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Weight loss programs for women are on the rise, including both face to face and online programs. However, current research is limited on the process measures and content which produce adherence and the largest outcomes. With obesity on the rise in the United States, it is important to understand out health coaches can strengthen their programs to better support the obese population in their weight loss journey. The purpose of this pilot study was to develop and test the acceptability of text message nudges among women participating in an online weight loss program; determine how dose may be associated with weight loss outcomes; and to test how goal setting text messaging nudges improve percent body weight loss among women participating in an online weight loss program. It was found that the implementation of text message nudges did not provide enough to continue to improve and extend the program to be more successful. However, qualitative data was recorded and found to provide helpful insight into what content was preferred by the participants.

Behavioral weight loss programs have been shown to be effective for short-term weight loss, however the impact of these programs on dietary changes is unclear. This study examined the changes in participant’s diet and physical activity over the course of a 16-week Internet behavioral weight-loss program. A single-center randomized controlled trial was conducted from August 2008 to December 2008 in Lexington, KY, and sixty-six women whose mean (SD) age was 48.6 (10.8) years and body mass index was 31.8 (3.7) kg/m2 completed all dietary and physical measures. Participants received two face-to-face group sessions with a dietitian, at baseline and 4-weeks, in addition to 16 weekly behavioral weight loss lessons delivered via an Internet website. Participants showed a significant reduction in energy intake (1879.2±771.7 vs. 1372.9±423.7; p<0.001), dietary energy density (2.1±0.5 vs. 1.9±0.5; p=0.002) and a significant increase in diet quality score as measured by the HEI-2005 (53.9±9.9 vs. 57.4±10.6; p =0.002). Participants did not show significant differences in physical activity intensity, duration or energy expenditure. However, post hoc analysis revealed that those who adopted a healthy life style, such as eating more fruits and vegetables and being physically active, achieved greater weight loss than those who did not adopt a healthy lifestyle. Participation in this Internet behavioral weight loss program significantly improved dietary intake in adult women and did not significantly improve daily physical activity levels.

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