JMIR Publications

ABSTRACT

Background:

Obesity is a global public health challenge, and there is a need to better understand how to support users of self-management programs to achieve longer-term weight loss.

Objective:

This study used data from the Commonwealth Scientific and Industrial Research Organisation (CSIRO) Total Wellbeing Diet Online program to explore the total weight loss and patterns of weight loss of members over their first 12-months membership and examine the patterns of platform usage associated with greater weight loss.

Methods:

Participants were adults who joined the program between October 2014 and June 2022 and were classified as longer-term members, meaning they completed at least 12 weeks of the program, had baseline and 12-week weight data, and had a paid membership of one year or more (n= 24,035). Weight loss and percentage of starting body weight loss were calculated at 3,6,9 and 12 months using three statistical approaches: 1) all available data, 2) multiple imputations method and 3) complete data only. Weight loss patterns were examined in members who had complete data at 3,6,9 and 12 months (n=6,602).

Results:

Members were mostly female (83.1%), aged 31-50 years (41.5%) or 51-70 years (50.1%) and almost all classified as overweight or obese (95.9%). Using multiple imputations, the average estimated weight loss was 5.9kg at 12 weeks, 6.7kg at 6 months, 6.2kg at 9 months, and 5.5kg at 12 months. At 12 months, almost half the members (48.8%) were at least 5% below their starting body weight and one in five (21.4%) were at least 10% below their starting body weight. In the sub-sample with complete data, the average weight loss at 12 months was 7.8kg. The most common (961/6,602 members) weight loss pattern over the first 12 months was 6 months of weight loss, followed by 6 months of weight maintenance. The average weight loss of this group was 10.6kg at 12 months (11.9% of starting body weight), and up to 22.3kg (or 21.7% of starting body weight) was achieved in the group who consistently lost weight over 12 months (4.3% of the sample). Weekly platform usage was positively associated with total weight loss (r=.287, p<0.001). Members who used the platform more than 30 times per week or more (~4+ times per day) were more likely to lose weight in the first 6 months of the program.

Conclusions:

This comprehensive evaluation of a commercial, online weight loss program showed effectiveness, with one in two members achieving clinically significant results after 1 year. Greater engagement with the platform was associated with consecutive periods of weight loss and greater weight loss success overall. This analysis demonstrates the ‘ups and downs’ in achieving longer-term weight loss success and will help to support manage expectations for realistic goal setting.