Report

Teaser, summary, work performed and final results

Periodic Reporting for period 3 - NoHoW (Evidence-based ICT tools for weight loss maintenance)

Teaser

Health problems associated with obesity are a major healthcare challenge. Effective interventions and successful commercial weight loss programmes to help people lose weight already exist. However, most people re-gain the weight they lose – the real challenge is to maintain...

Summary

Health problems associated with obesity are a major healthcare challenge. Effective interventions and successful commercial weight loss programmes to help people lose weight already exist. However, most people re-gain the weight they lose – the real challenge is to maintain weight loss.

Researchers already know that weight loss maintenance (WLM) depends on changing behaviours. There are many techniques available to help people change their behaviour in the long term but we still don’t know which of these techniques work best for WLM or why. We also don’t know how different personal or social contexts influence the effectiveness of different WLM techniques. To better tackle obesity and prevent weight regain, we need to learn more about what behaviour change techniques best maintain weight loss in the long term – this is the main research aim of NoHoW.

GATHERING EVIDENCE - NoHoW includes a survey to learn about patterns of weight loss, what people do to maintain their weight loss, and where people most often need support in preventing weight regain. The survey specifically targets people who have previously lost weight, and collects a wide range of information, including weight loss goals, motivation for weight loss, socioeconomic factors, and demographic information.

CHANGING BEHAVIOUR - NoHoW also includes in-depth interviews with people who have lost weight and are working to maintain their weight loss, looking at how they manage their daily activity and food intake, emotions/emotional eating and stress. These interviews will help us learn when support may be needed and propose the type of support that may work best to help people make lasting changes to behaviours that impact on their long-term WLM.

NoHoW TOOLKIT - Information technology offers attractive tools for delivering interventions that would otherwise be delivered only through resource-intensive face-to-face therapies. NoHoW develops an IT-based Toolkit, with a set of mobile apps, web-based tools and inputs from other technologies, such as smart scales and activity and sleep trackers.

EVIDENCE IT WORKS - The NoHoW Toolkit is currently being tested through a randomised controlled trial carried out in centres in the United Kingdom, Portugal and Denmark. We’re recruiting over one thousand overweight/obese adult men and women who have successfully lost more than 5% of their body weight in the past twelve months. Participants are being randomly divided into three different intervention groups and a control group, and being given different kinds of support, including motivation, goal setting and coping plans, emotion regulation and stress management through the Toolkit. Everyone is asked to weigh themselves regularly. Through the trial, we’ll learn if and how the Toolkit works by comparing success with WLM between the different groups.

Work performed

So far, we have gathered new evidence about WLM by conducting an online survey on lifestyle and weight management experiences in the UK, Denmark and Portugal. From the results of the survey, we learned about how people lose weight and how successful they are at maintaining their weight loss, as well as what types of support they need for successful weight management. The results of the survey confirmed that people need support with motivation, self-regulating their behaviours and regulating their emotions - these types of support were already planned as part of the Toolkit. We also discovered that there were differences between the countries, which were not expected. For example, people in Denmark were more likely to use physical activity to lose weight, while people in the UK were more likely to plan meals. From this, we learned that we need to tailor the support offered by the Toolkit to each country. The Toolkit embraces this by providing personal feedback based on individual needs.

In the UK, Denmark and Portugal, we have completed in-depth interviews with people who have recently lost weight to find out about what motivates them to lose weight, how they manage emotions and stress and regulate their diet. Results of these interviews were shared with the Toolkit developers and with the research teams designing the NoHoW trial.

The NoHoW Toolkit has been developed in three languages (English, Danish and Portuguese) and is now being used by participants in the NoHoW trial. Through the Toolkit, users learn behaviour change techniques that will help them maintain their weight loss. Users can also access useful information about their own weight, activity levels and sleep, helping them to set goals and monitor their own progress.

The NoHoW trial launched in March 2017 and by March 2018, the recruitment target was exceeded, with 1,627 participants randomised to the trial in the UK, Denmark and Portugal. We have collected baseline data about participants weight and health, individual characteristics associated with successful weight loss maintenance and how components of the Toolkit help them achieve this. In the trial, participants have access to the Toolkit, wireless scales and activity trackers, which they will use for 18 months. Follow-up measures of their weight and health have now been completed after 6 and 12 months, and the final participants are now completing their 18 months visits. In addition to health and psychological measures, we have also asked them if they like the Toolkit and whether they found it useful for helping them manage their weight in the long-term.

Final results

NoHoW has already generated new evidence that will have important impacts for researchers involved in obesity research, as well as commercial providers of weight management services. The first of this evidence has been published in academic journals and presented at obesity-related meetings, such as the European Congress on Obesity, attended by a broad range of stakeholders. We are now beginning to analyse the results of the trial, which will give insight into whether the Toolkit was effective in terms of long term weight loss maintenance. The trial will also help us to understand how self-regulation and stress and emotion regulation are involved in weight loss maintenance.

We have also begun to discuss how the NoHoW Toolkit might be used after the trial is completed to provide weight loss management support to a wider population. The consortium is engaged in discussions with a number of commercial companies across diverse sectors, from healthcare technology to pharma to weight management to explore potential licensing agreements for the NoHoW Toolkit.

Since the start of the project, NoHoW partners have been actively promoting the projects in the media, institutional publications, and academic conferences. Through the European Association for the Study of Obesity, we have circulated our newsletters to over 22,000 subscribers and maintained an active social media presence. These activities have created a growing audience of key stakeholders, with whom we share our emerging results. A final conference will be hosted by the European Association for the Study of Obesity in the closing months of the project to showcase our results to key stakeholders, from the general public to other researchers to commercial companies.

Website & more info

More info: http://nohow.eu/.