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Lookup NU author(s): Dominika Kwasnicka, Professor Falko Sniehotta, Dr Marta Marques
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2021 The Author(s) Published by S. Karger AG, BaselThere is substantial evidence documenting the effects of behavioural interventions on weight loss (WL). However, behavioural approaches to initial WL are followed by some degree of longer-term weight regain, and large trials focusing on evidence-based approaches to weight loss maintenance (WLM) have generally only demonstrated small beneficial effects. The current state-of-the-art in behavioural interventions for WL and WLM raises questions of (i) how we define the relationship between WL and WLM, (ii) how energy balance (EB) systems respond to WL and influence behaviours that primarily drive weight regain, (iii) how intervention content, mode of delivery and intensity should be targeted to keep weight off, (iv) which mechanisms of action in complex interventions may prevent weight regain and (v) how to design studies and interventions to maximise effective longer-term weight management. In considering these issues a writing team within the NoHoW Consortium was convened to elaborate a position statement, and behaviour change and obesity experts were invited to discuss these positions and to refine them. At present the evidence suggests that developing the skills to self-manage EB behaviours leads to more effective WLM. However, the effects of behaviour change interventions for WL and WLM are still relatively modest and our understanding of the factors that disrupt and undermine self-management of eating and physical activity is limited. These factors include physiological resistance to weight loss, gradual compensatory changes in eating and physical activity and reactive processes related to stress, emotions, rewards and desires that meet psychological needs. Better matching of evidence-based intervention content to quantitatively tracked EB behaviours and the specific needs of individuals may improve outcomes. Improving objective longitudinal tracking of energy intake and energy expenditure over time would provide a quantitative framework in which to understand the dynamics of behaviour change, mechanisms of action of behaviour change interventions and user engagement with intervention components to potentially improve weight management intervention design and evaluation.
Author(s): Stubbs RJ, Duarte C, O'Driscoll R, Turicchi J, Kwasnicka D, Sniehotta FF, Marques MM, Horgan G, Larsen S, Palmeira A, Santos I, Teixeira PJ, Halford J, Heitmann BL
Publication type: Article
Publication status: Published
Journal: Obesity Facts
Year: 2021
Volume: 14
Issue: 2
Pages: 246-258
Print publication date: 01/05/2021
Online publication date: 04/03/2021
Acceptance date: 13/11/2020
Date deposited: 31/03/2021
ISSN (print): 1662-4025
ISSN (electronic): 1662-4033
Publisher: S. Karger AG
URL: https://doi.org/10.1159/000513042
DOI: 10.1159/000513042
PubMed id: 33662958
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