Losing weight and keeping it off

Project title: The maintenance of Healthy Weight for Life program effects

Start date: January 2016
End date: August 2018

What is the issue?

Participants of weight loss programs often gradually regain any weight they have lost after the program ends, and there is limited evidence about strategies that help to prevent this weight re-gain.

Healthy Weight for Life (HWFL) is a weight loss program that private health insurance company HCF offers to members who have a Body Mass Index of 28 or more (ie. those who are overweight or obese) and have osteoarthritis, a cardiovascular condition or type 2 diabetes.

The program delivers a step-by-step weight loss program over three six-week phases.

Each phase includes:

A portion control eating plan
Recommendations for gentle activity and physiotherapist-developed strength, balance and mobility exercises
Personalised tracking of symptoms, progress and satisfaction
Personal motivation, support and advice via phone, SMS, email, message board and mail.

The program has been successful in helping participants to reduce their weight by an average of 7 per cent. More than 80 per cent of participants finish the program.

HCF was interested in ways to help its members to maintain the weight they had lost after the program finishes.

How did the project address the issue?

The project investigated the effectiveness of a 12-month maintenance program to maintain weight loss that participants achieve during the HWFL program.

Relevance for practice

There is currently little evidence around the maintenance of weight loss after the completion of an evidence-based program. Policy makers may find this information relevant for improving existing weight loss programs.

Private health insurance companies are in a position to provide healthy lifestyle interventions to a large proportion of the population but these interventions need to be evidence based. It is important to develop intervention approaches to weight loss maintenance that are relevant to the Australian health insurance context.

What are the expected outcomes?

The project showed whether a structured maintenance program helps participants of weight loss programs to maintain their weight loss longer term.

Project lead:

Associate Professor Philayrath Phongsavan, The University of Sydney

Project team:

Professor Adrian Bauman, The University of Sydney
Dr Andrew Cottrill, HCF
Dr Anne Grunseit, The University of Sydney
Bronwyn McGill, The University of Sydney
Dr Blythe O’Hara, The University of Sydney

This project was funded by the NHMRC, Australian Government Department of Health, NSW Ministry of Health, ACT Health and the HCF Research Foundation.

Recruitment and capturing consent for the evaluation of the Healthy Weight for Life (HWFL) Long-Term Weight Loss Maintenance Program commenced in January 2018
Data collection for the independent sub-study of the program commenced in January 2018
Mixed methods study published in February 2018

Publications

2021

McGill B, Grunseit AC, Phongsavan P, Harper C, O’Hara BJ. Meal replacement soups and shakes: Do they have a place in public health practice to manage weight loss? Public Health Res Pract. 2021;31(1):e30012002. First published: 29 January 2020. https://doi.org/10.17061/phrp30012002

2020

McGill B, O’Hara BJ, Phongsavan P, Bauman A, Lawler L, Grunseit AC. “I’m Still on Track”: A Qualitative Exploration of Participant Experiences of a Weight Loss Maintenance Program. Healthcare 2020 Mar(Vol. 8, No. 1, p. 21. doi: 10.3390/healthcare8010021
McGill B, Bauman A, Phongsavan P, Grunseit AC, Lees D, Shepherd L, et al. Beyond weight loss: Impact of a weight management programme for mid-older Australians in private health insurance. Clin Obes. 2020 Mar 26:e12359. doi: 10.1111/cob.12359. [Epub ahead of print].
McGill B, O’Hara BJ, Grunseit AC, Bauman A, Lawler L, Phongsavan P. Sociodemographic and health risk profile associated with participation in a private health insurance weight loss maintenance and chronic disease management program. Australian Health Review. 2020 Jan 29. doi: 10.1071/AH19046

2018

McGill B, O’Hara B, Bauman A, Grunseit A, Phongsavan P. Are financial incentives for lifestyle behaviour change informed or inspired by behavioural economics? Am J Health Promot. 2018. doi: 10.1177/0890117118770837
McGill B, O’Hara B, Grunseit A, Bauman A, Osborne D, Lawler L, Phongsavan P. Acceptability of financial incentives for maintenance of weight loss in mid-older adults: a mixed methods study. BMC Public Health. 2018;18:244 doi:10.1186/s12889-018-5136-z
McGill B, O’Hara BJ, Phongsavan P. Participant perspectives of a 6-month telephone-based lifestyle coaching program. Public Health Res Pract; 2018;28(2):327451705. doi: org/10.17061/phrp27451705

Presentations

World Congress on Public Health, oral presentation: Characteristics of Behavioural Economic Approaches to Promoting Behaviour Change in Lifestyle Interventions Using Financial Incentives. Melbourne, 5 April 2017.
International Society of Behavioural Nutrition and Physical Activity. Financial incentives are nice, but may not be enough to motivate weight loss maintenance: findings from a mixed method study of older health insurance members. ISBNPA 2017 Annual Meeting in Victoria, Canada, 8-10 June.
Public Health Research Showcase, oral presentation. Financial incentives may not be enough to motivate weight loss maintenance: findings from a mixed method study of older health insurance members. Sydney School of Public Health, 18 July 2017.
3rd Annual CPC EMCR Symposium, poster presentation. Losing weight is do-able, but keeping it off is challenging: can financial incentives help? Charles Perkins Centre, University of Sydney, 5-6 October 2017.
23^rd IUHPE World Conference on Health Promotion, Round table discussion. The power of partnership in real-world program evaluation: a case study. Rotorua, New Zealand 7-11 April 2019.