Considering depression as a risk factor for early disengagement in a 12-month eHealth weight loss intervention

Depression is often described as likely associated with engagement and risk of disengagement (i.e. non-usage attrition) in digital behavior change interventions, but is rarely studied in-depth outside of mental health-specific programs; thus, we sought to quantify its influence on disengagement risk. Data come from 363 adults (mean age = 51.86, SD = 10.86; 70.3% female) randomized to the intervention groups of the LoseNowPA eHealth weight management intervention. Kaplan-Meier and Cox proportional-hazards modeling were applied on the outcome of cessation of logins before program end at 12 months. Overall, mild to moderate depression symptoms were associated with an increased risk of early disengagement from this eHealth intervention, controlling for sociodemographic covariates (p < 0.0001). Subclinical levels of depression can still exert meaningful influence on participant risk of disengagement in digital weight loss interventions, which can limit their effectiveness. Future interventions may wish to consider tailoring on depression symptoms to possibly preserve engagement.