Background: Self-efficacy is a modifiable intervention target in behavioral weight loss interventions. However, its role in the context of digital interventions is less clear.
Purpose: To determine change in self-efficacy in a digital weight loss intervention, and whether self-efficacy is associated with engagement in self-monitoring diet or weight loss.
Methods: This is a secondary analysis of the GoalTracker study among 100 adults with overweight or obesity enrolled in a 12-week standalone digital weight loss intervention emphasizing daily self-monitoring. At baseline, 1 month, and 3 months, we assessed self-efficacy for controlling eating (via the Weight Efficacy Lifestyle Questionnaire; WELQ) and self-efficacy for tracking diet. Dietary self-monitoring engagement data were collected from the MyFitnessPal app. Weight was collected in person on a calibrated scale. Analyses included participants with complete data (N range: 72-99).
Results: Positive change from baseline to 1 month in self-efficacy for controlling eating was associated with higher dietary self-monitoring engagement (r = 0.21, P = .008) but not with 3-month weight change (r = -0.20, P = .052). Meanwhile, positive change from baseline to 1 month in self-efficacy for tracking diet was associated in a beneficial direction with both outcomes (r = 0.57, P < .001; r = -0.35, P < .001, respectively). However, on average, self-efficacy for controlling eating did not change over time while self-efficacy for tracking diet decreased (P < .001).
Conclusion: Improvements in self-efficacy-particularly for tracking diet-early on in a digital weight loss intervention served as a mechanism of greater engagement and weight loss, highlighting the need for strengthening intervention strategies that promote early self-efficacy within a digital context.
Keywords: adherence; digital; engagement; obesity; self-efficacy; self-monitoring; weight loss.
An important predictor of weight control is greater self-efficacy in making dietary changes. People with high self-efficacy feel more confident that they can resist overeating at a party or when upset. However, self-efficacy’s role in standalone digital weight loss interventions remains unclear. This study examined self-efficacy in a 12-week standalone digital weight loss intervention for adults with overweight or obesity. Two types of self-efficacy were assessed: self-efficacy for controlling eating (such as resisting overeating on vacation) and self-efficacy for tracking foods (such as tracking even when feeling tired). We looked at whether self-efficacy predicted either weight loss or actual engagement in tracking food each day via an app. This study found that improvement in self-efficacy for controlling eating in the first month of the intervention was linked to increased engagement in tracking food. Further, improvement in self-efficacy for tracking food was linked to both increased engagement and 3-month weight loss. These findings highlight the importance of developing self-efficacy early on in standalone digital weight loss interventions for optimal weight loss and engagement.
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