JMIR Publications

ABSTRACT

Background:

People tend to over-estimate their expectations for weight loss relative to what is achievable in a typical behavioral weight loss treatment program, which can impact treatment satisfaction and outcomes. We are engaged in formative research to design a digital intervention that addresses binge eating and weight management; thus, understanding expectations among this group can inform more engaging intervention designs to produce a digital intervention that can achieve greater clinical success. Studies examining weight loss expectations have primarily focused on people with overweight or obesity. Only one study has investigated weight loss expectations among people with binge eating disorder, a population that frequently experiences elevated weight/shape concerns and often presents to treatment with a goal of losing weight.

Objective:

We aim to investigate differences in weight loss expectations among people with varying levels of binge eating to inform the design of a digital intervention for binge eating and weight management. Such an evaluation may be crucial for people presenting to a digital intervention, given that engagement and dropout is a notable problem for digital behavior change interventions. We tested the hypotheses that: 1) people who endorse some or recurrent binge eating will expect to lose more weight than those who do not endorse binge eating, and 2) people who endorse more severe versus low or moderate overvaluation of weight/shape will have higher weight loss expectations.

Methods:

Seven hundred sixty adults (66% female, 58% non-Hispanic White) completed an online screening questionnaire. One-way analyses of variance were conducted to explore weight loss expectations for binge eating status as well as overvaluation of shape and weight.

Results:

Weight loss expectations significantly differed by binge eating status. Those who endorsed some and recurrent binge eating expected to lose more weight than those who endorsed no binge eating. Participants with severe overvaluation of weight/shape expected to lose the most weight compared to low or moderate levels of overvaluation of weight/shape.

Conclusions:

In our sample, people interested in a digital intervention for binge eating and weight management overestimate their expectations for weight loss. Given that weight loss expectations can impact treatment completion and success, it may be important to assess and modify weight loss expectations among people with binge eating prior to enrolling in a digital intervention. Future work should design and test features that can modify these expectations relative to individuals’ intended treatment goals to facilitate engagement and successful outcomes in a digital intervention.