Evaluating the effect of targeting body shape concerns on long-term weight change.

KayLoni L Olson, Tyler T Thaxton, Jacob D Landers, Charles F Emery

Journal: The International journal of eating disorders 2024;57(1):201-205

PMID: 37982344

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Plain Language Summary

Behavioural weight loss (BWL) is a lifestyle programme for people with higher body weight. However, success is varied for weight loss and may be influenced by perceived body shape concerns (BSC). This study aimed to assess whether addressing BSC can lead to meaningful long-term weight loss in adult women with higher body weight. This follow-up of a randomised trial where participants received either standard weight loss advice or a combined approach that included a specific intervention focused on body image. The follow-up examined changes in weight and body image factors at various intervals, including 8 weeks, 6 months, and 12 months.

The findings indicated that women who participated in the body project intervention achieved significant weight loss of at least 2.5%, which is considered clinically important. Additionally, improvements in body image were maintained over time. This suggests that addressing body shape concerns can be beneficial for weight management and body image satisfaction.

It was concluded that targeting BSC may improve long-term weight loss. This study could be used by healthcare professionals to understand that simply targeting diet and exercise is not enough for some women to lose weight. There may be a positive impact of targeting body shape concerns on weight loss and body image in women with higher body weight.

Abstract

OBJECTIVE

The goal of this follow-up to a randomized proof-of-concept study was to determine if targeting body shape concern (BSC) has a clinically significant impact on long-term weight change among adult women of higher body weight with BSC. A secondary aim was to observe the maintenance of body image improvements during follow-up.

METHOD

In the original 4-week trial, women were randomized to behavioral weight loss recommendations alone (control; n = 15) or combined with the evidence-based body project intervention (n = 17). All participants were directed to continue monitoring diet and exercise through Week 8. The current analysis focused on follow-up data collected on weight, BSC, internalized weight bias, internalized thin ideal, and body appreciation at 8 weeks, 6 months, and 12 months. Percent weight change was calculated from baseline and compared against clinical milestones of -2.5% and -5%. An intent-to-treat approach was used for individuals lost to follow-up (n = 11).

RESULTS

Body project participants achieved the clinically significant target of -2.5% weight loss by 12 months. Control participants did not reach the milestone and regained lost weight at 12 months. Neither condition reached the 5% clinical target. Both groups experienced improved body image, but body project participants maintained a greater magnitude of improvement in all measures except internalized thin ideal at 12 months.

CONCLUSION

The current study provides preliminary evidence that targeting BSC among women with BSC who want to lose weight may improve long-term weight loss. Further intervention development and testing are warranted.

PUBLIC SIGNIFICANCE

The results of this study suggest that targeting negative body image among adult women with high BSC might be a pathway to improve long-term weight loss in behavioral weight management. This is aligned with precision medicine priorities to optimize weight-related health care.

Address: The Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.; The Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA.; The Neuroscience Institute, University of Chicago, Chicago, Illinois, USA.; Milwaukee VA Medical Center, Milwaukee, Wisconsin, USA.; Department of Psychology, Ohio State University, Columbus, Ohio, USA.; Department of Internal Medicine, Wexner Medical Center, Columbus, Ohio, USA.; Institute for Behavioral Medicine Research, Columbus, Ohio, USA.

DOI: 10.1002/eat.24096