The H2020 "noHoW Project": A Position Statement on Behavioural Approaches to Longer-Term Weight Management

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  • R. James Stubbs
  • Cristiana Duarte
  • Ruairi O'Driscoll
  • Jake Turicchi
  • Dominika Kwasnicka
  • Falko F. Sniehotta
  • Marta M. Marques
  • Graham Horgan
  • Sofus Larsen
  • António Palmeira
  • Inês Santos
  • Pedro J. Teixeira
  • Jason Halford
  • Heitmann, Berit

There 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.

OriginalsprogEngelsk
TidsskriftObesity Facts
Vol/bind14
Udgave nummer2
Sider (fra-til)246-258
Antal sider13
ISSN1662-4025
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
The work should be attributed to the School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK. The NoHoW project is a 5 million Euro project that received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 643309. The project brings together a multidisciplinary team of academic experts in behaviour change, consumer science, weight management interventions (and intervention evaluation), weight management delivery, disease prevention, biomathematics, computer science, personal data tracking and human-computer interactions. The primary focus of the project was to develop and evaluate evidence-based behavioural approaches to weight loss maintenance.

Funding Information:
The NoHoW project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 643309. The Parker Institute, Bispebjerg and Frederiksberg Hospital is supported by a core grant from the Oak Foundation (grant agreement No. OCAY-18-774-OFIL).

Publisher Copyright:
© 2021

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