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Preliminary evidence of contextual factors’ influence on weight loss treatment outcomes: implications for future research

International Journal of Obesity volume 46, pages 1244–1246 (2022)Cite this article

Subjects

Abstract

Background/Objectives

Behavioral health interventions, including behavioral obesity treatment, typically target psychosocial qualities of the individual (e.g., knowledge, self-efficacy) that are largely treated as persistent, over momentary contextual factors (e.g., affect, environmental conditions). The variance in treatment outcomes that can be attributable to these two sources is rarely quantified but may help inform future research and treatment development efforts.

Subjects/Methods

The intraclass correlation coefficient (ICC) for weekly weight loss was calculated in three studies involving 10–12 weeks of behavioral obesity treatment delivered to adults via in-person group sessions, mobile application, or website. The ICC explains the proportion of variance between vs. within individuals, and was used to infer the contribution of individual vs. contextual factors to weekly weight loss. The analytic approach involved unconditional linear mixed effect models with a random effect for subject.

Results

The ICCs were very low, ranging from 0.01 to 0.06, suggesting that momentary contextual factors may influence obesity treatment outcomes to a substantial degree.

Conclusions

This study yielded preliminary evidence that the influence of contextual factors in behavioral obesity treatment may be underappreciated. Future research is needed to simultaneously identify and quantify sources of within- and between-subjects variance to optimize treatment approaches.

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Acknowledgements

The research team thanks the participants for their contribution to the research, without which the study would not have been possible.

Funding

National Institute of Diabetes and Digestive and Kidney Diseases; National Heart, Lung, and Blood Institute.

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Authors and Affiliations

  1. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA

    J. Graham Thomas, Stephanie P. Goldstein & Leslie A. Brick

  2. Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, USA

    J. Graham Thomas & Stephanie P. Goldstein

Authors
  1. J. Graham Thomas
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  2. Stephanie P. Goldstein
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  3. Leslie A. Brick
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Contributions

JGT and SPG led data collection. All authors contributed to data analysis. JGT and SPG led the writing and LAB provided feedback on manuscript drafts.

Corresponding author

Correspondence to J. Graham Thomas.

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Competing interests

JGT has received compensation as a member of the scientific advisory board of Lummé Health and owns stock in the company. SPG and LAB declare no potential competing interests.

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Thomas, J.G., Goldstein, S.P. & Brick, L.A. Preliminary evidence of contextual factors’ influence on weight loss treatment outcomes: implications for future research. Int J Obes 46, 1244–1246 (2022). https://doi.org/10.1038/s41366-022-01070-x

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