In Their Own Words: Topic Analysis of the Motivations and Strategies of Over 6,000 Long-Term Weight-Loss Maintainers
Open accessAbstract
OBJECTIVE: This study aimed to identify major themes of a large cohort experiencing long-term weight-loss maintenance who answered open-ended questions about weight-loss triggers, current motivations, strategies, and experiences. METHODS: Machine learning and topic modeling were used to analyze responses to six open-ended questions among 6,139 WW International, Inc., (formerly Weight Watchers) members with weight-loss maintenance; inclusion criteria included ≥9.1-kg loss with weight-loss maintenance for ≥1 year. RESULTS: ) had lost 24.5 kg and maintained the loss for 3.4 years. Descriptions of factors triggering weight loss coalesced into five topics: medical status, appearance, mobility, social prompts, and change needed. Factors currently motivating weight-loss maintenance yielded two topics: looking back at experiences at higher weight and health/appearance concerns. Advice for others to succeed in weight-loss maintenance coalesced on two recommendations: perseverance in the face of setbacks and consistency in tracking. Rewards for weight management included improved confidence, pain, mobility, fitness, body image, medical status, and affect. Two thematic negative consequences were clothing costs and sagging skin. CONCLUSIONS: Future weight-maintenance research should include more diverse populations and investigate weight-loss maintenance as a journey with highs and lows, perseverance in the face of setbacks, sustained tracking, and making changes in medical status more salient during the weight-maintenance journey.
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Weight loss maintainers found achieving improvements in their physical health (e.g., remission of diabetes, lower blood pressure, fewer medications, reduced pain with increased physical activity) as deeply rewarding.
“Furthermore, weight loss maintainers found achieving improvements in their physical health like the remission of diabetes, lower blood pressure, taking fewer medications, and reduced pain with increased physical activity level as deeply rewarding.”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [89]
The Results section on consequences of weight-loss maintenance (page not provided) reports that maintainers described less pain during exercise and daily activities, an active lifestyle, and improvements in blood pressure and diabetes. It does not establish diabetes remission, taking fewer medications, or that maintainers described these changes as deeply rewarding. (LLM, conf=0.84)
Experimental — accuracy not yet measuredWeight loss maintainers indicated achieving weight loss inspired increased self-confidence for pursuing personal goals and taking on new challenges that were meaningful and consistent with their personal values.
“They also indicated achieving weight loss inspired increased self-confidence for pursuing personal goals and taking on new challenges (e.g., seeking a promotion at work) that were meaningful and consistent with their personal values.”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [89]
In Results > Consequences of weight-loss maintenance, Table 6 quotes a maintainer who gained confidence to take on new challenges, including academic or professional goals, after weight loss. The paper does not say those goals were consistent with participants’ personal values or specifically mention seeking a promotion. No page number is available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredWeight loss maintainers regained focus quickly-the next day when possible-by restarting self-monitoring behaviors.
“Moreover, rather than being self-critical, weight loss maintainers regained focus quickly—the next day when possible—by restarting self-monitoring behaviors.”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [89]
The Discussion says maintainers recommended restarting after setbacks the next day or as soon as possible, and separately identifies tracking as a major theme. It does not specifically say they restarted self-monitoring behaviors after setbacks or establish the contrast with being self-critical. No page numbers are available in our copy. (LLM, conf=0.83)
Experimental — accuracy not yet measuredWeight loss maintainers describe having unpleasant memories about how it was to live with obesity.
“Weight loss maintainers describe having unpleasant memories about how it was to live with obesity, and these memories can be targeted for high-quality motivation for sustaining behavior change (89).”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [89]
These negative preweight loss memories were primarily concerned with declining physical health as well as shame and embarrassment about body size and shape.
“These negative preweight loss memories were primarily concerned with declining physical health as well as shame and embarrassment about body size and shape.”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [89]
Weight loss maintainers commonly suggested that having "perseverance" with behavioral effort and viewing loss of focus as a temporary setback rather than total defeat was beneficial.
“Specifically, weight loss maintainers commonly suggested that having “perseverance” with behavioral effort and viewing loss of focus as a temporary setback rather than total defeat was beneficial (89).”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [89]
Weight loss maintainers accept that tracking food intake is a necessary part of lifestyle change and is critically important for long-term weight loss maintenance.
“Unequivocally, weight loss maintainers accept that tracking food intake is a necessary part of lifestyle change and is critically important for long-term weight loss maintenance.”
From Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery (2022) · cites this paper as [89]
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Cited by
Sorted by citations
Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery
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- Authors
- Phelan, S., Roake, J., Alarcon, N., Ng, S. M., Glanz, H., Cardel, M. I., & Foster, G. D.
- Affiliations
- California Polytechnic State University (US)
- University of Florida Health (US)
- WW International, Inc. (United States) (US)
- Corresponding author
- Phelan, Suzanne
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2022-02-09
- Volume
- 30
- Issue
- 3
- Pages
- 751-761
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC9305441
- OpenAlex
- W4210830927
- Cited by
- 16
- References
- 35
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 4
- FWCI
- 2.96
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Obesity (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- WW International
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- weight loss maintenance, weight loss motivation, weight loss methods, Weight Watchers, body image, weight monitoring, clothing costs, medical status, mobility (physical function)
- MeSH terms
- Humans, Middle Aged, Motivation, Obesity, Weight Loss, Exercise, Overweight
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