Supporting the transition from weight loss to maintenance: development and optimisation of a face-to-face behavioural intervention component

Abstract

After weight loss, most individuals regain lost weight. Interventions to support the transition from successful loss to weight loss maintenance (WLM), regardless of the method of prior weight loss, are needed. The aims of this study were to (1) develop a face-to-face behavioural intervention session to support overweight and obese individuals who have recently lost a clinically significant amount of weight in the transition to WLM; (2) to assess the single-session intervention for acceptability and feasibility prior to its use in a larger, 12-month, multi-component trial; and (3) to optimise the intervention session for future use based on participant feedback. Participants with a Body Mass Index of ≥25 kg/m2 prior to a ≥5% weight loss in the previous 12 months were recruited via the local government authority and community-based advertisements. Each attended the one-hour session with a trained facilitator, which focused on setting maintenance-relevant weight, eating, and physical activity goals. Semi-structured interviews were carried out immediately post-session to obtain feedback on the acceptability of this intervention component. Data were used to generate recommendations for changes to the session, which were discussed by the team, and used to optimise the session. Seventeen participants (13 female; median WL = 13%) were recruited. All participants evaluated the intervention session positively; 11 participants suggested improvements including reducing information provision in favour of greater focus on identifying and coping with barriers, and the inclusion of practical examples. The systematic refinement and optimisation process resulted in an acceptable and feasible face-to-face behavioural intervention session (described here), which will be tested as part of a multi-component intervention. We anticipate the session could be used to supplement existing support including online services, and has the potential to benefit people who have lost a clinically significant amount of weight to achieve WLM over the long term.

“I’m Still on Track”: A Qualitative Exploration of Participant Experiences of a Weight Loss Maintenance Program

“…Participants in our study did not however, describe feeling that they were to blame for, or disempowered by getting off track [28,29]. They claimed to know what they needed to do to get back on track which they attributed to lessons learned during the HWFL program and to the ongoing relapse prevention strategies [30,31] embedded into the LTMP. These findings indicate that for participants in our study, the program empowered them to keep on track with their weight management, despite setbacks.…”

Behavioural intervention for weight loss maintenance versus standard weight advice in adults with obesity: A randomised controlled trial in the UK (NULevel Trial)

“…Participants met a research team member (psychologist) once, for around an hour, to learn about the intervention and receive support to set and plan for behavioural goals (diet and physical activity), plan for relapse prevention, and to learn how to self-monitor their diet, physical activity, and weight in the transition from weight loss to WLM. The development of this consultation has been described elsewhere [26]. Participants were given a pedometer (Omron UK Ltd, Milton Keynes, UK) and prompted to record their progress towards physical activity goals (step counts) and dietary goals in a weekly diary on the study interface.…”

Attribution of weight regain to emotional reasons amongst European adults with overweight and obesity who regained weight following a weight loss attempt

“…Given that the purpose of the wider study primarily involved the comprehensive description of weight trajectories, strategies, and experiences of the target sample, for the most part, the use of validated questionnaires measuring psychological constructs was deemed unnecessary. Instead, novel items were designed based on previous work with individuals trying to maintain weight loss [ 28 , 29 ]. Survey respondents completed a purpose-designed online survey including demographic and anthropometric details, weight loss history (age of first weight loss attempt, number of lifetime attempts), a range of self-reported weight variables relevant to their most recent completed attempt (weight prior to previous attempt, lowest weight achieved, weight after regain), strategy use (dietary; e.g.…”