The COVID-19 pandemic and its impact on participation in an online behavioural weight loss programme: A Qualitative Exploration

ABSTRACT

Introduction: Behavioural weight loss programmes have been shown to be efficacious in improving health and weight outcomes in adults living with obesity. The restrictions and changes imposed on the public due to COVID-19 resulted in a novel experience and environment for weight loss. The aim of this study was to assess the perceived impact of the COVID-19 pandemic on participation and the weight loss journey. Methods: Semi-structured interviews were conducted with 47 participants. Participants were predominantly female (83%) with a mean age of 48.9 (26-74) years and a mean BMI of 31.7 (24.2-44.4). Participants were recruited from a 12-week online behavioural weight loss programme. Interviews were conducted mid-way through the programme in November and December 2020. The interviews asked participants about their experience so far in the weight loss programme and the role that COVID-19 had played in their experience. Specifically, participants were asked about obesity as a risk factor for poorer COVID-19 outcomes and the impact the pandemic has had on their social life, environment, and weight. Interviews were transcribed and analysed in NVivo using a thematic approach. Results: The interviews revealed that COVID-19 played a role in participants weight loss journeys before and during the programme. COVID-19 played a role in weight gain, motivation, self-efficacy, and unhealthy temptations. Many attributed the “lockdown” restrictions earlier in the year to their weight gain or initial motivation to setting a goal of losing weight. Perceived risk of living with obesity or overweight was a motivator for change. Participants identified changes to the home, work, and social environments as facilitators and barriers to the lifestyle changes, they were trying to make. Particularly, participants reported having more ownership of their surroundings by being at home more but less social support. Conclusion: COVID-19 and the restrictions imposed had an impact on participant experiences in an online behavioural weight loss programme. The impact of the restrictions and knowledge of the virus itself served to promote motivation and self-efficacy. The findings provide novel insight into participant experience in a behavioural weight loss programme during a pandemic. Additionally, the study explores the experience of an often neglected population in obesity research-those living with lower levels of overweight and obesity. Such insights may be able to provide suggestions on how to improve online programmes which can be accessed by those who are unable to attend in-person programmes.