Weight Loss Attempts Research Articles

Self-Reported Weight-Loss Methods and Weight Change: Ten-Year Analysis in the Swedish Obese Subjects Study Control Group.

The Swedish Obese Subjects (SOS) study was designed to compare outcomes in patients with obesity treated by bariatric surgery and a matched control group given usual care. The aim of this study was to analyze self-reported weight-loss methods and weight changes over 10 years in the SOS control group. Self-reported weight-loss methods in the control group (n = 2,037; 71% women; 48.7 ± 6.3 years; BMI 40.1 ± 4.7 kg/m2 ) were analyzed at baseline and after 0.5, 1, 2, 3, 4, 6, 8, and 10 years of follow-up and studied in relation to weight changes. The average 10-year weight change was +2.1% (95% CI: 1.4%-2.8%). At every follow-up, 82.7% (95% CI: 81.3%-84.1%) of participants reported weight-loss attempts. At 10 years, 12.5% of the participants had ≥ 10% weight loss and 22.3% had ≥ 10% weight gain. Participants who lost or gained weight reported similar usage of weight-loss methods. Over 10 years, the majority of the participants of the SOS control group reported continuous efforts to lose weight. These results illustrate the constant struggle individuals with severe obesity are facing and that, on average, the results of long-term weight loss and weight maintenance were discouraging.

Obesity and weight misperception among adults in the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study.

SummaryObjectivePrior studies have suggested that weight misperception – underestimating one's actual weight – may be associated with reduced engagement in weight loss programmes, decreasing the success of initiatives to address obesity and obesity‐related diseases. The purpose of this study was to examine the factors associated with weight misperception among Eastern Caribbean adults and its influence on engagement in weight control behaviour.MethodsData from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study were analysed (adults aged 40 and older, residing in the US Virgin Islands, Puerto Rico, Barbados and Trinidad). Weight misperception is defined as participants who under‐assess their weight measured by body mass index (BMI). Multivariable logistic regression (n = 1,803 participants) was used to examine the association of weight misperception with BMI category, age, gender, education, history of non‐communicable disease and attempt to lose weight.ResultsWeight misperception was common, with 54% of overweight (BMI 25–29 kg m−2), and 23% of obese class I (BMI 30–34.9 kg m−2) participants under‐assessing their actual weight. Participants with higher levels of education, versus lower, had decreased odds of weight misperception (OR 0.5, p < 0.001). There were no significantly reduced odds of weight misperception in women versus men (OR 1.13, p = 0.367) or in individuals with history of diabetes versus none (OR 0.88, p = 0.418). Participants with weight misperception had 85% (p < 0.0001) lower odds of attempting weight loss than those with accurate weight perception.ConclusionWeight misperception is common among adults with overweight and obesity in the Eastern Caribbean and is associated with lower likelihood of attempting weight loss. Obesity interventions, targeting similar populations, should incorporate approaches for addressing weight misperception to achieve measurable success.

Experiences of Reframing during Self-Directed Weight Loss and Weight Loss Maintenance: Systematic Review of Qualitative Studies.

BackgroundReframing means changing the way that a person thinks or feels about a weight loss attempt or weight loss maintenance to enhance its experience or facilitate its success. Although participants have described this, it has not been explored in the academic literature. Here, we set out to systematically review qualitative studies to examine the ways in which people use and experience reframing in self‐directed weight loss.MethodsSeven electronic databases were searched to January 2017 for qualitative studies of adults with overweight or obesity attempting to lose weight or maintain weight loss through self‐directed behavior change. Studies must have contained some information pertinent to reframing. Thematic synthesis was used to identify descriptive and analytical themes from the available data.ResultsWe included 23 studies, representing 723 participants. No study focused specifically on reframing. Most studies involved people who had tried to lose weight previously. In the most common examples of reframing, participants spoke of construing previous weight management attempts as “dieting”, whereas in current attempts they used reframing to move away from this concept. Participants spoke of finding reframing helpful because it removed the sense of depriving themselves and instead allowed them to construe the food choices as healthful. Likewise, the language of dieting created a sense of temporary effort, while construing this as a way of life allowed continuation of conscious control over energy balance without the feeling of undue effort. In some cases, these changes were bolstered by change in self‐identity.ConclusionsSome people construe deliberate weight loss as a form of deprivation and cognitively reframe to avoid the negative emotions this creates and to prevent relapse. Reframing the dietary regimen as about healthy eating and a new way of life made weight control seem less burdensome for these participants and they felt able to maintain their efforts.

Efficacy of video-based education program in improving metabolic surgery perception among patients with obesity and diabetes

BackgroundMetabolic surgery remains underutilized despite its efficacy and safety. Poor perception of surgery has been cited as one of the major reasons. ObjectivesEvaluate current patient perceptions about metabolic surgery and measure the impact a video-based education program has on changing the perceptions of patients diagnosed with obesity and type 2 diabetes. SettingA university hospital in the United States. MethodsA prospective interventional study was performed at an endocrinology clinic. Patients were asked to complete surveys evaluating their perception of metabolic surgery before and after watching a short educational video. ResultsA total of 51 patients were recruited; almost all patients (98%) attempted weight loss in the past, and approximately 90.1% voiced dissatisfaction with their current weight. The video-based education program was effective in improving the patient's perception of the efficacy and safety with regard to surgery. In addition, the proportion of patients with overall positive impression toward metabolic surgery increased from 22.5% to 53.1% (P < .01) and those willing to undergo surgical consultation increased from 41.7% to 51.0% (P < .01). Among those that remained unwilling, fear of surgery in general was the most commonly voiced reason (31.4%), with safety (27.5%) and cost of metabolic surgery (27.5%) being equally concerning. ConclusionsMost patients with obesity and type 2 diabetes held negative impressions of metabolic surgery due to its perceived risk profile. A video-based educational intervention may improve patients’ perception and increase their willingness for surgical referral. Future trials with a broader sample and longer follow-up could provide answers to its efficacy in increasing metabolic surgery accessibility.

Sociodemographic factors associated with reported attempts at weight loss and specific dietary regimens in Sweden: The SWEDIET-2017 study.

The aim of this study was to investigate the prevalence of active weight loss attempts in Sweden, and to study the extent to which overweight individuals may or may not correctly identify themselves as overweight. Additional aims were to determine the sociodemographic factors associated with following a specific dietary regimen and with attempts at losing weight. A postal questionnaire was sent to 2000 randomly selected men and women living in Sweden. The inclusion criteria was an age of 20–65 years. In total, the response rate was 28% and the completed questionnaires from 555 participants were analyzed in this study. In total, 46% of participants were overweight or obese by self-reported height and weight. Additionally, 42% of overweight and 90% of obese individuals correctly identified themselves as being overweight. Weight loss was pursued by 41% and was more common among women, those with higher physical activity, higher BMI and higher socioeconomic position. Overall, 22% followed a specific diet, and following a dietary regimen was associated with female gender, higher education level and overweight. In conclusion, almost half of the participants were either overweight or trying to lose weight. Trying to lose weight and following a specific dietary regimen were related to female gender, high BMI and higher socioeconomic position. This could indicate that the socioeconomic disparities in health are further exacerbated, as overweight individuals with poor socioeconomic position might be more likely to remain overweight.

Polycystic ovary syndrome (PCOS) associates with dissatisfied body image and weight loss attempts at age 31 and 46 - A prospective, population-based Cohort study

Polycystic ovary syndrome (PCOS) associates with dissatisfied body image and weight loss attempts at age 31 and 46 - A prospective, population-based Cohort study

A Low Energy–Dense Diet in the Context of a Weight-Management Program Affects Appetite Control in Overweight and Obese Women

BackgroundLow energy–dense (LED) foods reduce energy intake (EI); whether this effect is sustained over time and during weight loss is unknown.ObjectiveThis trial examined the effects of LED compared with high energy–dense (HED) meals on appetite, EI, and control over eating in the laboratory and during a weight-management program that encourages unrestricted intake of LED foods [Slimming World, UK (SW)] compared with a self-led Standard Care program [NHS weight-loss plan (SC)].MethodsOverweight and obese women [n = 96; mean ± SD age: 41.03 ± 12.61 y; mean ± SD body mass index (in kg/m2): 34.00 ± 3.61] were recruited from the SW or SC programs. Primary outcomes included appetite, food preferences (liking and wanting for LED and HED foods), cravings, and evening meal EI (LED, HED) in response to calorie-matched LED (≤0.8 kcal/g) and HED (≥2.5 kcal/g) breakfast and lunch meals. Probe-day tests were conducted at weeks 3 and 4 and repeated at weeks 12 and 13 in a within-day crossover design. Secondary outcomes, including body weight and program experience, were measured from weeks 1 to 14 in a parallel-group design. Dietary compliance was monitored with the use of weighed food diaries at weeks 3 and 12.ResultsIntention-to-treat (ITT) and completers analyses showed that the SW group lost more weight than the SC group [ITT: −5.9% (95% CI: −4.7%, –7.2%) compared with −3.5% (−2.3%, −4.8%), P < 0.05; completers: −6.2% (−4.8%, −7.6%) compared with 3.9% (−2.5%, −5.2%), P < 0.05]. The SW group reported greater control over eating and more motivation to continue the program compared with the SC group. LED meals increased sensations of fullness and reduced hunger on probe days (P < 0.001). Total-day EI was 1057 ± 73 kcal less (95% CI: 912, 1203 kcal; 36%) under LED compared with HED conditions (P < .001). Liking for LED and HED foods and wanting for HED foods were lower before lunch under LED compared with HED conditions, and liking decreased to a greater extent after the LED lunch. The SW group reported fewer cravings under LED compared with HED conditions (P < 0.05). On probe days, appetite and EI outcomes did not differ between weeks 3 and 12 or between the SW and SC groups.ConclusionLED meals improve appetite control in women attempting weight loss and the effect is sustainable. Consumption of LED meals likely contributed to weight loss in the SW program. This study was registered at clinicaltrials.gov as NCT02012426.

Weight suppression and weight elevation are associated with eating disorder symptomatology in women age 50 and older: Results of the gender and body image study.

Weight suppression (WS), the difference between highest past non-pregnancy weight and current weight, predicts negative outcomes in eating disorders, but the impact of WS and related weight constructs are understudied in nonclinical, midlife populations. We examined WS (current weight < highest weight) and weight elevation (WE), the opposite of WS (current weight > lowest weight) and their associations with eating psychopathology in women aged 50+. Participants were a community-based sample (N = 1,776, Mage = 59) who completed demographic and eating psychopathology questions via online survey. WS, WE, and WS × WE were tested as predictors of outcome variables; BMI and medical conditions that affect weight were controlled for. Individuals that were higher on WS and WE were most likely to engage in current weight loss attempts, dieting in the past 5 years, and extreme lifetime restriction. Individuals with higher WS were more likely to experience binge eating, greater frequency of weight checking, overvaluation of shape and weight, and lifetime fasting. Individuals with higher WE were more likely to report negative life impacts of eating and dieting. Higher WS and WE each predicted higher levels of skipping meals over the lifetime. This novel study investigated WS in midlife women and introduced a new conceptualization of weight change (WE) that may be more relevant for aging populations given that women tend to gain weight with age. The findings implicate the utility of investigating both WS and WE as factors associated with eating psychopathology in midlife women.

Recent Trends in Weight Loss Attempts: Data From the Korea National Health and Nutrition Examination Survey.

Obesity is global health concern. It is important to understand trends in weight loss attempts from a preventive health standpoint. This study aimed to investigate trends in weight loss attempts among Korean adults. Data from 81 605 adults ≥18 years who participated in the 2005 to 2015 Korean National Health and Nutrition Examination Survey were analyzed. Participants were classified into 5 groups by body mass index. The percentage of weight loss attempts was standardized with the 2010 Korean Housing Census. The percentage of weight loss attempts increased significantly over time in both sexes. Stratified subgroups showed various trends in the percentage of weight loss attempts by the subjects. In particular, older men aged 60 to 69 years and ≥80 years and women aged 70 to 79 years showed significant increasing trends in the percentage of weight loss attempts. More obese subjects attempted to lose weight more frequently during the entire survey period in both sexes.

Current Weight Management Approaches Used by Primary Care Providers in Six Multidisciplinary Healthcare Settings in Ontario.

Obesity management in primary care has been suboptimal due to lack of access to allied health professionals, time, and resources. To understand the weight management approaches used by primary care providers working in team-based settings and how they assess the most suitable approach for a patient. A total of 20 primary care providers (13 nurse practitioners and 7 family physicians) working in 6 multidisciplinary clinics in Ontario were interviewed. All interviews were recorded, transcribed verbatim, and coded using NVivo qualitative software. Conventional content analysis was used to inductively elucidate codes, which were then clustered into categories. A referral to on-site programming was the most frequent weight management approach used. The pharmacological approach was underutilized due to adverse side effects and cost to patients. Primary care providers assessed the most suitable weight management approach based on patients': preference, level of motivation, income status and access to resources, body mass index and comorbidities, and previous weight loss attempts. Primary care providers perceived that referring to health professionals and educational resources were the approaches preferred by patients. The team-based nature of these clinics allowed for referrals to various on-site professionals and/or programs. Some barriers to pursuing weight management avenues with patients were patient dependent.

Abstract 146: Efficacy of a Nurse-Led Risk Factor Modification Program in Achieving Weight Loss in Obese Atrial Fibrillation Patients

Objective: Weight loss (WL) can improve arrhythmia outcomes in obese patients (pts) with atrial fibrillation (AF). Although WL in this population has been achieved by strict dietary and lifestyle modification in physician-led research protocols, these resource intensive strategies have limited real-life applicability. We report the efficacy of a pragmatic outpatient based nurse-led risk factor modification (RFM) program that utilizes a high-touch, single point of care approach for achieving WL in AF pts at a tertiary care arrhythmia program. Methods: All new AF pts with obesity (defined as body mass index (BMI) ≥30kg/m 2 ) were offered enrollment. The pragmatic approach to WL focused on patient engagement and education, motivational interviewing, development of individualized lifestyle modification goals to improve dietary and exercise habits, and longitudinal telephonic care management to reinforce these changes. WL and compliance with established goals were assessed during ongoing biweekly (initial 2 months) then monthly follow-up support calls for up to 12 months. Continuing participation in RFM program was on a voluntary basis. Pts unable to achieve ≥3% WL by 3 months were referred for escalated care to a WL physician specialist. Pts who declined participation served as controls. Student t-test and chi-square tests were used to compare continuous and dichotomous variables. Results: Between 11/1/16 to 10/31/17, 189 pts (BMI 36.3±6) enrolled in RFM program, and 115 pts (BMI 35.5±5.4; P=NS) declined participation. The majority of enrolled pts (72%, n=136 of 189) had failed ≥1 previous WL attempts. Follow-up WL data (5.5±4.1 months for enrolled; 5.2±2.9 months for declined; P=NS) was available and compared in 162 enrolled (86%, n=162 of 189) and 59 declined (51%, n=59 of 115) pts. Pts enrolled in RFM program achieved significantly greater WL than declined pts (2.7±3.8% vs. 0.3±3.5%, respectively; p&lt;0.05). See table for details. Conclusions: A pragmatic nurse-led risk factor modification strategy focusing on lifestyle changes reinforced by frequent patient follow-up can be effective in achieving weight loss in obese atrial fibrillation patients. This single point of care approach is a potentially sustainable model for maintaining weight loss in this population.

Attribution of weight regain to emotional reasons amongst European adults with overweight and obesity who regained weight following a weight loss attempt

PurposeDespite the wide availability of effective weight loss programmes, maintenance of weight loss remains challenging. Difficulties in emotion regulation are associated with binge eating and may represent one barrier to long-term intervention effectiveness in obesity. The purpose of this study was to determine the relationship between emotion regulation difficulties and the extent of weight regain in a sample of adults who had lost, and then regained, weight, and to examine the characteristics associated with emotional difficulties.Methods2000 adults from three European countries (UK, Portugal, and Denmark) completed an online survey assessing self-reported weight loss and regain following their most recent weight loss attempt. They also completed a binge eating disorder screening questionnaire and, if they had regained weight, were asked if they attributed it to any emotional factors (a proxy for emotion regulation difficulties). Spearman’s correlations and logistic regression were used to assess the associations between emotion regulation, weight regain, and strategy use.ResultsEmotion regulation difficulties were associated with greater weight regain (N = 1594 who lost and regained weight). Attribution to emotional reasons was associated with younger age, female gender, loss of control and binge eating, lower perceptions of success at maintenance, using more dietary and self-regulatory strategies in weight loss, and fewer dietary strategies in maintenance.ConclusionsWeight-related emotion regulation difficulties are common amongst regainers and are associated with regaining more weight. Affected individuals are already making frequent use of behavioural strategies during weight loss, but do not apply these consistently beyond active attempts. Simply encouraging the use of more numerous strategies, without concurrently teaching emotion regulation skills, may not be an effective means to improving weight outcomes in this group.Level of evidenceLevel V, descriptive (cross-sectional) study.

Bariatric surgery and its impact on pseudotumor cerebri: A case report

PurposePseudotumor cerebri is a debilitating condition that causes severe headaches and progressive visual field loss. In this report, we present a patient with Class III obesity, with pseudotumor cerebri who failed medical management and attempted weight loss via diet and exercise. ObservationsAfter undergoing bariatric surgery, the patient had significant weight loss and improvement of visual field defects. Conclusion and importanceThese results suggest that bariatric surgery may be an effective option for patients with rapidly progressing visual loss due to pseudotumor cerebri.

Support needs of patients with obesity in primary care: a practice-list survey

BackgroundUK guidelines recommend that patients with obesity in primary care receive opportunistic weight loss advice from health care professionals, but there is a lack of research into the characteristics and existing weight management practices of these patients. The aim of this study was to characterise primary care patients with obesity in England, to inform the screening, support, and referral options appropriate to this group.MethodsWe surveyed 1309 patients registered at 15 GP practices in North East England, aged ≥18 years and with objectively recorded obesity (BMI ≥ 30 kg/m2). Study participants reported their weight history, health status, past and current weight loss activities, motivating factors, weight loss strategies used, professional support received, and perceived barriers to weight loss.Results62% of participants were actively trying to lose weight, and a further 15% had attempted and discontinued weight loss in the last 12 months. Only 20% of the sample had sought GP support for weight loss in the last 12 months; instead, most efforts to lose weight were self-guided and did not use evidence-based strategies. Those who sought GP weight loss support were likely to use it and find it motivating. Participants had attempted weight loss on multiple previous occasions and overall felt less confident and successful at maintaining weight loss than losing it. Participants at greatest clinical risk (higher BMI and more health conditions) reported particularly low confidence and multiple barriers to weight loss, but were nevertheless highly motivated to lose weight and keep it off.ConclusionsWe identified the need for informational, structural, and weight loss maintenance-specific support for GP patients with objectively-recorded obesity. Study participants were motivated to lose weight and keep it off, but lacked the confidence and understanding of effective strategies required to do this. GP weight loss support was acceptable and useful but underutilised, indicating that screening and brief referral interventions to structured programmes may augment patients’ current weight management activities and meet key support needs whilst optimising limited primary care resources.

Body Size Misperception and Overweight or Obesity among Saudi College-Aged Females.

The aim of the study was to investigate the associations between perceived and desired body size and overweight and obesity among college-aged females. A multistage stratified cluster random sample was used to select 907 healthy females from a major Saudi public university. The Stunkard Figure Rating Scale (FRS) was used for body size assessment. Overweight/obesity classification was based on BMI less than or equal to/greater than 25 kg/m2. Overweight plus obesity prevalence was 28.1%. There were significant differences between females with overweight/obesity and those without overweight/obesity in both perceived and desired body size scores. Compared with only 4% of females without overweight/obesity, 37% of the participants with overweight/obesity scored higher than five (median) in the FRS. The perceived body size correlated more strongly with many of the selected variables than did the desired body size, especially with BMI (r=0.679; p < 0.001), body weight (r=0.652; p < 0.001), and weight loss attempts (r=0.466; p < 0.001). Also, there was a significant relationship between BMI and weight loss attempts (r=0.370; p < 0.001). BMI and weight loss attempts appear to predict the perceived body size and the discrepancy between perceived and desired body size scores. Psychosocial and lifestyle factors that might influence female's body misperception need to be addressed in future studies.

Understanding Dieting and Previous Weight Loss Attempts among Overweight and Obese Participants: Insights into My Body Is Fit and Fabulous at Work Program.

BackgroundA qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program.MethodsThirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed.ResultsThe participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors.ConclusionReal-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.

Describing Weight Loss Attempts and Physical Activity Among Individuals With TBI Prior to Participation in a Weight-Loss Program.

Describe (1) weight loss history, (2) perceptions about lifestyle changes, and (3) physical activity among a sample of individuals with traumatic brain injury prior to a 12-month lifestyle change program. Community-based. Individuals enrolled in a lifestyle change program, 6 months or more post-traumatic brain injury, body mass index of 25 or greater, 18 to 64 years of age, with physician's clearance to participate. Convenience sample. Self-report data were collected before beginning the lifestyle change program including descriptive, weight loss history and physical activity behavior using the Modifiable Activity Questionnaire. The final sample included 22 participants (M age = 46 years) injured a median of 8 years ago. Mean weight was 208.5 lb (SD = 40.2), with average body mass index of 31.84 (SD = 4.4). Since injury, 72.7% reported prior weight loss attempts, with 50% gaining 10 lb or more. All participants indicated high motivation for lifestyle changes. Perceived benefits included feeling better, improving overall health, and increased energy. Barriers included physical health complications. Types of physical activity completed included walking (68%, 180 min/mo) and swimming (32%, 79 min/mo). Results indicate that many individuals gained weight since injury and attempted weight loss, demonstrating a need for evidence-based lifestyle interventions. Future research is needed to determine whether individuals with traumatic brain injury are able to achieve and maintain weigh loss through intervention.

Supplemental Material for Self-Perceived Overweight, Weight Loss Attempts, and Weight Gain: Evidence From Two Large, Longitudinal Cohorts

Supplemental Material for Self-Perceived Overweight, Weight Loss Attempts, and Weight Gain: Evidence From Two Large, Longitudinal Cohorts

Insights From Google Play Store User Reviews for the Development of Weight Loss Apps: Mixed-Method Analysis.

BackgroundSignificant weight loss takes several months to achieve, and behavioral support can enhance weight loss success. Weight loss apps could provide ongoing support and deliver innovative interventions, but to do so, developers must ensure user satisfaction.ObjectiveThe aim of this study was to conduct a review of Google Play Store apps to explore what users like and dislike about weight loss and weight-tracking apps and to examine qualitative feedback through analysis of user reviews.MethodsThe Google Play Store was searched and screened for weight loss apps using the search terms weight loss and weight track*, resulting in 179 mobile apps. A content analysis was conducted based on the Oxford Food and Activity Behaviors taxonomy. Correlational analyses were used to assess the association between complexity of mobile health (mHealth) apps and popularity indicators. The sample was then screened for popular apps that primarily focus on weight-tracking. For the resulting subset of 15 weight-tracking apps, 569 user reviews were sampled from the Google Play Store. Framework and thematic analysis of user reviews was conducted to assess which features users valued and how design influenced users’ responses.ResultsThe complexity (number of components) of weight loss apps was significantly positively correlated with the rating (r=.25; P=.001), number of reviews (r=.28; P<.001), and number of downloads (r=.48; P<.001) of the app. In contrast, in the qualitative analysis of weight-tracking apps, users expressed preference for simplicity and ease of use. In addition, we found that positive reinforcement through detailed feedback fostered users’ motivation for further weight loss. Smooth functioning and reliable data storage emerged as critical prerequisites for long-term app usage.ConclusionsUsers of weight-tracking apps valued simplicity, whereas users of comprehensive weight loss apps appreciated availability of more features, indicating that complexity demands are specific to different target populations. The provision of feedback on progress can motivate users to continue their weight loss attempts. Users value seamless functioning and reliable data storage.

A systematic review of the relationship between weight status perceptions and weight loss attempts, strategies, behaviours and outcomes.

SummaryIt is commonly assumed that a person identifying that they are ‘overweight’ is an important prerequisite to successful weight management. However, there has been no systematic evaluation of evidence supporting this proposition. The aim of the present research was to systematically review evidence on the relationship between perceived overweight and (i) weight loss attempts, (ii) weight control strategies (healthy and unhealthy), (iii) weight‐related behaviours (physical activity and eating habits), (iv) disordered eating and (v) weight change. We synthesized evidence from 78 eligible studies and evaluated evidence linking perceived overweight with outcome variables separately according to the gender, age and objective weight status of study participants. Results indicated that perceived overweight was associated with an increased likelihood of attempting weight loss and with healthy and unhealthy weight control strategies in some participant groups. However, perceived overweight was not reliably associated with physical activity or healthy eating and was associated with greater disordered eating in some groups. Rather than being associated with improved weight management, there was consistent evidence that perceived overweight was predictive of increased weight gain over time. Individuals who perceive their weight status as overweight are more likely to report attempting weight loss but over time gain more weight.