Obesity Facts (Apr 2021)

Evidence-Based Digital Tools for Weight Loss Maintenance: The NoHoW Project

  • R. James Stubbs,
  • Cristiana Duarte,
  • António L. Palmeira,
  • Falko F. Sniehotta,
  • Graham Horgan,
  • Sofus C. Larsen,
  • Marta M. Marques,
  • Elizabeth H. Evans,
  • Miikka Ermes,
  • Marja Harjumaa,
  • Jake Turicchi,
  • Ruari O’Driscoll,
  • Sarah E. Scott,
  • Beth Pearson,
  • Lauren Ramsey,
  • Elina Mattila,
  • Marcela Matos,
  • Paul Sacher,
  • Euan Woodward,
  • Marie-Louise Mikkelsen,
  • Kirby Sainsbury,
  • Inês Santos,
  • Jorge Encantado,
  • Carol Stalker,
  • Pedro J. Teixeira,
  • Berit Lilienthal Heitmann

DOI
https://doi.org/10.1159/000515663

Abstract

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Background: Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.g., provide choice). Stress management and emotion regulation techniques show potential for prevention of relapse and weight regain. Digital technologies (including networked-wireless tracking technologies, online tools and smartphone apps, multimedia resources, and internet-based support) offer attractive tools for teaching and supporting long-term behaviour change techniques. However, many digital offerings for weight management tend not to include evidence-based content and the evidence base is still limited. The Project: First, the project examined why, when, and how many European citizens make WL and WLM attempts and how successful they are. Second, the project employed the most up-to-date behavioural science research to develop a digital toolkit for WLM based on 2 key conditions, i.e., self-management (self-regulation and motivation) of behaviour and self-management of emotional responses for WLM. Then, the NoHoW trial tested the efficacy of this digital toolkit in adults who achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25). The primary outcome was change in weight (kg) at 12 months from baseline. Secondary outcomes included biological, psychological, and behavioural moderators and mediators of long-term energy balance (EB) behaviours, and user experience, acceptability, and cost-effectiveness. Impact: The project will directly feed results from studies on European consumer behaviour, design and evaluation of digital toolkits self-management of EB behaviours into development of new products and services for WLM and digital health. The project has developed a framework and digital architecture for interventions in the context of EB tracking and will generate results that will help inform the next generation of personalised interventions for effective self-management of weight and health.

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