Skip to main content

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


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.

This is a preview of subscription content, access via your institution.

Fig. 1

Data, materials and/or code availability

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


  • Abdi, H. (2007). Bonferroni and Šidák corrections for multiple comparisons. Encyclopedia of Measurement and Statistics, 3, 103–107.

    Google Scholar 

  • Appelhans, B. M., French, S. A., Pagoto, S. L., & Sherwood, N. E. (2016). Managing temptation in obesity treatment: A neurobehavioral model of intervention strategies. Appetite, 96, 268–279.

    Article  Google Scholar 

  • Caleyachetty, R., Thomas, G. N., Toulis, K. A., Mohammed, N., Gokhale, K. M., Balachandran, K., & Nirantharakumar, K. (2017). Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women. Journal of the American College of Cardiology, 70, 1429–1437.

    Article  Google Scholar 

  • Carels, R. A., Douglass, O. M., Cacciapaglia, H. M., & O’Brien, W. H. (2004). An ecological momentary assessment of relapse crises in dieting. Journal of Consulting and Clinical Psychology, 72, 341–348.

    Article  PubMed  Google Scholar 

  • Carels, R. A., Hoffman, J., Collins, A., Raber, A. C., Cacciapaglia, H., & O’Brien, W. H. (2002). Ecological momentary assessment of temptation and lapse in dieting. Eating Behaviors, 2, 307–321.

    Article  Google Scholar 

  • Crochiere, R. J., Mangubat, C. J., Manasse, S. M., & Forman, E. M. (2019). Does executive function moderate the relation between momentary affective and physical states and subsequent dietary lapse? An EMA investigation. Journal of Behavioral Medicine, 42, 1148–1152.

    Article  Google Scholar 

  • Danaei, G., Ding, E. L., Mozaffarian, D., Taylor, B., Rehm, J., Murray, C. J., & Ezzati, M. (2009). The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS medicine, 6, e1000058.

    Article  Google Scholar 

  • Douketis, J. D., & Sharma, A. M. (2005). Obesity and cardiovascular disease: Pathogenic mechanisms and potential benefits of weight reduction. Paper presented at the Seminars in vascular medicine, 5, 25–33.

    Article  Google Scholar 

  • Forman, E. M., & Butryn, M. L. (2015). A new look at the science of weight control: How acceptance and commitment strategies can address the challenge of self-regulation. Appetite, 84, 171–180.

    Article  Google Scholar 

  • Forman, E. M., Goldstein, S. P., Crochiere, R. J., Butryn, M. L., Juarascio, A. S., Zhang, F., & Foster, G. D. (2019). Randomized controlled trial of OnTrack, a just-in-time adaptive intervention designed to enhance weight loss. Translational Behavioral Medicine, 9, 989–1001.

    Article  Google Scholar 

  • Forman, E. M., Goldstein, S. P., Zhang, F., Evans, B. C., Manasse, S. M., Butryn, M. L., Juarascio, A. S., Abichandani, P., Martin, G. J., & Foster, G. D. (2018). OnTrack: Development and feasibility of a smartphone app designed to predict and prevent dietary lapses. Translational Behavioral Medicine, 9, 236–245.

    Article  Google Scholar 

  • Forman, E. M., Schumacher, L. M., Crosby, R., Manasse, S. M., Goldstein, S. P., Butryn, M. L., Wyckoff, E. P., & Graham, J. (2017). Thomas Ecological momentary assessment of dietary lapses across behavioral weight loss treatment: Characteristics, predictors, and relationships with weight change. Annals of Behavioral Medicine, 51, 741–753.

    Article  Google Scholar 

  • Fryar, C., Carroll, M., & Afful, J. (2020). Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats.

  • Goldstein, S. P., Brick, L. A., Thomas, J. G., & Forman, E. M. (2021). Examination of the relationship between lapses and weight loss in a smartphone-based just-in time adaptive intervention. Translational Behavioral Medicine, 11, 993–1005.

    Article  Google Scholar 

  • Goldstein, S. P., Dochat, C., Schumacher, L. M., Manasse, S. M., Crosby, R. D., Thomas, J. G., Butryn, M. L., & Forman, E. M. (2018). Using ecological momentary assessment to better understand dietary lapse types. Appetite, 129, 198–206.

    Article  Google Scholar 

  • Goldstein, S. P., Zhang, F., Thomas, J., Butryn, M., Herbert, J., & Forman, E. (2018). Application of machine learning to predict dietary lapses during weight loss. Journal of Diabetes Science and Technology, 12, 1045–1052.

    Article  Google Scholar 

  • Grilo, C. M., Shiffman, S., & Wing, R. R. (1989). Relapse crises and coping among dieters. Journal of Consulting and Clinical Psychology, 57, 488.

    CAS  Article  Google Scholar 

  • Hartmann-Boyce, J., Jebb, S. A., Fletcher, B. R., & Aveyard, P. (2015). Self-help for weight loss in overweight and obese adults: Systematic review and meta-analysis. American Journal of Public Health, 105, e43–e57.

    Article  Google Scholar 

  • Herman, C., & Polivy, J. (2011). The self-regulation of eating: Theoretical and practical problems. In K. D. Vohs & R. F. Baumeister (Eds.), Handbook of self-regulation: Research, theory, and applications. New York: The Guilford Press.

    Google Scholar 

  • Jensen, P., Zachariae, C., Christensen, R., Geiker, N. R., Schaadt, B. K., Stender, S., Astrup, A., Hansen, P., & Skov, L. (2014). Effect of weight loss on the cardiovascular risk profile of obese patients with psoriasis. Acta dermato-venereologica, 94, 691–694.

    Article  Google Scholar 

  • Lowe, M. R. (2003). Self-regulation of energy intake in the prevention and treatment of obesity: Is it feasible? Obesity, 11, 44S-59S.

    Article  Google Scholar 

  • MacLean, P. S., Wing, R. R., Davidson, T., Epstein, L., Goodpaster, B., Hall, K. D., & Rosenbaum, M. (2015). NIH working group report: Innovative research to improve maintenance of weight loss. Obesity, 23, 7–15.

    Article  Google Scholar 

  • McKee, H. C., Ntoumanis, N., & Taylor, I. M. (2014). An ecological momentary assessment of lapse occurrences in dieters. Annals of Behavioral Medicine, 48, 300–310.

    Article  Google Scholar 

  • Nikolaou, C. K., & Lean, M. (2017). Mobile applications for obesity and weight management: Current market characteristics. International Journal of Obesity, 41, 200.

    CAS  Article  Google Scholar 

  • Pagoto, S., Tulu, B., Waring, M. E., Goetz, J., Bibeau, J., Divito, J., Groshon, Laurie, & Schroeder, M. (2021). Slip buddy app for weight management: Randomized feasibility trial of a dietary lapse tracking app. JMIR mHealth and uHealth, 9, e24249.

    Article  Google Scholar 

  • Schumacher, L. M., Martin, G. J., Goldstein, S. P., Manasse, S. M., Crosby, R. D., Butryn, M. L., Lillis, J., & Forman, E. M. (2017). Ecological momentary assessment of self-attitudes in response to dietary lapses. Health Psychology.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stone, A. A., Schwartz, J. E., Neale, J. M., Shiffman, S., Marco, C. A., Hickcox, M., Paty, J., Porter, L. S., & Cruise, L. J. (1998). A comparison of coping assessed by ecological momentary assessment and retrospective recall. Journal of Personality and Social Psychology, 74, 1670.

    CAS  Article  Google Scholar 

  • Wing, R. R., Lang, W., Wadden, T. A., Safford, M., Knowler, W. C., Bertoni, A. G., Hill, O., Brancati, F. L., Peters, A., & Wagenknecht, L. (2011). Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care, 34, 1481–1486.

    CAS  Article  Google Scholar 

Download references


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.

Author information

Authors and Affiliations



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.

Corresponding author

Correspondence to Rebecca J. Crochiere.

Ethics declarations

Conflict of interest

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

Ethical approval

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.

Consent to participate

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

Consent for publication

Participants signed informed consent regarding publishing their data.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

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).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


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