Exploring potential reach and representativeness of a self-weighing weight gain prevention intervention in adults with overweight and obesity

Most adults with obesity do not enrol in comprehensive weight loss interventions when offered. For these individuals, lower burden self-weighing interventions may offer an acceptable alternative, though data is lacking on the potential for reach and representativeness of such interventions. Health system patients with BMI ≥30 kg/m² (or 25–30 kg/m² with an obesity comorbidity) completed a general health survey. During the survey, patients were given information about comprehensive weight loss interventions. If they denied interest or did not enrol in a comprehensive intervention, they were offered enrolment in a low-burden weight gain prevention intervention focused on daily self-weighing using a cellular network-connected in-home scale without any dietary or physical activity prescriptions. Enrolment in this program was documented. Among patients offered the self-weighing intervention (n = 85; 55.3% men; 58.8% White; BMI = 34.2 kg/m²), 44.2% enrolled. Compared to those who did not enrol, enrollers had higher educational attainment (57.1% vs. 42.9% with bachelor's degree p = .02), social anxiety (5.8 vs. 2.8, p < .001), and perceptions of the effectiveness of the self-weighing intervention (25.8 vs. 20.9 on 35, p = .007). The most highly endorsed reason for not enrolling in the self-weighing intervention was that it would make individuals overly focused on weight. A low-intensity weight gain prevention intervention may serve as a viable alternative to comprehensive weight loss interventions for the substantial portion of patients who are at risk for continued weight gain but would otherwise not enrol in a comprehensive intervention. Differential enrolment by education, however, suggests potential for inequitable uptake.