Background

The purpose of this study was to use validated questionnaires to identify novel behavioral and psychological strategies used among weight loss maintainers (WLM) in a nationally available, commercial weight management program.

Methods

Participants were 4,930 WLM in WW (formerly Weight Watchers) who had lost 24.4 kg, maintained >9.1 kg weight loss for 3.3 yr, and had a BMI of 27.7 kg/m2.A comparison group of weight stable individuals with obesity (OB; N = 538) had a BMI of 38.9 kg/m2and < 2.3 kg weight change over previous 5 yr. Validated questionnaires included Weight Control Strategies Scale, Self-Compassion Scale, Food Craving Acceptance & Action, the Habit Strength Index, and the SF-20.

Results

WLM vs. OB practiced more frequent dietary (3.3 vs 1.3; ηp2=0.38), self-monitoring (2.6 vs. 0.7; ηp2= 0.27), physical activity (2.3 vs 1.0; ηp2=0.10) and psychological (2.5 vs 1.1; ηp2=0.23) strategies. WLM also reported higher mindful self-compassion (7.2 vs 6.9;ηp2=m 0.03) and more willingness to ignore cravings (4.5 vs 3.5 ηp2=0.16). WLM had greater habit strength for healthy eating (5.3 vs 3.2; ηp2= 0.21) and physical activity (PA; 4.4 vs 2.7; ηp2= 0.10). Std canonical coefficients indicated that dietary (0.52), self-monitoring (0.42) and psychological (0.15) strategies and habit strength for healthy eating (0.15) and PA (0.15) contributed most (49% of variance) to discriminating the two groups. Higher scores on these domains were related to better overall quality of life (b = 3.6 [3.3, 3.9]).

Conclusions

More frequent practice of dietary, self-monitoring, and psychological strategies and development of greater habit strength were associated with long-term weight control and improved quality of life among participants in a nationally available commercial program.