Learning more about weight loss maintenance – what works and what doesn’t work?
The best way to help people lose weight and keep it off is to develop programmes based on solid evidence of what works and what doesn’t work. At the moment, we don’t know enough about how people maintain their weight loss, or why they regain weight, to develop really effective programmes for weight loss maintenance (WLM). NoHoW researchers will tackle this problem, building the evidence base needed to put WLM research on a firm scientific footing, and to build and test the NoHoW Toolkit for WLM in the UK, Denmark and Portugal.
Weight loss survey
We will start by carrying out a survey to learn about patterns of weight loss, what people do to maintain their weight loss and where people most often need support in preventing weight regain. The survey will specifically target people who have previously lost weight. We will collect a wide range of information, including weight loss goals, motivation for weight loss, socioeconomic factors and demographic information. The survey will be carried out twice, at different times of the year, to see if the time of year has any effect. The results will be an important data resource for weight loss, obesity and related disciplines in Europe. It will help also us design the NoHoW Toolkit to be tested in our international study.
Strategies and predictors for WLM
Most of the WLM studies already carried out have looked at really specific groups of people in non-European countries. Not many people have looked at how to promote WLM for Europeans in general, so there is still a lot we can learn here. NoHoW researchers will start by carrying out in-depth interviews with people who have lost weight and are working to maintain their weight loss, looking at their physical activity profile,how they manage their food intake, and how they deal with stress and emotions in relation to their behaviours. Based on the results of these interviews, we will identify when support is needed and the type of support that will work best to help people make lasting changes to behaviours that impact on their weight. This information will also help us design the NoHoW Toolkit. We’ll also look at ways to make the Toolkit more interesting and easier to use.
Putting it all together – the NoHoW Toolkit for Weight Loss Maintenance
We’ll create the NoHoW Toolkit based on what we already know about theories, methods, and evidence-based techniques of health behavior change, and what we learn about WLM during the project. This includes how technology can be best used to successfully support behavior change and maintenance, which we will explore through a systematic review. The Toolkit will ultimately include a set of web-based tools, mobile apps, and inputs from other technologies, such as smart scales and activity trackers. We’ll also learn what our potential users would like to see included and how they would like to interact with the Toolkit.
Users will be able to access the Toolkit using portable devices (smartphones, tablets), as well as via the web on their computers. The Toolkit will use data input directly by users, as well as data collected from other sources, such as activity monitors, to build personally relevant user profiles. In addition, the Toolkit will be used to deliver information for the intervention, such as text messages and announcements.Once built, a pilot version of the Toolkit will be tested with users. User feedback and usage patterns will be used to improve the Toolkit and develop the final version (English, Portuguese and Danish) for use in the NoHoW study.
Does the Toolkit work?
Once we’ve put the NoHoW Toolkit together, we’ll test it to see how it works through an intervention research study carried out in the United Kingdom, Portugal and Denmark. We’ll recruit overweight/obese men and women who have lost ≥5% of their body weight in the last twelve months and assign them randomly to one of four groups.
Group 1 will be encouraged to self-monitor their weight through wireless scales, but have no access to the Toolkit. Group 4 will self-monitor their weight and have access to the full Toolkit. Groups 2 and 3 will self-monitor their weight and have access to versions of the Toolkit with only certain types of tools. We’ll learn about if and how the Toolkit works by comparing measurements from the different groups.
When the study starts, we will measure body weight, health markers (blood pressure, blood lipids, etc.), physical activity, motivation, emotional state, stress, well-being and quality of life, and dietary intake. We’ll take the same measurements again after 6 months and again after 18 months. We’ll also ask participants in Groups 2, 3 and 4 what they thought about the Toolkit so we can improve it in the future.
How will we manage and analyse the information we collect?
During the project, we’ll collect a lot of information in different locations across Europe. We’ll store all the information in one central and secure database, dedicated to the project. NoHoW researchers from across Europe will be able to access the information they need for their research. In addition, there will be a central statistical analysis to learn about common factors related to weight loss maintenance, as well as the cost effectiveness of the Toolkit. Participants in the NoHoW study will also have some of their data analysed centrally, and receive their individual results through the Toolkit to help them meet their WLM goals.
What will we do with our results?
We will share what we learn with a wide range of key audiences, including other researchers, health professionals and the general public. How we will communicate our results will be tailored to the audience but will include online channels (website, social media), print media (brochures, press releases, academic publications), representation at events (academic conferences, exhibitions, final NoHoW workshop conference), and interactions with related projects (workshops at key meetings). We will also interact with consumers and patients through the European Association for the Study of Obesity (EASO) Patient Council and with experts through the EASO Scientific Advisory Board and Task Forces.
What we learn about the Toolkit during the project will also be used to develop weight loss maintenance services. A business plan, including market research and branding, will be co-created by the NoHoW team and key health and policy stakeholders. We will also create international networks of communication and practice to promote a new generation of WLM services. Activities to establish the networks will include marketing, workshops, websites, sponsored symposia at international weigh loss and obesity conferences, and co-branding with key stakeholders, such as EASO, the World Obesity Forum and others. The aim will be to being the right people together to develop and share best practice for the prevention of weight gain and regain.