In their own words: Topic analysis of the motivations and strategies of over 6,000 long-term weight-loss maintainers

Abstract

Objective: This study aimed to identify major themes of a large cohort experiencing long-term weight-loss maintenance who answered open-ended questions about weight-loss triggers, current motivations, strategies, and experiences. Methods: Machine learning and topic modeling were used to analyze responses to six open-ended questions among 6,139 WW International, Inc., (formerly Weight Watchers) members with weight-loss maintenance; inclusion criteria included ≥9.1-kg loss with weight-loss maintenance for ≥1 year. Results: Participants (mean age = 53.6 years; 94.3% White; mean BMI = 27.8 kg/m2) had lost 24.5 kg and maintained the loss for 3.4 years. Descriptions of factors triggering weight loss coalesced into five topics: medical status, appearance, mobility, social prompts, and change needed. Factors currently motivating weight-loss maintenance yielded two topics: looking back at experiences at higher weight and health/appearance concerns. Advice for others to succeed in weight-loss maintenance coalesced on two recommendations: perseverance in the face of setbacks and consistency in tracking. Rewards for weight management included improved confidence, pain, mobility, fitness, body image, medical status, and affect. Two thematic negative consequences were clothing costs and sagging skin. Conclusions: Future weight-maintenance research should include more diverse populations and investigate weight-loss maintenance as a journey with highs and lows, perseverance in the face of setbacks, sustained tracking, and making changes in medical status more salient during the weight-maintenance journey.