How Do Emotions during Goal Pursuit in Weight Change over Time? Retrospective Computational Text Analysis of Goal Setting and Striving Conversations with a Coach during a Mobile Weight Loss Program

Predictive capacity of COVID-19-related risk beliefs on weight management behaviors on a commercial weight loss program and speed of COVID-19 vaccination uptake: prospective cohort study

BACKGROUND

Recent work has shown that obesity may be a risk factor for severe COVID-19. However, it is unclear to what extent individuals have heard or believe this risk factor information, and how these beliefs may predict their preventive behaviors (e.g., weight management behaviors or COVID-19 preventive behaviors). Previous work has primarily looked at overall risk likelihood perceptions (i.e., not about obesity as a risk factor) within general populations of varying weight and concentrated on COVID-19-related preventive behaviors. Therefore, this prospective cohort study explored whether beliefs about obesity as a risk factor and overall risk likelihood perceptions predicted weight management and COVID-19 preventive behaviors over the next 16 weeks in individuals with obesity or overweight.

METHODS

Participants were 393 individuals in the US who joined a commercial weight management program in January, 2021. We leveraged the mobile program's automatic measurement of real-time engagement in weight management behaviors (e.g., steps taken), while surveys measured risk beliefs at baseline as well as when individuals received COVID-19 vaccination doses (asked monthly) over the next 16 weeks. Mixed effects models predicted engagement and weight loss each week for 16 weeks, while ordinal logistic regression models predicted the month that individuals got vaccinated against COVID-19.

RESULTS

We found that belief in obesity as a risk factor at baseline significantly predicted greater engagement (e.g., steps taken, foods logged) in program-measured weight management behaviors over the next 16 weeks in models adjusted for baseline BMI, age, gender, and local vaccination rates (minimally adjusted) and in models additionally adjusted for demographic factors. Belief in obesity as a risk factor at baseline also significantly predicted speed of COVID-19 vaccination uptake in minimally adjusted models but not when demographic factors were taken into account. Exposure to obesity risk factor information at baseline predicted greater engagement over 16 weeks in minimally adjusted models.

CONCLUSIONS

The results highlight the potential utility of effective education to increase individuals' belief in obesity risk factor information and ultimately promote engagement or faster vaccination. Future research should investigate to what extent the results generalize to other populations.

Goal language is associated with attrition and weight loss on a digital program: Observational study

Behavioral weight loss reduces risk of weight-related health complications. Outcomes of behavioral weight loss programs include attrition and weight loss. There is reason to believe that individuals' written language on a weight management program may be associated with outcomes. Exploring associations between written language and these outcomes could potentially inform future efforts towards real-time automated identification of moments or individuals at high risk of suboptimal outcomes. Thus, in the first study of its kind, we explored whether individuals' written language in actual use of a program (i.e., outside of a controlled trial) is associated with attrition and weight loss. We examined two types of language: goal setting (i.e., language used in setting a goal at the start of the program) and goal striving (i.e., language used in conversations with a coach about the process of striving for goals) and whether they are associated with attrition and weight loss on a mobile weight management program. We used the most established automated text analysis program, Linguistic Inquiry Word Count (LIWC), to retrospectively analyze transcripts extracted from the program database. The strongest effects emerged for goal striving language. In striving for goals, psychologically distanced language was associated with more weight loss and less attrition, while psychologically immediate language was associated with less weight loss and higher attrition. Our results highlight the potential importance of distanced and immediate language in understanding outcomes like attrition and weight loss. These results, generated from real-world language, attrition, and weight loss (i.e., from individuals' natural usage of the program), have important implications for how future work can better understand outcomes, especially in real-world settings.