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Adherence to Behavioral Weight Management: A Scoping Review of Definitions, Measurement, and Components.

Deng Wang1, Miguel A Rojo-Tirado1, Pedro J Benito1

  • 1LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Madrid, Spain.

Obesity Reviews : an Official Journal of the International Association for the Study of Obesity
|December 20, 2025
PubMed
Summary

Weight management adherence lacks consistent definitions and measurement, hindering research and policy. Standardizing adherence metrics and using behavior change techniques like self-monitoring can improve outcomes for obesity and overweight individuals.

Keywords:
adherenceattritionbehavior changebody weightsession attendance

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Area of Science:

  • Obesity and Weight Management Research
  • Health Behavior Science
  • Evidence Synthesis

Background:

  • Adherence to weight management interventions is crucial for success.
  • Variability in defining and measuring adherence limits research, policy, and study comparisons.
  • Obesity and overweight populations require effective, consistent weight management strategies.

Purpose of the Study:

  • To identify definitions, components, metrics, and measurement methods of adherence in weight management literature.
  • To explore behavior change techniques used to enhance adherence in weight management interventions.
  • To provide recommendations for standardizing adherence in obesity and overweight research.

Main Methods:

  • A comprehensive scoping review following PRISMA-ScR guidelines.
  • Searches across major databases: Web of Science, PubMed/MEDLINE, Scopus, and Cochrane.
  • Inclusion of 182 papers on weight management interventions for obesity and overweight.

Main Results:

  • Significant variability exists in the definition, operationalization, and measurement of adherence.
  • Common adherence components include dietary/physical activity adherence, session attendance, self-monitoring, medication adherence, attrition, retention, and dropout.
  • Self-monitoring and social support were identified as key behavior change techniques for improving adherence.

Conclusions:

  • The World Health Organization's (WHO) adherence framework is recommended, adapted for weight management.
  • Standardized measurement metrics for adherence are crucial for consistency and comparability.
  • Implementing behavior change techniques can enhance adherence in weight management programs.