Comparing Large Language Model AI and Human-Generated Coaching Messages for Behavioral Weight Loss

Automated coaching messages for weight control can save time and costs, but their repetitive, generic nature may limit their effectiveness compared to human coaching. Large language model (LLM) based artificial intelligence (AI) chatbots, like ChatGPT, could offer more personalized and novel messages to address repetition with their data-processing abilities. While LLM AI demonstrates promise to encourage healthier lifestyles, studies have yet to examine the feasibility and acceptability of LLM-based BWL coaching. Eighty-seven adults in a weight-loss trial (BMI ≥ 27 kg/m²) rated ten coaching messages' helpfulness (five human-written, five ChatGPT-generated) using a 5-point Likert scale, providing additional open-ended feedback to justify their ratings. Participants also identified which messages they believed were AI-generated. The evaluation occurred in two phases: messages in Phase 1 were perceived as impersonal and negative, prompting revisions for messages in Phase 2. In Phase 1, AI-generated messages were rated less helpful than human-written ones, with 66% receiving a helpfulness rating of 3 or higher. However, in Phase 2, the AI messages matched the human-written ones regarding helpfulness, with 82% scoring three or above. Additionally, 50% were misidentified as human-written, suggesting AI's sophistication in mimicking human-generated content. A thematic analysis of open-ended feedback revealed that participants appreciated AI's empathy and personalized suggestions but found them more formulaic, less authentic, and too data-focused. This study reveals the preliminary feasibility and perceived helpfulness of LLM AIs, like ChatGPT, in crafting potentially effective weight control coaching messages. Our findings also underscore areas for future enhancement.

The online version contains supplementary material available at 10.1007/s41347-025-00491-5.