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

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.

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).

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.

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.

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.