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Momentary predictors of dietary lapse from a mobile health weight loss intervention

Abstract

Identifying factors that influence risk of dietary lapses (i.e., instances of dietary non-adherence) is important because lapses contribute to suboptimal weight loss outcomes. Existing research examining lapse risk factors has had methodological limitations, including retrospective recall biases, subjective operationalizations of lapse, and has investigated lapses among participants in gold-standard behavioral weight loss programs (which are not accessible to most Americans). The current study will address these limitations by being the first to prospectively assess several risk factors of lapse (objectively operationalized) in the context of a commercial mobile health (mHealth) intervention, a highly popular and accessible method of weight loss. N = 159 adults with overweight or obesity enrolled in an mHealth commercial weight loss program completed ecological momentary assessments (EMAs) of 15 risk factors and lapses (defined as exceeding a point target for a meal/snack) over a 2-week period. N = 9 participants were excluded due to low EMA compliance, resulting in a sample of N = 150. Dietary lapses were predicted by momentary increases in urges to deviate from one’s eating plan (b = .55, p < .001), cravings (b = .55, p < .001), alcohol consumption (b = .51, p < .001), and tiredness (b = .19, p < .001), and decreases in confidence related to meeting dietary goals (b = −.21, p < .001) and planning food intake (b = −.15, p < .001). This study was among the first to identify prospective predictors of lapse in the context of a commercial mHealth weight loss program. Findings can inform mHealth weight loss programs, including just-in-time interventions that measure these risk factors, calculate when risk of lapse is high, and deliver momentary interventions to prevent lapses.

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Data, materials and/or code availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This research was supported by the Weight Watchers Karen Miller Kovach Research Grant from The Obesity Society and the Drexel Ventures Innovation Fund awarded to Dr. Evan Forman.

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All authors made substantial contributions to the conception or design of the work or the acquisition, analysis, or interpretation of data; drafted the work or revised it critically for important intellectual content; approved the version to be published; and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Rebecca J. Crochiere.

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Conflict of interest

Dr. Forman reports membership on the scientific advisory board for Nutrisystem. None of the remaining authors report a conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and animal rights and informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Informed consent was obtained from all individual participants included in the study.

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Participants signed informed consent regarding publishing their data.

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Crochiere, R.J., Abber, S.R., Taylor, L.C. et al. Momentary predictors of dietary lapse from a mobile health weight loss intervention. J Behav Med 45, 324–330 (2022). https://doi.org/10.1007/s10865-021-00264-4

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  • DOI: https://doi.org/10.1007/s10865-021-00264-4

Keywords

  • Dietary lapse
  • Ecological momentary assessment
  • Weight loss
  • Risk factors