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Cited by 25Mobile Health and mHealth ApplicationsObesity, Physical Activity, DietPharmacology and Obesity Treatment

Levels of adherence needed to achieve significant weight loss

Johnston, Craig A., Moreno, Jennette P., Hernandez, Daphne C., Link, Brittany A., Chen, Tzu-An, Wojtanowski, Alexis C., Foster, Gary D., Foreyt, John P.·2019·International Journal of Obesity
DOI 10.1038/s41366-018-0226-7
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Abstract

Background/objectives Positive associations have been found between adherence and weight loss in behavioral weight-management interventions. However, less attention has been given to the level of adherence needed to reach clinically significant weight loss. This study examined the levels of adherence associated with a ≥ 5% - < 10% or ≥ 10% weight loss in a community-based, intensive behavioral weight management program, Weight Watchers® (WW), which included three modes of access: (1) 24-weekly WW meetings over 6 months, (2) the WW member website, and (3) the WW mobile application.Methods A total of 292 participants were randomized to a WW (n = 147) or a self-help (SH) (n = 145) condition. To assess the impact of adherence, only participants in the WW condition were included in analyses (n = 147). Adherence was defined as use of the three modes of access. Measured heights and weights were obtained at baseline and 6 months. Receiver-operating characteristic curve analyses were conducted to determine the minimal level of adherence associated with clinically significant weight loss.Results In a 6-month period, increased likelihood of achieving a weight loss ≥ 5% - < 10% was associated with attending approximately one-third (35.4%) of weekly meetings, use of the member website about 25% of days, and use of the mobile application 16.1% of days. Attendance at approximately two-thirds (64.5%) of meetings, use of the member website 41.6% of days, and use of the mobile application 14.7% of days were associated with a clinically significant weight loss of ≥ 10%. Meeting attendance was the strongest predictor of weight loss at 6 months.Conclusions Although adherence to a behavioral weight management program was an important predictor of weight loss, extremely high levels were not needed to achieve clinically significant weight loss. These results are important to help patients and treatment providers understand realistic goals for weight management.

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Crossref · 10.1038/s41366-018-0226-7

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Authors
Johnston, C. A., Moreno, J. P., Hernandez, D. C., Link, B. A., Chen, T.-A., Wojtanowski, A. C., Foster, G. D., & Foreyt, J. P.
Affiliations
  • University of Houston (US)
  • Baylor College of Medicine (US)
  • WW International, Inc. (United States) (US)
Corresponding author
Johnston, Craig A.
ORCID
Venue
International Journal of Obesity
Publisher
Springer Science and Business Media LLC
Published
2018-10-09
Volume
43
Issue
1
Pages
125-131
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
DOI
10.1038/s41366-018-0226-7
OpenAlex
W2896238740
Cited by
25
References
37
Citations by year
2026: 3 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 2 · 2021: 5 · 2020: 3
FWCI
3.05
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • International Journal of Obesity (publishedVersion)
  • PubMed (publishedVersion)
Funders
WW International
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
Keywords
medication adherence, weight loss, behavioral weight management, Weight Watchers, meeting attendance, mobile application use, self-help, obesity treatment
MeSH terms
Adult, Aged, Behavior Therapy, Humans, Middle Aged, Obesity, Patient Compliance, ROC Curve, Self Care, Weight Loss, Health Behavior, Weight Reduction Programs, Mobile Applications

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