RESUMO
Background: For individuals who are eligible but unlikely to join comprehensive weight loss programs, a low burden self-weighing intervention may be a more acceptable approach to weight management. Methods: This was a single-arm feasibility trial of a 12-month self-weighing intervention. Participants were healthcare patients with a BMI ≥25 kg/m2 with a weight-related comorbidity or a BMI >30 kg/m2 who reported lack of interest in joining a comprehensive weight loss program, or did not enroll in a comprehensive program after being provided program information. In the self-weighing intervention, participants were asked to weigh themselves daily on a cellular connected scale and were sent text messages every other week with tailored weight change feedback, including messages encouraging use of comprehensive programs if weight gain occurred. Results: Of 86 eligible patients, 39 enrolled (45.3%) in the self-weighing intervention. Self-weighing occurred on average 4.6 days/week (SD = 1.4). At 12 months, 12 participants (30.8%) lost ≥3% baseline weight, 11 (28.2%) experienced weight stability (±3% baseline), 6 (15.4%) gained ≥3% of baseline weight, and 10 (25.6%) did not have available weight data to evaluate. Three participants reported joining a weight loss program during the intervention (7.7%). Participants reported high intervention satisfaction in quantitative ratings (4.1 of 5), and qualitative interviews identified areas of satisfaction (e.g., timing and content of text messages) and areas for improvement (e.g., increasing personalization of text messages). Conclusion: A low-burden self-weighing intervention can reach adults with overweight/obesity who would be unlikely to engage in comprehensive weight loss programs; the efficacy of this intervention for preventing weight gain should be further evaluated in a randomized trial.
RESUMO
Most adults with obesity do not enrol in comprehensive weight loss interventions when offered. For these individuals, lower burden self-weighing interventions may offer an acceptable alternative, though data is lacking on the potential for reach and representativeness of such interventions. Health system patients with BMI ≥30 kg/m2 (or 25-30 kg/m2 with an obesity comorbidity) completed a general health survey. During the survey, patients were given information about comprehensive weight loss interventions. If they denied interest or did not enrol in a comprehensive intervention, they were offered enrolment in a low-burden weight gain prevention intervention focused on daily self-weighing using a cellular network-connected in-home scale without any dietary or physical activity prescriptions. Enrolment in this program was documented. Among patients offered the self-weighing intervention (n = 85; 55.3% men; 58.8% White; BMI = 34.2 kg/m2), 44.2% enrolled. Compared to those who did not enrol, enrollers had higher educational attainment (57.1% vs. 42.9% with bachelor's degree p = .02), social anxiety (5.8 vs. 2.8, p < .001), and perceptions of the effectiveness of the self-weighing intervention (25.8 vs. 20.9 on 35, p = .007). The most highly endorsed reason for not enrolling in the self-weighing intervention was that it would make individuals overly focused on weight. A low-intensity weight gain prevention intervention may serve as a viable alternative to comprehensive weight loss interventions for the substantial portion of patients who are at risk for continued weight gain but would otherwise not enrol in a comprehensive intervention. Differential enrolment by education, however, suggests potential for inequitable uptake.
