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The H2020 “Nohow Project”: A position statement on behavioural approaches to longer-term weight management

Lookup NU author(s): Dominika Kwasnicka, Professor Falko Sniehotta, Dr Marta Marques

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Abstract

© 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.


Publication metadata

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

Issue: ePub ahead of Print

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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