A Digital Toolkit for Weight Loss Maintenance in European Adults (NoHoW): 2×2 Factorial Randomized Controlled Trial

Area of Science:

• Digital health interventions
• Behavioral science
• Obesity research

Background:

• Digital health tools offer scalable solutions for weight management.
• Behavior change interventions often incorporate self-regulation and emotion regulation strategies.

Purpose of the Study:

• To evaluate a digital behavior change toolkit for weight loss maintenance in European adults.
• To compare interventions targeting self-regulation, emotion regulation, or both, against an active control.

Main Methods:

• A 2x2 factorial randomized controlled trial (Navigating to a Healthier Weight [NoHoW] trial) involving 1627 adults with prior weight loss.
• Participants were assigned to self-regulation, emotion regulation, combined, or active control groups.
• Primary outcome was weight change at 12 months; secondary outcomes included cardiometabolic markers.

Main Results:

• No significant differences in weight change were observed between any intervention arms and the active control at 12 months.
• Nearly half of participants regained weight, with no significant improvements in cardiometabolic markers.
• A small, clinically non-meaningful effect of motivation intervention was noted in men.

Conclusions:

• The NoHoW trial found no evidence that digital interventions for self-regulation or emotion regulation improved weight loss maintenance compared to an active control.
• Digital behavior change interventions show limitations for long-term weight outcomes.
• Future digital interventions may require enhanced engagement and tailored content for better results.