Table 6.
Behavioural determinants, percentage of directional consistency and level of evidence
| Conceptual category of determinant | Determinant | % Positively predictive of weight loss maintenance | % Not significantly predictive of weight loss maintenance | % Negatively predictive of weight loss maintenance | Level of evidence | Number of studies |
|---|---|---|---|---|---|---|
| Weight‐related determinants | ||||||
| Weight | Pre‐weight loss BMI/weight/fat mass at baseline. | 33.3 | 55.6 | 11.1 | Insufficient | n = 9 |
| Weight loss patterns | Initial weight loss (kg) | 71.4 | 28.6 | 0 | Insufficient | n = 14 |
| Duration to weight loss goal, and gradual and sustained weight loss vs. early but not sustained | 40 | 40 | 20 | Insufficient | n = 5 | |
| Duration of weight loss maintenance | 100 | 0 | 0 | Insufficient | n = 1 | |
| Weight history (weight cycling and history of weight loss) | 0 | 100 | 0 | Strong | n = 3 | |
| Weight gain since menopause | 0 | 0 | 100 | Insufficient | n = 1 | |
| Monitoring determinants | ||||||
| Monitoring weight | Weekly data reports completed, being frequently weighed in trial, frequent self‐weighing/monitoring body weight | 80 | 20 | 0 | Strong | n = 10 |
| Weight management | 100 | 0 | 0 | Insufficient | n = 1 | |
| Self‐monitoring exercise | Self‐monitoring exercise, use of a pedometer | 75 | 25 | 0 | Moderate | n = 4 |
| Self‐monitoring diet | Counting carbohydrates and counting fats | 0 | 100 | 0 | Insufficient | n = 1 |
| Self‐monitoring eating | 75 | 25 | 0 | Strong | n = 4 | |
| Physical activity determinants | ||||||
| Energy expenditure | Physical activity level at baseline††† | 0 | 100 | 0 | Moderate | n = 3 |
| Increase in physical activity level, energy expenditure, leisure time activity at follow‐up‡‡‡ | 76.2 | 23.8 | 0 | Strong | n = 21 | |
| Change in cardiovascular fitness from baseline to follow‐up‡ | 100 | 0 | 0 | Insufficient | n = 1 | |
| Baseline TV viewing†† | 0 | 0 | 100 | Insufficient | n = 1 | |
| Increase in TV viewing‡‡ | 0 | 0 | 100 | Insufficient | n = 1 | |
| Time sitting | 0 | 100 | 0 | Insufficient | n = 1 | |
| Dietary intake | ||||||
| Eating behaviour | Restrained eating; cognitive restraint eating at baseline††† | 44.4 | 55.6 | 0 | Insufficient | n = 9 |
| Increase in restrained eating‡‡‡ | 50 | 50 | 0 | Insufficient | n = 2 | |
| Flexible restraint post‐weight loss | 0 | 0 | 100 | Insufficient | n = 1 | |
| Meal replacement usage during weight loss and maintenance (as weight management technique) | 20 | 80 | 0 | Strong | n = 4 | |
| Portion control and reducing the amount of food during weight loss and maintenance | 75 | 25 | 0 | Strong | n = 4 | |
| Following a diet (book) or adherence to a diet during weight loss and maintenance. | 66.7 | 33.3 | 0 | Insufficient | n = 3 | |
| Healthy eating at baseline†† | 100 | 0 | 0 | Insufficient | n = 1 | |
| Increase in healthy eating‡‡ | 100 | 0 | 0 | Insufficient | n = 1 | |
| Cut unhealthy food (cut sweet/junk food, decreased fried food consumption, decrease fast food consumption, decrease dessert consumption) during weight loss and maintenance | 87.5 | 12.5 | 0 | Strong | n = 7 | |
| Low fat product use during weight loss maintenance | 0 | 100 | 0 | Insufficient | n = 1 | |
| Not skipping meals and eating breakfast during weight loss maintenance | 50 | 50 | 0 | Insufficient | n = 2 | |
| Energy intake, baseline energy/calorie intake, energy intake level, energy density. | 33.3 | 66.7 | 0 | Insufficient | n = 6 | |
| Decrease or reduction in energy intake, energy density, calories (liquid or solid)‡‡‡ | 80 | 20 | 0 | Strong | n = 10 | |
| Eating out or eating at restaurants during weight loss maintenance | 0 | 100 | 0 | Strong | n = 2 | |
| Eating packaged meals during maintenance | 0 | 100 | 0 | Insufficient | n = 1 | |
| Dietary intake, product level | Change in meat and cheese consumption, decrease‡‡‡ | 50 | 50 | 0 | Insufficient | n = 2 |
| Change in fish consumption, increase‡‡‡ | 0 | 100 | 0 | Moderate | n = 2 | |
| Change in whole grain consumption, increase‡‡‡ | 0 | 100 | 0 | Moderate | n = 2 | |
| Fruit and vegetable intake at baseline††† | 40 | 60 | 0 | Insufficient | n = 5 | |
| Change in fruit and vegetable consumption, increase‡‡‡ | 83.3 | 16.7 | 0 | Strong | n = 6 | |
| Eating takeaway, fast food and sweets at baseline††† | 0 | 50 | 50 | Insufficient | n = 2 | |
| Eating fried food and using unhealthy cooking practices (i.e. cooking with butter) during maintenance | 0 | 100 | 0 | Insufficient | n = 1 | |
| Sugar‐sweetened beverages intake during maintenance | 0 | 100 | 0 | Insufficient | n = 1 | |
| Change in consumption of sugar‐sweetened beverages, coffee and tea with sugar, and juice, decrease‡‡‡ | 80 | 20 | 0 | Strong | n = 5 | |
| Change in consumption of coffee and tea without sugar, without milk and diet drinks, increase‡‡‡ | 33.3 | 66.7 | 0 | Insufficient | n = 3 | |
| Diet drinks intake and water during maintenance | 0 | 100 | 0 | Insufficient | n = 1 | |
| Dietary intake, nutrient level | Change in dietary calcium intake, dairy intake and milk intake, increase‡‡‡ | 50 | 50 | 0 | Insufficient | n = 4 |
| Protein intake | 0 | 100 | 0 | Moderate | n = 2 | |
| Increase in protein intake, substituting protein for fat, substituting protein for carbohydrates during weight loss maintenance | 100 | 0 | 0 | Moderate | n = 2 | |
| (Dietary) fibre intake at baseline††† | 40 | 60 | 0 | Insufficient | n = 5 | |
| Change in (dietary) fibre intake, increase‡‡ | 0 | 100 | 0 | Insufficient | n = 1 | |
| Carbohydrate intake during weight loss and maintenance | 40 | 40 | 20 | Insufficient | n = 5 | |
| Change in carbohydrates, substitute fat for carbs, decrease‡‡ | 100 | 0 | 0 | Insufficient | n = 1 | |
| Fat intake at baseline††† | 37.5 | 50 | 12.5 | Insufficient | n = 8 | |
| Change in fat intake, decrease‡‡‡ | 75 | 25 | 0 | Strong | n = 4 | |
| Cholesterol intake at baseline† | 0 | 100 | 0 | Insufficient | n = 1 | |
| Problematic eating | Binge eating, uncontrolled eating, emotional eating during weight loss and maintenance | 0 | 20 | 80 | Moderate | n = 5 |
| External eating during weight loss maintenance | 0 | 100 | 0 | Insufficient | n = 1 | |
| Reward‐based eating during weight loss and maintenance | 0 | 100 | 0 | Insufficient | n = 1 | |
| Other behaviours | ||||||
| Smoking | 33.3 | 66.7 | 0 | Insufficient | n = 3 | |
| Alcohol intake at baseline‡‡‡ | 33.3 | 66.7 | 0 | Insufficient | n = 3 | |
| Change in alcohol consumption, increase‡ | 0 | 100 | 0 | Insufficient | n = 1 | |
†
Baseline measurement at the beginning of a weight loss intervention.
††
Baseline measurement at the beginning of a weight maintenance cohort.
†††
Baseline measurements at the beginning of a long‐term weight loss intervention or at baseline entry in a weight maintenance intervention/cohort.
‡
Increase in measurement from baseline of a weight loss intervention to the end of the follow‐up period.
‡‡
Increase in measurement from baseline of a weight maintenance intervention/cohort to the end of the follow‐up period.
‡‡‡
Increase in measurement from baseline of a weight loss intervention or weight maintenance intervention/cohort to the end of the follow‐up period.