Weight loss and weight management are significant concerns for many, with a considerable portion of adults actively trying to lose or maintain their weight. However, sustaining weight loss long-term presents a formidable challenge. This article delves into the complexities of weight loss, weight maintenance, and the various strategies, including digital tools and behavioral techniques, that can aid individuals in achieving their goals. We will also explore the journey of Jada Kingdom, a public figure whose weight loss has garnered attention and sparked discussions about body image and mental health.
The Challenge of Weight Loss and Maintenance
Overweight and obesity pose substantial challenges to the health and well-being of populations worldwide. Obesity prevalence accounts for a significant percentage of health costs and deaths. The overall cost of obesity is substantial, as obesity is linked to a range of physical and psychological illnesses. These costs are projected to increase in line with obesity prevalence. Beyond the economic burden, obesity affects psychological well-being, self-esteem, and overall life expectancy.
While numerous evidence-based interventions and commercial programs for weight loss (WL) are readily available, the majority of individuals regain weight. Long-term weight loss maintenance (WLM) is more challenging; weight relapse is common, and obesity is a chronic relapsing condition. National weight control registries have demonstrated that WLM is possible for some individuals previously diagnosed with obesity, but not probable for most.
Effective Strategies for Weight Loss Maintenance
Several systematic reviews and analyses have identified critical elements for effective interventions, emphasizing the need to amplify modest effect sizes to improve longer-term weight outcomes. Knowledge has accumulated regarding predictors and mediators of sustained change in eating behaviors, illustrating the potential to advance obesity management at the individual level.
Evidence suggests that some behaviors that lead to WL are continued during WLM, and additional behaviors are adopted during WLM. The transition from WL to WLM is a dynamic interaction between behavioral strategies to lose weight and the physiological resistance to WL, which can undermine the behaviors that led to the initial WL.
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Avoiding weight regain requires behavioral strategies in which relapse coping and WLM become learned skills of self-regulation, autonomy, and motivation as part of a longer-term process. Core features of more effective WLM interventions include behavior change techniques such as self-monitoring (of weight and behavior), relapse prevention, goal setting, and action plans for diet and physical activity, which improve self-efficacy.
The Role of Digital Technologies
Digital technologies, including networked-wireless tracking technologies, online tools, smartphone apps, multimedia resources, and internet-based support, offer attractive tools for teaching and supporting long-term behavior change techniques. These technologies can facilitate self-management of behavior and emotional responses for WLM.
However, it's important to note that many weight management apps previously missed key evidence-based approaches for longer-term behavior changes. Systematic reviews suggest that apps alone produce modest effects on weight and health outcomes and may be more effective as part of multicomponent interventions.
The NoHoW Project: A Digital Toolkit for Weight Loss Maintenance
The NoHoW project was a European Commission Horizon 2020-funded Research and Innovation Action focused on developing evidence-based digital technologies and tools for WLM. The project was developed around promising behavior change techniques for WLM (self-monitoring, goal setting, action control, autonomous motivation, and building self-efficacy) combined with contextual behavioral science approaches to emotion regulation and stress management to facilitate weight-regain prevention.
The project examined why European citizens make WL efforts, how often these efforts are made over a year, and the specific methods people use for WL. It surveyed digital interventions for WLM in the context of behavioral science research, using this knowledge to develop a digital toolkit (TK) for WLM based on self-management of behavior and emotional responses. The project targeted adults who have achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25).
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The Emotional Dimension of Weight Management
Weight management has a large emotional dimension. The relationship between stress, emotion, and food intake can derail strategies of planned behavior and promote relapse. Shame and self-criticism are associated with binge eating, obesity, and problems linked to body image. Acceptance, self-compassion, and mindfulness-based approaches may help to address these issues and reduce obesity-related eating behaviors.
Jada Kingdom's Journey: A Public Figure's Experience
Jada Kingdom, a singer, has publicly addressed her weight loss journey, which has been intertwined with her mental health challenges. Kingdom, who has shared her bipolar diagnosis, relocated to The States in 2021, which was when fans first highlighted a difference in her appearance. She has spoken about battling depression and how it affected her weight.
Kingdom has defended having a natural body, adding that she comes from a big-boned, “shape good” family. She also acknowledged the support of her ex-boyfriend Verse Simmonds for helping to improve her diet and lifestyle.
Her weight loss has elicited varied reactions from fans, with some expressing their preference for her "old" physique. Kingdom has responded to these comments, emphasizing her happiness and well-being.
Ten Top Tips (10TT): A Primary Care Intervention
Primary care is the 'first port of call' for weight control advice, creating a need for simple, effective interventions that can be delivered without specialist skills. Ten Top Tips (10TT) is a leaflet based on habit-formation theory that could fill this gap.
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A two-arm, individually randomized, controlled trial in primary care found that adults with obesity who received the 10TT leaflet lost significantly more weight over 3 months than those receiving usual care. At 24 months, the 10TT group had maintained their weight loss, but the ‘usual care’ group had lost a similar amount. The 10TT leaflet delivered through primary care is effective in the short-term and a low-cost option over the longer term.
The intervention focused explicitly on the recommendations of habit-formation theory; negative energy balance behaviors are listed alongside advice on repetition and context stability in the leaflet. Patients randomized to ‘usual care’ were referred to each PCPs usual care treatment, which they received either within their PCP at subsequent appointments (for example, from a dietitian) or from an external provider (for example, Weight Watchers).