JMIR Publications

ABSTRACT

Background:

In behavioral weight loss interventions, participants are asked to set goals each week in an effort to develop long-term habits that lead to weight loss. Using data from an online weight loss intervention, we examined whether participants articulated their goals and accomplishments in measurable and repeating terms was associated with greater weight loss.

Objective:

Using data from an online weight loss intervention, we examined whether participants articulated their goals and accomplishments in measurable and repeating terms was associated with greater weight loss.

Methods:

Adults with overweight or obesity received a 12-week Facebook-delivered weight loss intervention based on the Diabetes Prevention Program Lifestyle Intervention. Participants replied to conversation threads that queried about their goals and accomplishments. Two independent coders classified participants’ posts that articulated a goal and/or accomplishment as measurable and as repeating (signaling habit formation) (signaling a one-time occurrence). Crude and age-adjusted linear regression models were used to examine the relationship between frequency of post type and percent weight loss.

Results:

Participants (N=53; 90.6% female; 90.6% non-Hispanic white) were on average 46.2±10.5 years old with a mean BMI of 32.4±4.8 kg/m2. Over 12 weeks, participants shared a median of 4 posts (IQR=1-8) that mentioned goals and 10 posts (IQR=4-24) that mentioned accomplishments. Most participants made >1 post that mentioned a goal (81.1%) and ≥1 post that mentioned an accomplishment (88.7%). Each additional post mentioning a goal was associated with -0.2% (95% CI: -0.3, 0.0) greater weight loss. Sharing >1 post that included a repeating goal was associated with an average of -2.2% (95% CI: -3.9, -0.4) greater weight loss and, each additional post that mentioned a repeating goal was associated with an average of -0.5% (95% CI: -1.0, 0.0) greater weight loss. Sharing >1 post that included measurable and repeating goals was associated with an average of -1.9% (95% CI: -3.7, -0.2) greater weight loss. Sharing each post with an accomplishment was associated with an average of -0.1% (95% CI: -0.1, 0.0) greater weight loss. Every post that included an accomplishment that was repeating was associated with an average of -0.2% (95% CI: -0.3, 0.0) greater weight loss. Sharing other types of goals and accomplishments was not associated with greater weight loss.

Conclusions:

In an online weight loss intervention, sharing goals in repeating or both measurable and repeating terms was associated with greater weight loss. For accomplishments, only those articulated in repeating terms were associated with greater weight loss. Articulating goals and accomplishments in repeating terms may signal habit formation among participants. Posts about one-time goals and accomplishments represent an opportunity to encourage planning for future behaviors. Clinical Trial: As this was a pilot trial, with data collection initiated before 2017, it did not meet the Applicable Clinical Trial final rule for clinicaltrials.gov and was not preregistered.