In their own words: Topic analysis of the motivations and strategies of over 6,000 long-term weight-loss maintainers.

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: Participants (mean age = 53.6 years; 94.3% White; mean BMI = 27.8 kg/m2 ) 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.

Factors associated with food choice among long-term weight loss maintainers.

BACKGROUND: The present study aimed to examine motivations for food choice among long-term weight loss maintainers (WLM) in a widely used commercial weight management program. METHODS: A cross-sectional study was employed where determinants of food choice were measured in the USA using validated scales: Food Choice Questionnaire, Consideration of Future Consequences, and Eating in the Absence of Hunger. Participants were 3806 WLM following a commercial weight management program (WW International, Inc.) who had maintained a weight loss ≥ 9.1 kg (mean 24.7 kg) for 3.3 years and had a body mass index (BMI) of 27.6 kg m2 . A control group of weight stable individuals with obesity (controls; n = 519) had a BMI of 38.9 kg m2 and a weight change < 2.3 kg over the previous 5 years. RESULTS: WLM vs. controls made food decisions more based on health (18.9 vs. 16.3; ηp 2 = 0.052) and weight control (9.9 vs. 7.5; ηp 2 = 0.16) and less based on price (8.4 vs. 9.1; ηp 2 = 0.10). WLM also scored higher than controls with respect to considering future consequences of behaviours (44.3 vs. 38.4; ηp 2 = 0.060) and reported less external eating in the absence of hunger (7.1 vs. 7.5; ηp 2 = 0.058). Standard canonical coefficients indicated that making food choices based on weight (0.717) with less value placed on price (-0.33) and greater consideration of future consequences (0.262) contributed independently and most (overall r = 0.593; p = 0.0001) to discriminating WLM from controls. CONCLUSIONS: In a widely used commercial weight management program, successful WLM reported food decisions based more on weight and less on price and considered future consequences of current behaviours.

Sitting Time, Type, and Context Among Long-Term Weight-Loss Maintainers.

OBJECTIVE: This study aimed to investigate sitting time, the home sedentary environment, and physical activity among weight-loss maintainers in WW (formerly Weight Watchers). METHODS: Participants were 4,305 weight-loss maintainers who had maintained ≥9.1 kg of weight loss (24.7 kg on average) for 3.3 years and had an average current BMI of 27.6 kg/m2 . A control group of weight-stable individuals with obesity (n = 619) had an average BMI of 38.9 kg/m2 . The Multicontext Sitting Time Questionnaire and Paffenbarger physical activity questionnaire were administered. RESULTS: Weight-loss maintainers versus controls spent 3 hours less per day sitting during the week (10.9 vs. 13.9; η p 2 = 0.039; P = 0.0001) and weekends (9.7 vs. 12.6; η p 2 = 0.038). Weight-loss maintainers versus controls spent 1 hour less per day in non-work-related sitting using a computer or video games during the week (1.4 vs. 2.3; η p 2 = 0.03; P = 0.0001) and weekends (1.5 vs. 2.5; η p 2 = 0.03; P = 0.0001). Weight-loss maintainers versus controls had similar numbers of sedentary-promoting devices (15.8 vs. 14.8) and expended significantly more calories per week in physical activity (1,835 vs. 785; η p 2 = 0.036; P = 0.0001). CONCLUSIONS: Weight-loss maintainers reported less time sitting than weight-stable individuals with obesity. Future research should test the efficacy of targeting sitting time to help promote long-term weight-loss maintenance.