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BACKGROUND: Emerging adults (EAs) ages 18-25 are at high risk for overweight/obesity, but little is known about their motivations for weight loss or how these may differ from those of middle aged adults (MAs) and relate to treatment outcomes. PURPOSE: The purpose of this study was to examine potential differences in weight loss motivations between EAs and MAs and determine the association between motivation and engagement/outcomes in a weight loss trial. METHODS: Data were pooled from two behavioural weight loss interventions: one targeting EAs (n = 52) and one targeting MAs ages 40-60 (n = 101). Motivation, attendance, dietary self-monitoring and weight change were measured in both trials across 3 months of treatment. RESULTS: Emerging adults were less motivated by health concerns than MAs (p < .05). Motivation to lose weight in order to improve appearance was of similar importance for both MAs and EAs but demonstrated differential associations with treatment variables. Appearance-related motivation was associated with higher program engagement for MA but was associated with poorer weight loss for EAs. Overall engagement, weight loss and retention were worse for EAs than MAs (ps < .05). CONCLUSIONS: Specific motivations for weight loss were associated with treatment outcomes, but effects varied by developmental stage. Findings of this study highlight the potential differences between motivation to initiate weight loss efforts and motivation to successfully change weight-related behaviours. Future research should explore methods for intervening directly on motivation within the context of weight control interventions among EAs.
RESUMO
BACKGROUND: Frequent self-weighing is associated with better weight loss and maintenance among adults. Emerging adults ages 18-25 rarely enroll in behavioural weight loss trials, and thus, little is known about their willingness to engage in frequent self-weighing and its association with weight loss in this age group. PURPOSE: The purpose of this study is to examine the frequency of self-weighing among 18-25-year-old over the course of a brief lifestyle intervention and to determine the association between frequent self-weighing and weight loss. METHODS: Emerging adults (EA) ages 18-25 [N = 52, 54% racial/ethnic minority, 79% female, BMI = 34.2 (5.4)] enrolled in a 3-month lifestyle intervention with structure and content modified for EA. Benefits of frequent self-weighing were presented; participants were encouraged to weigh themselves at least weekly and no more than daily. Assessments occurred at baseline and post-treatment (3 months). RESULTS: At baseline, a majority of participants (63.5%) reported self-weighing less than once a week. Frequency of self-weighing increased over treatment (p < 0.001), with 42.9% weighing weekly and 38.2% weighing several times per week or more (i.e. frequent self-weighing) at 3 months. Frequent self-weighing was associated with greater weight loss (p = 0.03) and greater likelihood of achieving 5% weight loss (p = 0.01) at post-treatment. CONCLUSIONS: Frequent self-weighing may be a viable approach to promoting self-regulation during the high-risk developmental period of emerging adulthood. Consistent with findings among other adult samples, frequent self-weighing was associated with greater weight losses.
RESUMO
OBJECTIVE: Emerging adults ages 18-25 are at high risk for obesity, but are markedly underrepresented in behavioural weight loss (BWL) programs and experience lower engagement and retention relative to older adults. PURPOSE: To utilize a mixed methods approach to inform future efforts to effectively recruit and engage this high-risk population in BWL programs. METHODS: We used a convergent parallel design in which quantitative and qualitative data were given equal priority. Study 1 (N = 137, age = 21.8 + 2.2, BMI = 30.1 + 4.7) was a quantitative survey, conducted online to reduce known barriers and minimize bias. Study 2 (N = 7 groups, age = 22.3 + 2.2, BMI = 31.5 + 4.6) was a qualitative study, consisting of in person focus groups to gain greater depth and identify contextual factors unable to be captured in Study 1. RESULTS: Weight loss was of interest, but weight itself was not a central motivation; an emphasis on overall lifestyle, self-improvement and fitness emerged as driving factors. Key barriers were time, motivation and money. Recruitment processes should be primarily online with messages tailored specifically to motivations and preferences of this age group. Preferences for a program were reduced intensity and brief, hybrid format with some in-person contact, individual level coaching, experiential learning and peer support. Key methods of promoting engagement and retention were autonomy and choice, money and creating an optimal default. CONCLUSIONS: An individually tailored lifestyle intervention that addresses a spectrum of health behaviours, promotes autonomy and emphasizes activity and fitness may facilitate recruitment and engagement in this population better than traditional BWL protocols.
