Weight management programmes: Re-analysis of a systematic review to identify pathways to effectiveness

Area of Science:

• Behavioral Science
• Public Health
• Intervention Science

Background:

• Systematic reviews of weight management programmes (WMPs) struggle to explain effectiveness variations using traditional taxonomies.
• Complex interventions like WMPs may have overlapping causal pathways influencing outcomes.
• Qualitative comparative analysis (QCA) offers a method to explore these complex pathways.

Purpose of the Study:

• To identify combinations of components sufficient for effective weight management programmes (WMPs).
• To explore pathways to effectiveness and ineffectiveness in adult WMPs using QCA.
• To investigate the role of user-provider and peer relationships in WMP outcomes.

Main Methods:

• Selected 10 most and 10 least effective adult WMPs from a previous systematic review based on 12-month weight loss.
• Labeled interventions based on the presence of components derived from user views.
• Employed QCA to develop pathways of component combinations linked to intervention effectiveness.

Main Results:

• Effective WMPs featured opportunities for supportive relationships (user-provider or peer).
• Directive, provider-led goal setting was a characteristic of successful interventions.
• Components fostering self-regulation were associated with greater effectiveness.

Conclusions:

• QCA identified critical, previously underestimated aspects of WMPs, such as relationship quality.
• The study highlights the importance of relational factors alongside concrete content (e.g., diet) in WMPs.
• This approach offers novel insights into the complex nature of effective behavior change interventions.