Behavioral and Psychological Strategies of Long-Term Weight Loss Maintainers in a Widely Available Weight Management Program

Abstract

Objective: The study's purpose was to use validated questionnaires to identify novel behavioral and psychological strategies among weight loss maintainers (WLMs) in a commercial weight management program.

Methods: Participants were 4,786 WLMs in WW (formerly Weight Watchers, New York, New York) who had maintained weight loss ≥ 9.1 kg (24.7 kg/23.8% weight loss on average) for 3.3 years and had a current mean BMI of 27.6 kg/m² . A control group of 528 weight-stable individuals with obesity had a mean BMI of 38.9 kg/m² and weight change < 2.3 kg over the previous 5 years.

Results: WLMs versus Controls practiced more frequent healthy dietary choices (3.3 vs. 1.9; ${\eta }_p^2$ = 0.37), self-monitoring (2.6 vs. 0.7; ${\eta }_p^2$ = 0.30), and psychological coping (2.5 vs. 1.1; ${\eta }_p^2$ = 0.25) strategies. WLMs also reported more willingness to ignore food cravings (4.4 vs. 3.5; ${\eta }_p^2$ = 0.16) and had greater habit strength for healthy eating (5.3 vs. 3.2; ${\eta }_p^2$ = 0.21). Standard canonical coefficients indicated that dietary (0.52), self-monitoring (0.40), and psychological (0.14) strategies as well as habit strength for healthy eating (0.15) contributed independently and most (49.5% of variance) to discriminating groups.

Conclusions: In a widely available weight management program, more frequent practice of healthy dietary, self-monitoring, and psychological coping strategies as well as development of greater habit strength for healthy eating differentiated long-term WLMs from weight-stable individuals with obesity.