Effective Behavior Change Techniques for Successful Weight Loss and Weight Loss Maintenance Among Adults With...

Achieving and maintaining weight loss are challenging and require sustained lifestyle changes. This study examined which behavior change techniques (BCTs) support long-term weight outcomes among adults with overweight or obesity. We synthesized evidence from randomized controlled trials of behavioral interventions versus control or alternative interventions, focusing on nonclinical adults (BMI > 25) with ≥ 6-month follow-up, published between 2010 and 2025, that reported weight outcomes. Sixty-five studies (approximately 10,000 participants) evaluating 87 behavioral interventions targeting physical activity, diet, or both were included. BCTs were coded using the BCT Taxonomy v1. Meta-analysis estimated pooled effects on total weight loss (baseline to follow-up) and weight maintenance (posttreatment to follow-up). Behavioral interventions produced a mean effect size for total weight loss of Hedges' g = -0.19 (95% CI = -0.30 to -0.13), equating to an average additional weight loss of approximately 3.25 kg compared to controls. No significant effect was found for weight maintenance after initial loss, indicating no statistically significant difference in weight change between intervention and control groups during follow-up. Meta-regression examined the number of BCTs, intervention type, and follow-up duration, but none significantly moderated effects. Subgroup analyses identified the following effective BCTs: goal setting, feedback on behavior and outcome(s) of behavior, self-monitoring of behavior and outcome(s) of behavior, instruction on how to perform the behavior, demonstration of the behavior, conserving mental resources and incentives. These BCTs appear to support relative long-term weight outcomes and warrant further investigation.