE

Self-regulation interventions encouraging daily weighing prevent weight gain in young adults; however, concerns have been raised that such interventions may have undesirable effects on eating pathology, depression, and health-related quality of life (HRQL). The present study examined whether self-regulation interventions and self-weighing frequency were associated with these indices in normal weight individuals and those with overweight or obesity.

METHODS

Young adults (n = 599), 18-35 years with a body mass index (BMI) 21.0-30.9 kg/m² were randomized to control, self-regulation with small changes (SC) or self-regulation with large changes (LC). Interventions taught frequent self-weighing to guide behavioral changes. SC prescribed daily small decreases in intake and increases in physical activity. LC prescribed a 5- to 10-lb weight loss to buffer against anticipated gains. Psychological indices were assessed at baseline and periodically over 2 years of follow-up.

RESULTS

There was no evidence that the interventions increased depressive symptoms or compensatory behaviors or decreased HRQL relative to control. LC increased flexible and rigid control and SC decreased disinhibition. Results did not differ by weight status with the exception of rigid control; here, differences between LC and the other conditions were smaller among those with BMI ≥ 25. Greater self-weighing frequency over time was associated with increases in flexible and rigid control, dietary restraint, and improvements in HRQL.

CONCLUSIONS

The self-regulation interventions and increases in self-weighing had no untoward effects. Encouraging weight gain prevention in young adults through frequent weighing and self-regulation appears to be safe for normal weight young adults and those with overweight. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Daily self-weighing and weight gain prevention: a longitudinal study of college-aged women

Daily self-weighing has been suggested as an important factor for weight loss maintenance among samples with obesity. This study is a secondary analysis that examined daily self-weighing in association with weight and body composition outcomes over 2 years among young women with vulnerability for weight gain. Women (N = 294) of varying weight status completed self-weighing frequency questionnaires and weight was measured in the clinic at baseline, 6 months, 1, and 2 years; DXA scans were completed at baseline, 6 months and 2 years. Multilevel models examined the relationship between daily self-weighing (at any point in the study) and trajectories of BMI and body fat percentage. Daily self-weighing was associated with significant declines in BMI and body fat percent over time. Future research is needed to examine causal relations between daily self-weighing and weight gain prevention. Nonetheless, these data extend the possibility that daily self-weighing may be important for prevention of unwanted weight gain.

A mixed methods approach to improving recruitment and engagement of emerging adults in behavioural weight loss programs

Objective

Emerging adults ages 18–25 are at high risk for obesity, but are markedly underrepresented in behavioural weight loss (BWL) programs and experience lower engagement and retention relative to older adults.

Purpose

To utilize a mixed methods approach to inform future efforts to effectively recruit and engage this high‐risk population in BWL programs.

Methods

We used a convergent parallel design in which quantitative and qualitative data were given equal priority. Study 1 (N = 137, age = 21.8 + 2.2, BMI = 30.1 + 4.7) was a quantitative survey, conducted online to reduce known barriers and minimize bias. Study 2 (N = 7 groups, age = 22.3 + 2.2, BMI = 31.5 + 4.6) was a qualitative study, consisting of in person focus groups to gain greater depth and identify contextual factors unable to be captured in Study 1.

Results

Weight loss was of interest, but weight itself was not a central motivation; an emphasis on overall lifestyle, self‐improvement and fitness emerged as driving factors. Key barriers were time, motivation and money. Recruitment processes should be primarily online with messages tailored specifically to motivations and preferences of this age group. Preferences for a program were reduced intensity and brief, hybrid format with some in‐person contact, individual level coaching, experiential learning and peer support. Key methods of promoting engagement and retention were autonomy and choice, money and creating an optimal default.

Conclusions

An individually tailored lifestyle intervention that addresses a spectrum of health behaviours, promotes autonomy and emphasizes activity and fitness may facilitate recruitment and engagement in this population better than traditional BWL protocols.

What is the psychological impact of self-weighing? A meta-analysis

Many people self-weigh and many interventions addressing weight-related problems such as obesity promote self-weighing. However, while self-weighing has been associated with weight loss, there is mixed evidence regarding the psychological impact of this behaviour. The present review aimed to quantify the relationship between self-weighing and: (i) affect (e.g., anxiety, depression); (ii) psychological functioning (e.g., self-esteem); (iii) body-related attitudes and (iv) disordered eating. A computerized search of scientific databases in September 2014 and subsequent ancestry and citation searches identified 29 independent tests of the relationship between self-weighing on psychological outcomes. Meta-analysis was used to quantify the size of the association across the tests. Results indicated that there was no association between self-weighing and affect, body-related attitudes or disordered eating. There was, however, a small-sized negative association between self-weighing and psychological functioning. The age of participants, obesity status, the extent of weight loss, duration of self-weighing and study design (RCT versus correlational) were found to influence at least some of the psychological outcomes of self-weighing. The findings suggest that, for the most part, self-weighing is not associated with adverse psychological outcomes. However, in some cases the association between self-weighing and psychological outcomes may be more negative than in others.

Young Adults' Attitudes and Perceptions of Obesity and Weight Management: Implications for Treatment Development

Young adults are underrepresented in standard behavioral weight loss trials, and evidence suggests that they differ from older adults on many weight-related constructs. The aim of this review is to explore young adults' attitudes toward obesity and weight management, with particular attention to those factors that may play a role in the development of future treatment efforts. Both intrapersonal and interpersonal considerations unique to young adulthood are assessed; in addition, we examine young adults' perceptions of specific weight-related behaviors such as dieting, physical activity, and self-weighing. Conclusions are consistent with other findings suggesting that weight management interventions should be adapted and designed specifically for this age group.

Frequency of self-weighing and weight loss outcomes within a brief lifestyle intervention targeting emerging adults

Background

Frequent self‐weighing is associated with better weight loss and maintenance among adults. Emerging adults ages 18–25 rarely enroll in behavioural weight loss trials, and thus, little is known about their willingness to engage in frequent self‐weighing and its association with weight loss in this age group.

Purpose

The purpose of this study is to examine the frequency of self‐weighing among 18–25‐year‐old over the course of a brief lifestyle intervention and to determine the association between frequent self‐weighing and weight loss.

Methods

Emerging adults (EA) ages 18–25 [N = 52, 54% racial/ethnic minority, 79% female, BMI = 34.2 (5.4)] enrolled in a 3‐month lifestyle intervention with structure and content modified for EA. Benefits of frequent self‐weighing were presented; participants were encouraged to weigh themselves at least weekly and no more than daily. Assessments occurred at baseline and post‐treatment (3 months).

Results

At baseline, a majority of participants (63.5%) reported self‐weighing less than once a week. Frequency of self‐weighing increased over treatment (p < 0.001), with 42.9% weighing weekly and 38.2% weighing several times per week or more (i.e. frequent self‐weighing) at 3 months. Frequent self‐weighing was associated with greater weight loss (p = 0.03) and greater likelihood of achieving 5% weight loss (p = 0.01) at post‐treatment.

Conclusions

Frequent self‐weighing may be a viable approach to promoting self‐regulation during the high‐risk developmental period of emerging adulthood. Consistent with findings among other adult samples, frequent self‐weighing was associated with greater weight losses.