TOPLINE

A 10-week pilot trial of a remotely delivered digital weight-loss program found that a harder calorie goal was associated with greater weight loss than an easier goal among adults with overweight or obesity. The greatest weight loss was observed when the harder calorie goal was combined with harder goals for steps; eating windows; or high-calorie, low-nutrition foods.

METHODOLOGY

• Goal setting is a core feature of behavioral weight-loss programs; however, the optimal level of goal difficulty remains unclear. Although harder goals may promote greater behavior change, evidence from digital weight-loss interventions remains limited, particularly when patients are asked to manage multiple goals simultaneously.
• Researchers conducted the Ignite pilot optimization trial to examine the feasibility, acceptability, and proof of concept of a 10-week fully digital, remotely delivered weight-loss intervention among 32 adults (mean age, 47.7 years; 75.0% women; mean BMI, 30.3) with overweight or obesity in the US.
• Participants were randomly assigned to receive either harder or easier goals in four key weight-loss domains: calorie intake; steps; eating windows; and high-calorie, low-nutrition foods.
• They were assigned a calorie limit with (easier) or without (harder) an extra 250 daily calories; a step count of either their baseline target (easier) or that target plus 1500 more steps (harder); a 12-hour (easier) or 9-hour (harder) daily eating window; and a daily limit of no more than five (easier) or one (harder) high-calorie, low-nutrition “Red Zone” foods, such as soda and fried chicken.
• All participants self-monitored body weight, dietary intake, daily steps, and eating windows using digital tools and received weekly behavioral lessons, action plans, and personalized feedback throughout the intervention.

TAKEAWAY

• Feasibility benchmarks were largely achieved, with all intervention-engagement and assessment-completion benchmarks achieved, but only one of the five goal-attainment benchmarks met. Participants were consistently engaged with the digital program, tracking their dietary intake on a median 76% of days and daily steps on 99% of days over the 10 weeks; 97% reviewed their progress reports each week as intended, and no adverse events were reported.
• Over 10 weeks, participants assigned the harder calorie goal achieved significantly greater weight loss than those assigned the easier goal (between-group difference, -2.3 kg; 95% CI, -4.1 to -0.6 kg). Overall, participants lost a mean of 3.3 kg with 56% achieving 3% weight loss and 28% achieving 5% weight loss.
• The weight-loss benefit was more pronounced when the harder calorie goal was combined with a harder goal for steps; eating windows; or high-calorie, low-nutrition foods.
• Overall, 9 of 14 acceptability benchmarks were met (harder goals met four of six; easier goals met three of six). Among 13 intervention components, self-monitoring tools for weight, food intake, and steps were rated most helpful, with at least 90% of participants finding them helpful.

IN PRACTICE

“The Ignite pilot optimization trial demonstrated feasibility of study procedures, high engagement, and moderate‐to‐high acceptability, supporting progression to a fully powered optimization‐RCT [randomized controlled trial] following minor refinements,” the authors wrote.

SOURCE

The study was led by Michele L. Patel, PhD, Stanford University School of Medicine, Palo Alto, California. It was published online in Obesity Science & Practice.

LIMITATIONS

The trial relied on participant-reported data for several behavioral measures, which may have introduced reporting inaccuracies. The pilot design and short intervention duration limited the interpretation of the weight-loss findings. The lack of step count measurements before the intervention limited the assessment of participants’ baseline activity levels.

DISCLOSURES

The study was funded by the Stanford Diabetes Research Center Pilot and Feasibility Grants Program and a National Institutes of Health grant to the lead author, both through the National Institute of Diabetes and Digestive and Kidney Diseases. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.