Behavioral Weight Management Interventions Research Articles

The impact of behavioral weight management interventions on eating behavior traits in children with overweight or obesity: Systematic review and meta‐analysis

SummaryIntroductionBehavioral weight management interventions (BWMIs) are an evidence‐based strategy for addressing childhood obesity. Targeting eating behavior traits (EBTs; individual tendencies determining food intake/occasions) could play a pivotal role in improving the effectiveness of these behavioral interventions. The present study describes a systematic review and meta‐analysis of the impact of BWMIs on eating behavior traits in children with overweight or obesity.MethodsSeven databases were searched, and eligible studies included randomized controlled trials reporting EBT outcomes following BWMIs delivered to children with overweight or obesity (<18 years of age). Random effects meta‐analyses were conducted to compare EBT outcomes for intervention and control groups. Synthesis without meta‐analysis (SWiM) was applied for EBTs where meta‐analysis was not feasible.ResultsThe review identified eight trials characterizing the impact of BWMIs on 15 EBTs. Meta‐analyses of data from three trials at intervention completion and post‐intervention (average of 28 weeks [±8]) revealed positive short‐term increases in dietary restraint (SMD random effect 0.42 [95% CI 0.13, 0.70]). However, these effects were not sustained at follow‐up. Improvements in emotional eating, external eating, food responsiveness, and enjoyment of food were shown in studies which could not be pooled quantitatively.ConclusionBWMIs in children living with overweight/obesity are beneficial for the improvement of some EBTs at intervention completion including dietary restraint, emotional eating, external eating, food responsiveness, and enjoyment of food. However, this remains a relatively unexplored area and more research is needed to strengthen understanding of the multifaceted impact of child BWMIs on a comprehensive range of EBTs.

Behavioral Weight Management Interventions for Hispanic Men in the United States: A Systematic Review.

Hispanic men have the highest prevalence of obesity relative to other racial and ethnic subgroups; however, this population is consistently underrepresented in weight management interventions. This systematic review aims to provide an overview of behavioral weight management interventions adapted for Hispanic men and describe their tailoring strategies and efficacy. Six online databases were selected for their abundant collection of high-quality, peer-reviewed literature and searched for studies which evaluated and reported weight outcomes for a cohort of adult (>18 years) Hispanic men. Of 6,508 unique publications screened, 12 interventions met inclusion criteria, the majority of which were published in the past 10 years. Only one study regarding an intervention tailored for Hispanic men was a randomized controlled trial adequately powered to assess a weight-based outcome; the remaining assessed feasibility or utilized quasi-experimental methods. Intervention characteristics and tailoring strategies varied considerably, but content was most frequently based on the Diabetes Prevention Program. Tailoring strategies commonly focused on improving linguistic access and incorporating social or family support. Follow-up varied from 1 month to 30 months and mean change in weight, the most common outcome, ranged from 0.6 to -6.3 kg. Our findings reveal a need for more fully powered randomized controlled trials evaluating the efficacy of interventions systematically tailored specifically for Hispanic men. Although the majority were not fully powered, these interventions showed some efficacy among their small cohorts for short-term weight loss. Future directions include exploring how to tailor goals, concepts, and metaphors included in interventions and comparing individual to group delivery settings.

Intermittent Energy Restriction for Adolescents With Obesity

Adolescent obesity requires effective and accessible treatment. Intensive dietary interventions have the potential to be used as adjunctive therapy for behavioral weight management. To examine the effectiveness of 2 diet therapies, delivered as part of an intensive behavioral weight management intervention, in adolescents with metabolic complications associated with obesity. This multisite, 52-week randomized clinical trial was conducted from January 31, 2018, to March 31, 2023, at 2 tertiary pediatric centers in Australia. Adolescents (aged 13-17 years) with obesity and 1 or more associated complications were included. Intensive behavioral interventions, delivered by a multidisciplinary team, comparing intermittent energy restriction (IER) or continuous energy restriction (CER), with 3 phases: very low-energy diet (weeks 0-4), intensive intervention (weeks 5-16), and continued intervention and/or maintenance (weeks 17-52). The primary outcome was body mass index (BMI) z score at 52 weeks in the IER vs CER group. Anthropometry, body composition, and cardiometabolic health were assessed at baseline and 52 weeks. The BMI z score and percentiles were determined using Centers for Disease Control and Prevention growth charts. Insulin resistance, dyslipidemia, and elevated hepatic function were assessed. A total of 141 adolescents (median [IQR] age, 14.8 [12.9-17.9] years; 71 male [50.4%]) were enrolled, 71 in the IER group and 70 in the CER group, and 97 (68.8%) completed the intervention, 43 in the IER group and 54 in the CER group. At week 52, both groups had reduced BMI z scores (estimated marginal mean change, -0.28 [95% CI, -0.37 to -0.20] for IER and -0.28 [95% CI, -0.36 to -0.20] for CER) and reduced BMI expressed as a percentage of the 95th percentile (estimated marginal mean change, -9.56 [95% CI, -12.36 to -6.83] for IER and -9.23 [95% CI, -11.82 to -6.64] for CER). No differences were found in body composition or cardiometabolic outcomes between the groups. Both groups had a reduction in the occurrence of insulin resistance (from 52 of 68 [76.5%] to 32 of 56 [57.1%] in the IER group and from 59 of 68 [86.8%] to 31 of 60 [57.1%] in the CER group) at week 16; however, at week 52, this effect was observed in the CER group only (from 59 of 68 [86.7%] to 30 of 49 [61.2%]). The occurrence of dyslipidemia was unchanged between baseline and week 52 (60 of 137 [42.6%] and 37 of 87 [42.5%], respectively), with a small improvement in occurrence of impaired hepatic function tests (37 of 139 [27.0%] and 15 of 87 [17.2%], respectively). No differences were found in dyslipidemia or hepatic function between groups. These findings suggest that for adolescents with obesity-associated complications, IER can be incorporated into a behavioral weight management program, providing an option in addition to CER and offering participants more choice. http://anzctr.org.au Identifier: ACTRN12617001630303.

The impact of behavioural weight management interventions on eating behaviour traits in children with overweight or obesity: systematic review and meta-analysis

The impact of behavioural weight management interventions on eating behaviour traits in children with overweight or obesity: systematic review and meta-analysis

A non-randomized comparison of engagement and outcomes for in-person versus virtual delivery of the Partner2Lose weight management trial.

Existing behavioral weight management interventions produce clinically meaningful weight loss. The onset of the COVID-19 pandemic led to the quick transition of such interventions from in-person to virtual platforms. This provided a unique opportunity to compare engagement and outcomes for an in-person versus virtually delivered weight management intervention. A non-randomized comparison of engagement and weight outcomes was performed between two cohorts who participated in a weight management intervention in person (N=97) versus three who participated virtually via videoconference (N=134). Various metrics of engagement were examined, including group class and individual phone call attendance and duration, and retention for weight assessments. Behavioral targets of daily caloric intake and step-counts and the clinical weight outcome were explored. Cohorts (mean [standard deviation] age 47.3 (11.5), 67.1% women: 86.8% White) that participated virtually attended more group sessions (p<0.001) and had maintenance telephone calls that were of a longer duration (p<0.001). No other engagement or weight outcomes significantly differed by delivery modality. Virtual weight management programs are promising and may generate similar outcomes to those delivered in-person. Future research should seek to understand how best to promote and sustain engagement in virtual interventions.

A predictive model for medium-term weight loss response in people with type 2 diabetes engaging in behavioural weight management interventions.

To develop and evaluate prediction models for medium-term weight loss response in behavioural weight management programmes. We conducted three longitudinal analyses using the Action for HEalth in Diabetes (LookAHEAD) trial, Weight loss Referrals for Adults in Primary care (WRAP) trial, and routine data from the National Health Service Greater Glasgow and Clyde Weight Management Service (NHS-GGCWMS). We investigated predictors of medium-term weight loss (>5% body weight) over 3 years in NHS-GGCWMS and, separately, predictors of weight loss response in LookAHEAD over 4 years. We validated predictors in both studies using WRAP over 5 years. Predictors of interest included demographic and clinical variables, early weight change in-programme (first 4 weeks) and overall in-programme weight change. In LookAHEAD and WRAP the only baseline variables consistently associated with weight loss response were female sex and older age. Of 1152 participants in NHS-GGCWMS (mean age 57.8 years, 60% female, type 2 diabetes diagnosed for a median of 5.3 years), 139 lost weight over 3 years (12%). The strongest predictor of weight loss response was early weight change (odds ratio 2.22, 95% confidence interval 1.92-2.56) per 1% weight loss. Losing 0.5% weight in the first 4 weeks predicted medium-term weight loss (sensitivity 89.9%, specificity 49.5%, negative predictive value 97.3%). Overall in-programme weight change was also associated with weight loss response over 3 years in NHS-GGCWMS and over 5 years in WRAP. Not attaining a weight loss threshold of 0.5% early in weight management programmes may identify participants who would benefit from alternative interventions.

Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model.

Increasing overweight and obesity rates represent one of the global public health challenges. COM-B is a theoretical model used to identify areas to target to achieve behavior change. It identifies three factors that are needed for any behavior to occur: capability, opportunity, and motivation. We aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B. The study included 139 people with overweight and obesity (mean age 48.81 ± 14.49 years; 64.5% female; body mass index 32.64 ± 6.51 kg/m2; waist-to-height ratio 0.62 ± 0.10) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Overall Evaluation of Health (OEH). Multiple linear regression was performed to analyse the data. The associations between sociodemographic and clinical variables and COM-B domains attenuated or were no longer significant when psychological resources were added to the regression models. Self-efficacy was identified as a stronger facilitator of health behavior change (p < 0.001) when compared to self-esteem (p < 0.05). No associations between automatic motivation and psychological resources were identified, however. Automatic motivation was found to be associated with higher age, being in a relationship, and better health. Behavioral interventions for weight management should specifically target different components of COM-B. Self-efficacy and self-esteem may play a significant role in individual capabilities, opportunities, and reflective motivation and should be included in tailored public health interventions. Health programs targeting younger and single people, and people with chronic conditions may help to promote sustainable behavior change.

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity.

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity.

Characterising individual variability in associations between self-monitoring and weight change during and after a behavioral weight management program.

Greater self-monitoring of caloric intake and weight has been associated with success at both initial weight loss and long-term maintenance. Given the existence of wide variability in weight loss outcomes and the key role of self-monitoring within behavioral weight management interventions, this study examined individual variability in associations between self-monitoring and weight change and whether demographic factors could predict who may best benefit from self-monitoring. Participants were 72 adults with overweight or obesity (mean±SD, age=50.6±10.3; body mass index=31.2±4.5kg/m2; 71%Female; 83%White) enrolled in a 12-week weight loss program followed by a 40-week observational maintenance period. Participants were encouraged to self-monitor caloric intake and weight daily and to report these data via a study website each week. Multilevel mixed models were used to estimate week-to-week associations between self-monitoring and weight change, by individual and linear regressions and ANOVAs were used to explore demographic differences in these associations. Most participants (68%) demonstrated statistically significant negative associations between self-monitoring of either caloric intake or weight and weight change. Of these, 76% benefited from self-monitoring both caloric intake and weight, 18% from self-monitoring caloric intake only, and 6% from self-weighing only. The magnitude of associations between self-monitoring and weight change did not significantly differ by age, gender, race/ethnicity, education, or income, all ps>0.05. Differences in the effectiveness of self-monitoring for weight loss were not observed by demographic characteristics. Future research should examine if other factors may predict the effectiveness of self-monitoring.

Eating disorders in weight-related therapy (EDIT): Protocol for a systematic review with individual participant data meta-analysis of eating disorder risk in behavioural weight management.

The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual participant data (IPD) meta-analysis which aims to identify participants at risk of developing eating disorders, or related symptoms, during or after weight management interventions conducted in adolescents or adults with overweight or obesity. We systematically searched four databases up to March 2022 and clinical trials registries to May 2022 to identify randomised controlled trials of weight management interventions conducted in adolescents or adults with overweight or obesity that measured eating disorder risk at pre- and post-intervention or follow-up. Authors from eligible trials have been invited to share their deidentified IPD. Two IPD meta-analyses will be conducted. The first IPD meta-analysis aims to examine participant level factors associated with a change in eating disorder scores during and following a weight management intervention. To do this we will examine baseline variables that predict change in eating disorder risk within intervention arms. The second IPD meta-analysis aims to assess whether there are participant level factors that predict whether participation in an intervention is more or less likely than no intervention to lead to a change in eating disorder risk. To do this, we will examine if there are differences in predictors of eating disorder risk between intervention and no-treatment control arms. The primary outcome will be a standardised mean difference in global eating disorder score from baseline to immediately post-intervention and at 6- and 12- months follow-up. Identifying participant level risk factors predicting eating disorder risk will inform screening and monitoring protocols to allow early identification and intervention for those at risk.

P23-071-23 BB-Health: A Pilot Randomized Feasibility Trial of Food Supplement and Behavioral Weight Management Interventions To Prevent Cognitive Decline in Older Adults

P23-071-23 BB-Health: A Pilot Randomized Feasibility Trial of Food Supplement and Behavioral Weight Management Interventions To Prevent Cognitive Decline in Older Adults

Coconstruction of adjunct behavioral interventions to bariatric surgery: The INTER-Change program.

The INTER-Change program aims to use systematic frameworks to develop adjunct behavioral interventions to enhance long-term behavior change and improve outcomes in patients undergoing bariatric surgery (BS). This paper details the program strategies and how engagement of interested parties is shaping the research. The core elements of this work include: (a) A living systematic review of behavioral weight management (BWM) interventions adjunct to BS; (b) Focus groups of interested parties, including patients, healthcare professionals, and administrators, on different aspects of designing and implementing adjunct behavioral interventions; (c) A patient-generated survey to assess needs for behavioral interventions to support BWM; (d) An international eDelphi study involving interested parties to prioritize intervention components and delivery structures; and (e) An international consensus meeting to construct testing intervention protocol(s). The systematic review revealed that delivering BWM interventions during the postoperative period resulted in better weight maintenance; however, most interventions reviewed were poorly developed, and none included interested parties. Initial themes from ongoing focus groups highlighted nonweight-related outcomes as being key goals of adjunct behavior change interventions, with a strong emphasis on psychological well-being and health-related behaviors. The patient survey will add patients' feedback on current interventions and expectations. Finally, the eDelphi process and international consensus meeting will integrate all the findings to develop more efficient behavioral interventions and appropriate testing protocol(s). This integrated knowledge translation approach will help ensure that the behavioral adjunct interventions are relevant to interested parties' needs, well-designed, effective, and more likely to be implemented successfully. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Formative Development of a Weight Management Intervention for Adolescents with Type 1 Diabetes Mellitus and Obesity.

The prevalence of overweight and obesity in youth with type 1 diabetes mellitus (T1D) now exceeds that of youth without T1D. Comorbid T1D and excess adiposity are associated with multiple serious negative health outcomes. Unfortunately, youth with T1D are often excluded from and/or not referred to standard behavioral lifestyle interventions. This is often attributed to the complexities of managing T1D and an effort not to overburden persons who have T1D. Furthermore, standard behavioral weight management intervention recommendations can be perceived as contradicting T1D disease management (e.g., removing sugar-sweetened beverages from diet, energy balance with exercise, and caloric restriction). A weight management intervention specifically designed for youth with T1D is needed to provide treatment to youth with comorbid T1D and overweight/obesity. The current study interviewed adolescents with T1D and overweight/obesity (n = 12), their caregivers (n = 12), and pediatric endocrinologists (n = 9) to understand (a) whether they would be interested in a weight management intervention adapted for youth with T1D and (b) specific adaptations they would want and need. Five central themes emerged following applied thematic analysis: (1) program content, (2) programmatic messaging, (3) program structure, (4) social support, and (5) eating disorder risk. Results provide detailed recommendations for the adaptation of a behavioral weight management intervention for youth with T1D.

Commentary: Addressing Health Disparities in Hospital-Based Interventions for Adolescents and Their Caregivers.

Adolescent obesity is a complex and significant public health concern affecting over 340 million children and adolescents aged 5–19 worldwide in 2016 (WHO, 2021). To mitigate such risks, the U.S. Preventative Services Task Force recommended behavioral weight management (WM) interventions for children >6 years of age (Grossman et al., 2017). However, the prevalence of income disparities in structured WM programs amongst adolescents from lower-income backgrounds exhibits fewer positive outcomes (e.g., reduction in weight, body fat, blood pressure) than peers from middle-class backgrounds (Demeule-Hayes et al., 2016; Kalarchian et al., 2009). Concerningly, adolescents from low-income backgrounds have higher attrition and less engagement in structured WM programs suggesting a need to identify the specific mechanisms influencing the lack of engagement with this population (Hawkins et al., 2018; Rhodes et al., 2017). Kilbourne and colleagues’ (2006) framework highlights the necessity to identify existing health disparities (phase 1), specific mechanisms driving health disparities (phase 2), and action on interventions and policy change (phase 3) to understand, reduce, and eliminate gaps in healthcare. (Darling et al., this issue)’ qualitative study (this issue) goes beyond describing existing differences in access to care, expanding our understanding of specific factors influencing WM program initiation, engagement, and attrition amongst adolescents and their caregivers from low-income backgrounds. Overall, findings highlight a clear gap concerning participants’ comprehension of program goals, misconceptions, and the importance of engaging caregivers to enhance adolescent program engagement and positive outcomes. There is no doubt that this study fills a significant gap in the literature; however, it is important to consider (a) strengths and (b) future directions to inform research in the broader context of pediatric psychology.

Program Factors Affecting Weight Loss and Mobility in Older Adults: Evidence From the Mobility and Vitality Lifestyle Program (MOVE UP).

Background. The Mobility and Vitality Lifestyle Program (MOVE UP) is a behavioral weight-management intervention for improving mobility among community-dwelling older adults. We examined program factors that affect implementation outcomes and participant-level health outcomes. Methods. The MOVE UP program was implemented in the greater Pittsburgh area from January 2015 to June 2019 to improve lower extremity performance in community-dwelling older adults who were overweight or obese. Thirty-two sessions were delivered over 13 months. All sessions were designed to be 1-hour in length, on-site, group-based, and led by trained and supported community health workers (CHWs). Participants completed weekly Lifestyle Logs for self-monitoring of body weight, diet, and physical activity. We evaluated the MOVE UP program using the RE-AIM framework, and collected quantitative data at baseline, 5-, 9-, and 13-months. Multilevel linear regression models assessed the impacts of program factors (site, CHW, and participant characteristics) on implementation outcomes and participant-level health outcomes. Results. Twenty-two CHWs delivered MOVE UP program to 303 participants in 26 cohorts. Participants were similar to the target source population in weight but differed in some demographic characteristics. The program was effective for weight loss and lower extremity function in both intervention and maintenance periods (ps < .01), with an independent effect for Lifestyle Logs submission but not session attendance. Discussion. CHWs were able to deliver a multi-component weight loss intervention effectively in community settings. CHW and site characteristics had independent impacts on participants' adherence. Lifestyle Log submission may be a more potent measure of adherence in weight loss interventions than attendance.

Eating disorder risk during behavioral weight management in adults with overweight or obesity: A systematic review with meta-analysis.

This systematic review examined change in eating disorder risk during weight management interventions. Four databases and clinical trials registries were searched in March and May 2022, respectively, to identify behavioral weight management intervention trials in adults with overweight/obesity measuring eating disorder symptoms at pre- and post-intervention or follow-up. Random effects meta-analyses were conducted examining within group change in risk. Of 12,023 screened, 49 were eligible (n = 6337, mean age range 22.1 to 59.9 years, mean (SD) 81(20.4)% female). Interventions ranged from 4 weeks to 18 months, with follow-up of 10 weeks to 36 months post-intervention. There was a within group reduction in global eating disorder scores (20 intervention arms; Hedges' g = -0.27; 95% CI -0.36, -0.17; I2 67.1%) and binge eating (49 intervention arms; -0.66; 95% CI -0.76, -0.56; I2 82.7%) post-intervention, both maintained at follow-up. Of 14 studies reporting prevalence or episodes of binge eating, all reported a reduction. Four studies reported eating disorder symptoms, not present at baseline, in a subset of participants (0%-6.5%). Overall, behavioral weight management interventions do not increase eating disorder symptoms for most adults; indeed, a modest reduction is seen post-intervention and follow-up. A small subset of participants may experience disordered eating; therefore, monitoring for the emergence of symptoms is important.

Are there inequalities in the attendance and effectiveness of behavioural weight management interventions for adults in the UK? Protocol for an individual participant data (IPD) meta-analysis

IntroductionIt is important to identify whether behavioural weight management interventions work well across different groups in the population so health inequalities in obesity are not widened. Previous systematic reviews of...

IMPROVING THE PERFORMANCE OF COMMUNITY HEALTH WORKERS IN A BEHAVIORAL LIFESTYLE INTERVENTION FOR OLDER ADULTS

Abstract Community health workers (CHWs) play essential roles in implementing community-based behavioral lifestyle interventions. This qualitative analysis aimed to explore what program factors and CHW characteristics would help improve CHW performance in the Mobility and Vitality Lifestyle Program (MOVE UP), a community-based behavioral weight-management intervention for improving mobility among overweight or obese older adults. The MOVE UP program was implemented from January 2015 to June 2019 at 23 community-based sites in Pittsburgh, Pennsylvania. Trained and supported CHWs delivered 32 group sessions over 13 months. We collected data from semi-structured interviews with 21 CHWs and 14 community key informants (community site directors or coordinators); seven focus group discussions with participants from 9 sites, and 124 pieces of graduation advice provided by MOVE UP graduates for future participants; onsite CHW performance observation at 18 sites, and 124 meeting memos of support phone calls with CHWs. Interviews and focus groups were audio-recorded and transcribed verbatim. All data were thematically analyzed in a deductive approach, using the CHW generic logic model. Emerging themes were: Trained CHWs still require onsite support by experienced CHWs or training staff to deliver the first session; Participants need a Q&amp;A session by specialists to address their questions beyond CHWs’ knowledge; Desirable CHW characteristics could increase CHWs’ relation and accessibility to participants, such as the same age group, similar weight loss experience, and living or working in the same community. These findings provide important insight as to recruiting and supporting CHWs in a community-based behavioral lifestyle intervention for older adults.

Association between Indicators of Inequality and Weight Change following a Behavioural Weight Loss Intervention

Introduction: Weight loss through behavioural weight management interventions can have important health benefits for people with obesity. However, to maximise the health benefits, weight loss must be maintained. Evidence suggests that behavioural weight loss interventions do not exacerbate inequalities in the short term. However, no study has yet considered whether inequalities exist in long-term weight change following intervention. We aimed to investigate if there are inequalities in weight change following weight loss intervention. Methods: We conducted a cohort analysis of data from the Weight Loss Referrals for Adults in Primary Care (WRAP) trial (N = 1,267). WRAP randomised participants to receive a brief intervention information booklet or vouchers for 12-weeks or 52-weeks of WW (formerly WeightWatchers) and followed them for 5 years. Multiple linear regression estimated the association between exposures (indicators of inequality) and outcomes (change in weight between 1- and 5-years). Each model was adjusted for the intervention group, baseline weight, weight change between baseline and 1-year, research centre, and source of the 5-year weight data. Results: Of the 1,267 participants in WRAP, 708 had weight change data available. Mean weight change between 1- and 5-years was +3.30 kg (SD 9.10 kg). A 1 year difference in age at baseline was associated with weight change of 0.11 kg ((95% CI 0.06, 0.16), p < 0.001). We did not find evidence of associations between ethnicity, gender, education, indices of multiple deprivation, household income, or other family members participating in a weight loss programme and weight change. Conclusion: Except for age, we did not find evidence of inequalities in weight change following a behavioural intervention. Findings further support the use of behavioural weight management interventions as part of a systems-wide approach to improving population health.

Weight Loss Program Preferences of Men Working in Blue-Collar Occupations: A Qualitative Inquiry.

Men who work in blue-collar occupations (skilled and unskilled trades) experience high rates of obesity and comorbid conditions. This group is underrepresented in behavioral interventions for weight management, which may stem from a mismatch between the features of available programs and these men’s preferences. This qualitative study explored the views of these men, their experiences with weight loss, their preferences for weight loss programs, and messaging related to these programs. We conducted remote interviews with 20 men (age: 43 ± 13 years, M ± SD) currently working in blue-collar occupations (50% construction, 25% transportation, and 25% manufacturing) who had body mass indices (BMIs) in the overweight/obese categories (BMI: 33 ± 6 kg/m2). Deductive codes and summary themes were developed and discussed by the first two authors. A selection of transcripts was reviewed following theme development to confirm accuracy of the themes. Most participants (n = 16, 80%) reported a prior weight loss attempt. The most common approaches to weight loss reported were increased exercise and following their own approach to changing diet (e.g., “eating less junk food”). For program and message preferences, two major themes emerged: participants wanted accurate and trustworthy information and wanted programs that fit their lifestyle. Results suggest that weight loss programs targeting men working in blue-collar occupations should emphasize the accuracy of information related to the program and the ease of incorporating it into participants’ lifestyles. There is an urgent need to incorporate these preferences into effective programs.