Improving weight loss outcomes of community interventions by incorporating behavioral strategies

Abstract

Objectives: We examined whether adding behavioral weight loss strategies could improve the outcomes of a community weight loss campaign.

Methods: Shape Up RI is a 12-week, online, team-based program for health improvement in Rhode Island. In study 1, we randomly assigned participants to the standard Shape Up RI program or to the program plus video lessons on weight loss. In study 2, we randomly assigned participants to the standard program or to the program plus video lessons; daily self-monitoring of weight, eating, and exercise; and computer-generated feedback.

Results: Adding video lessons alone (study 1) did not result in significantly improved weight loss (2.0 ±2.8 kg vs 1.4 ±2.9 kg; P = .15). However, when the video lessons were supplemented with self-monitoring and feedback (study 2), the average weight loss more than doubled (3.5 ±3.8 kg vs 1.4 ±2.7 kg; P < .01), and the proportion of individuals achieving a weight loss of 5% or more tripled (40.5% vs 13.2%; P < .01). Participants in study 2 submitted self-monitoring records on 78% of days, and adherence was significantly related to outcome.

Conclusions: Adding behavioral strategies to community campaigns may improve weight loss outcomes with minimal additional cost.

Figures

FIGURE 1

Flow of participants in study 1: Shape Up RI (SURI), 2008–2009.

FIGURE 2

Weight loss of participants in study 1 and study 2: Shape Up RI (SURI), 2008–2009. Note. Study 1 compares the standard SURI program with the SURI program plus video lessons. Study 2 compares the standard SURI program with the SURI program plus video lessons, daily self-monitoring of behaviors, and automated feedback.