Stigmatization, Obesity, Weight Loss
Conditions
Brief summary
This is a randomized controlled trial to test the effects on WBI of a novel psychological intervention combined with standard behavioral weight loss (BWL) treatment, as compared to BWL alone. Participants will be a total of 72 men and women seeking weight loss, ages 18-65 years, with a body mass index (BMI) of 30 kg/m2 or above, a history of experiencing weight bias, and elevated levels of WBI. Participants will attend a screening visit in which they will complete a behavioral evaluation with a psychologist and a medical history that will be reviewed by a nurse practitioner or physician. Questionnaires assessing experiences and internalization of weight bias, with confirmation by interviewer assessment during the behavioral evaluation, will be used to determine whether participants meet criteria for having high levels of WBI. Eligible consenting participants will be randomly assigned to the standard BWL intervention (n = 36) or the BWL + BIAS program (n = 36). All participants will attend weekly, 90-minute group meetings for 12 weeks (12 visits). In the BWL + stigma intervention, 60 minutes will be devoted to BWL and 30 minutes to weight stigma. In the standard BWL treatment group, the additional 30 minutes will be devoted to sharing recipes and food preparation tips. Following 12 weeks of weight loss treatment, participants will attend group meetings focused on weight loss maintenance, every-other-week from weeks 13-16 (2 visits), and monthly from weeks 17-26 (2 visits). Maintenance sessions in the BWL + stigma group will continue to incorporate discussion of WBI. Assessments - which include questionnaires and measurements of body weight - will occur at baseline and weeks 12 and 26. Weight will be measured at every group meeting for clinical purposes.
Interventions
BEHAVIORALBWL
The BWL sessions will be based on the Diabetes Prevention Program (DPP) manual. A diet of 1200-1499 calories per day will be prescribed for participants \< 250 lb, and 1500-1800 for those ≥ 250 lb. Participants will be instructed to eat a balanced deficit diet. Session topics during the first 12 weeks will include self-monitoring, stimulus control, slowing eating, social support, cognitive restructuring, portion sizes, and goal-setting. Those during weeks 13-26 will focus on continued self-monitoring and skills required for weight loss maintenance and relapse prevention. Physical activity will be prescribed at a level consistent with data showing that \>250 min/wk is associated with improved long-term weight loss. BWL sessions will last 60 minutes.
BEHAVIORALBIAS
Following 60 minutes of BWL treatment, the BIAS intervention will devote 30 minutes to stigma-related content. Session topics will include: psychoeducation about weight and weight stigma; challenging myths and cognitive distortions related to weight; strategies for coping with instances of stigma; and increasing empowerment and body esteem. The effects of weight stigma on health behaviors will be discussed, and sessions will focus specifically on helping participants overcome stigma-related barriers to weight management. In the every-other-week and monthly weight loss maintenance sessions from weeks 13-26, strategies for coping with weight stigma and challenging internalized beliefs will be reviewed, and participants will be encouraged to use these strategies in the context of weight management.
Sponsors
WW International Inc
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Eligible participants will be men and women ages 18-65 years. * Participants must have obesity (defined as a BMI ≥ 30 kg/m2); report a history of experiencing weight bias as assessed by self-report questionnaire and in-person interview; and have elevated levels of WBI as indicated by an average score of 4 (midpoint) or above on the Weight Bias Internalization Scale (WBIS) and by in-person interview. * Participants must be seeking weight loss. * If currently taking medications, dosages must be stable for at least 3 months. * Participants will be eligible to participate if they exhibit mild to moderate severity of depression, anxiety, or binge eating disorder, as determined by the behavioral evaluation and the screening measures (Beck Depression Inventory-II and Questionnaire for Eating and Weight Patterns; see below for details). Elevated WBIS scores are often associated with these variables. * Participants taking anti-depressant medication will be eligible if their dose has been stable for a minimum of 3 months. Eligible female patients will be: * non-pregnant, evidenced by a negative urine dipstick pregnancy test * non-lactating * surgically sterile or postmenopausal, or they will agree to continue to use a method of birth control during the study Participants must: * have a PCP who is responsible for providing routine care * have reliable telephone service with which to participate in conference calls * understand and be willing to comply with all study-related procedures and agree to participate in the study by giving written informed consent
Exclusion criteria
Applicants will be excluded if they have: * a diagnosis of type I or II diabetes; * uncontrolled hypertension (blood pressure ≥ 160/100 mm Hg); * experienced a cardiovascular event (e.g., stroke, myocardial infarction) in the last 12 months; * lost ≥ 5% of their initial weight in the last 6 months; * or have participated in individual or group psychotherapy in the last 3 months (due to the potentially confounding effects of receiving a simultaneous cognitive-behavioral intervention). Applicants who have recently participated in or are currently receiving counseling for concerns unrelated to mood, self-esteem, or weight (e.g. career, marriage, or grief counseling; caregiver support) may be eligible per Principal Investigator's discretion. * Applicants with severe symptoms of mood (for example, BDI-II score ≥ 29), anxiety, or binge eating disorder, and any severity of thought or substance use disorders will not be accepted into the study, as these symptoms may interfere with individuals' ability to adhere to a weight loss program. Clinician judgment will be used to determine severity of mood disorder symptoms independent from obesity-related concerns and complications (e.g., fatigue), and decisions about applicants' eligibility based on psychiatric symptoms will fall within the Principal Investigator's discretion. * Individuals with bulimia nervosa will not be eligible to participate, because weight loss may be contraindicated. * Applicants with current, active suicidal ideation, and/or a suicide attempt within the past year will be excluded from the study and referred to psychiatric treatment facilities in the greater Philadelphia area. * Applicants will not be eligible if they have a history of bariatric surgery. * Women who are nursing, pregnant, or planning to become pregnant in the next 12 months are not eligible to participate.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Weight Bias Internalization | Baseline to week 12 | Estimated mean change score on the Weight Bias Internalization Scale (scale scoring 1-7; higher scores indicate greater weight bias internalization) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Weight Self-Stigma Questionnaire (WSSQ) | Baseline to week 12 | Estimated mean change score for Total score (WSSQ-Total, summed 12-60) and two subscales of Self-Devaluation (WSSQ-SD) and Fear of Enacted Stigma (WSSQ-FNE) (summed 6-30); higher scores indicate greater weight self-stigma |
| Weight Bias | Baseline to week 12 | Estimated mean change score on the Fat Phobia Scale (scale scoring 1-5; higher scores indicate greater weight bias) |
| Weight-Related Quality of Life | Baseline to week 12 | Estimated mean change score on the Impact of Weight on Quality of Life Questionnaire-Lite for Total score and five subscales of Physical Function, Self Esteem, Sexual Life, Work, and Public Distress (transformed scores 0-100; higher scores indicate better quality of life) |
| Perceived Stress | Baseline to week 12 | Estimated mean change score on the Perceived Stress Scale (summed 0-40; higher scores indicate greater perceived stress) |
| Depression | Baseline to week 12 | Estimated mean change score on the Patient Health Questionnaire - 9 (summed 0-27; higher scores indicate more symptoms of depression) |
| Weight Bias Internalization | Baseline to week 26 | Estimated mean change score on the Weight Bias Internalization Scale (scale scoring 1-7; higher scores indicate greater weight bias internalization) |
| Eating Self-Efficacy | Baseline to week 12 | Estimated mean change score on the Weight and Lifestyle Efficacy - Short Form (summed 0-80; higher scores indicate greater self-efficacy) |
| Percent Weight Change | Baseline to week 26 | Estimated mean change in percent weight change. Weight measured in kilograms (kg). |
| Waist Circumference | Baseline to week 26 | Estimated mean change in waist circumference (cm). |
| Blood Pressure | Baseline to week 26 | Estimated mean change in blood pressure (systolic blood pressure and diastolic blood pressure; mmHg), controlling for blood pressure medication. |
| Exercise Self-Efficacy | Baseline to week 12 | Estimated mean change score on the Self-Efficacy for Exercise Scale (summed 0-90; higher scores indicate greater self-efficacy) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Perceived Stress | Baseline to week 52 | Estimated mean change score on the Perceived Stress Scale (summed 0-40; higher scores indicate greater perceived stress) |
| Exercise Self-Efficacy | Baseline to week 52 | Estimated mean change score on the Self-Efficacy for Exercise Scale (summed 0-90; higher scores indicate greater self-efficacy) |
| Weight-Related Quality of Life | Baseline to week 52 | Estimated mean change score on the Impact of Weight on Quality of Life Questionnaire-Lite for Total score and five subscales of Physical Function, Self Esteem, Sexual Life, Work, and Public Distress (transformed scores 0-100; higher scores indicate better quality of life) |
| Eating Self-Efficacy | Baseline to week 52 | Estimated mean change score on the Weight and Lifestyle Efficacy - Short Form (summed 0-80; higher scores indicate greater self-efficacy) |
| Coping Behaviors in Response to Weight Stigma | Baseline to week 12 | Estimated mean change score on the Coping with Weight Stigma Questionnaire for Full scale and four subscales of Negative Affect, Maladaptive Eating, Healthy Lifestyle, and Exercise Avoidance (scale scoring 0-4 for Full scale and all subscales); higher scores indicate greater endorsement of coping strategies |
| Waist Circumference | Baseline to week 52 | Estimated mean change in waist circumference (cm) |
| Blood Pressure | Baseline to week 52 | Estimated mean change in blood pressure (systolic blood pressure and diastolic blood pressure; mmHg), controlling for blood pressure medication. |
| Treatment Acceptability Ratings | Week 26 | To assess treatment acceptability, participants in both groups rated (1-7) the BWL treatment, as well as the stigma intervention (i.e., BIAS component) or recipe exchange, on how helpful they found each component of the program, how much they liked the components, and how much they learned new skills or information from each component. Scores for these three items were averaged (1-7) separately for the BWL treatment, BIAS component, and recipe exchange. Higher scores indicate greater treatment acceptability. |
| Percent Weight Change | Baseline to week 52 | Estimated mean change in percent weight change. Weight measured in kilograms (kg) |
| Body Esteem | Baseline to Week 12 | Estimated mean change score on the Body Appreciation Scale (scale scoring 1-5; higher scores indicate greater body appreciation) |
| Body Dissatisfaction | Baseline to Week 12 | Estimated mean change score on the Body Areas Satisfaction Subscale of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (scale scoring 1-5; higher scores indicating greater satisfaction) |
| Disordered Eating | Baseline to Week 12 | Estimated mean change score on the Eating Disorders Examination Questionnaire for Global score and four subscales of Eating Restraint, Eating Concern, Weight Concern, and Shape Concern (scale scoring 0-6 for Global score and all subscales; higher scores indicate greater pathology) |
| Eating Behaviors | Baseline to Week 12 | Estimated mean change score on the Eating Inventory Questionnaire for three subscales of Dietary Restraint (summed 0-21), Disinhibition (summed 0-16), and Hunger (summed 0-14); higher values indicate greater restraint/disinhibition/hunger |
| Anxiety | Baseline to Week 12 | Estimated mean change score on the Generalized Anxiety Disorder-7 Questionnaire (summed 0-21; higher scores indicate greater anxiety) |
| Dietary Monitoring | Baseline to Week 12 | Estimated mean change in number of days recording caloric intake |
| Self-Reported Self-Monitoring Behaviors | Baseline to Week 12 | Estimated mean change in self-reported frequency of tracking of: weight, food/drink, calories, and physical activity; 0-4 rating for each of the four behaviors (higher scores indicate greater self-reported frequency of self-monitoring behavior) |
| Weight Bias Internalization | Baseline to week 52 | Estimated mean change score on the Weight Bias Internalization Scale (scale scoring 1-7; higher scores indicate greater weight bias internalization) |
| Weight Self-Stigma Questionnaire (WSSQ) | Baseline to week 52 | Estimated mean change score for Total score (WSSQ-Total, summed 12-60) and two subscales of Self-Devaluation (WSSQ-SD) and Fear of Enacted Stigma (WSSQ-FNE) (summed 6-30); higher scores indicate greater weight self-stigma |
| Weight Bias | Baseline to week 52 | Estimated mean change score on the Fat Phobia Scale (scale scoring 1-5; higher scores indicate greater weight bias) |
| Depression | Baseline to week 52 | Estimated mean change score on the Patient Health Questionnaire - 9 (summed 0-27; higher scores indicate more symptoms of depression) |
Countries
United States
Participant flow
Recruitment details
Recruitment began April 2018 and ended October 2018. Participants were recruited by flyers, local media, and physician referrals for a study about weight loss and social experiences related to weight. Participants were screened by telephone and by a subsequent in-person behavioral evaluation and brief medical evaluation.
Participants by arm
| Arm | Count |
|---|---|
| BWL + BIAS In the behavioral weight loss (BWL) + weight bias internalization and stigma (BIAS) group, participants received 60-minute BWL sessions followed by 30 minutes of a weight stigma-reduction intervention. Participants received weekly group treatment sessions for 12 weeks, followed by every-other-week and monthly sessions from weeks 13-26. | 36 |
| Standard BWL In the BWL group, participants received 60-minute BWL sessions followed by 30 minutes devoted to discussing recipes and food preparation. Participants received weekly group treatment sessions for 12 weeks, followed by every-other-week and monthly sessions from weeks 13-26. | 36 |
| Total | 72 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 3 | 2 |
| Overall Study | No longer available for study visits | 2 | 1 |
| Overall Study | No longer interested | 1 | 2 |
Baseline characteristics
| Characteristic | Total | BWL + BIAS | Standard BWL |
|---|---|---|---|
| Age, Continuous | 47.1 years STANDARD_DEVIATION 11.5 | 47.7 years STANDARD_DEVIATION 11.4 | 46.6 years STANDARD_DEVIATION 11.8 |
| Anxiety | 5.4 scores on a scale STANDARD_DEVIATION 4.3 | 5.6 scores on a scale STANDARD_DEVIATION 4.5 | 5.2 scores on a scale STANDARD_DEVIATION 4.2 |
| Blood Pressure Diastolic Blood Pressure | 73.7 mmHg STANDARD_DEVIATION 8.5 | 73.0 mmHg STANDARD_DEVIATION 9.2 | 74.3 mmHg STANDARD_DEVIATION 7.9 |
| Blood Pressure Systolic Blood Pressure | 127.7 mmHg STANDARD_DEVIATION 10.3 | 127.4 mmHg STANDARD_DEVIATION 10.2 | 128.0 mmHg STANDARD_DEVIATION 10.7 |
| Body Esteem | 2.6 scores on a scale STANDARD_DEVIATION 0.7 | 2.8 scores on a scale STANDARD_DEVIATION 0.6 | 2.5 scores on a scale STANDARD_DEVIATION 0.7 |
| Body Mass Index (BMI) | 39.3 kg/m^2 STANDARD_DEVIATION 6.1 | 40.1 kg/m^2 STANDARD_DEVIATION 6.5 | 38.4 kg/m^2 STANDARD_DEVIATION 5.6 |
| Depression | 8.0 scores on a scale STANDARD_DEVIATION 4.8 | 7.5 scores on a scale STANDARD_DEVIATION 5.1 | 8.4 scores on a scale STANDARD_DEVIATION 4.5 |
| Eating Behaviors Dietary Restraint | 8.7 scores on a scale STANDARD_DEVIATION 3.7 | 8.5 scores on a scale STANDARD_DEVIATION 3.7 | 8.9 scores on a scale STANDARD_DEVIATION 3.8 |
| Eating Behaviors Disinhibition | 9.7 scores on a scale STANDARD_DEVIATION 3.3 | 9.2 scores on a scale STANDARD_DEVIATION 3.5 | 10.2 scores on a scale STANDARD_DEVIATION 3.1 |
| Eating Behaviors Hunger | 7.1 scores on a scale STANDARD_DEVIATION 3.7 | 7.8 scores on a scale STANDARD_DEVIATION 3.6 | 6.4 scores on a scale STANDARD_DEVIATION 3.6 |
| Eating Self-Efficacy | 40.0 scores on a scale STANDARD_DEVIATION 17.5 | 39.4 scores on a scale STANDARD_DEVIATION 17.4 | 40.7 scores on a scale STANDARD_DEVIATION 17.9 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 6 Participants | 4 Participants | 2 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 66 Participants | 32 Participants | 34 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Exercise Self-Efficacy | 51.2 scores on a scale STANDARD_DEVIATION 20 | 48.3 scores on a scale STANDARD_DEVIATION 20.1 | 54.2 scores on a scale STANDARD_DEVIATION 19.9 |
| Height | 166.8 centimeters STANDARD_DEVIATION 8.5 | 167.0 centimeters STANDARD_DEVIATION 8.7 | 166.6 centimeters STANDARD_DEVIATION 8.5 |
| Perceived Stress | 17.3 scores on a scale STANDARD_DEVIATION 6.4 | 17.6 scores on a scale STANDARD_DEVIATION 6.2 | 16.9 scores on a scale STANDARD_DEVIATION 6.5 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 2 Participants | 2 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 48 Participants | 26 Participants | 22 Participants |
| Race (NIH/OMB) More than one race | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 21 Participants | 7 Participants | 14 Participants |
| Self-Reported Self-Monitoring Behaviors Self-Reported Weighing | 0.9 scores on a scale STANDARD_DEVIATION 1.2 | 0.9 scores on a scale STANDARD_DEVIATION 1.2 | 0.9 scores on a scale STANDARD_DEVIATION 1.1 |
| Self-Reported Self-Monitoring Behaviors Track Activity | 1.2 scores on a scale STANDARD_DEVIATION 1.5 | 1.0 scores on a scale STANDARD_DEVIATION 1.5 | 1.3 scores on a scale STANDARD_DEVIATION 1.5 |
| Self-Reported Self-Monitoring Behaviors Track Calories | 0.5 scores on a scale STANDARD_DEVIATION 1 | 0.4 scores on a scale STANDARD_DEVIATION 1 | 0.6 scores on a scale STANDARD_DEVIATION 1.1 |
| Self-Reported Self-Monitoring Behaviors Track Food/Drink | 0.5 scores on a scale STANDARD_DEVIATION 0.8 | 0.4 scores on a scale STANDARD_DEVIATION 0.7 | 0.5 scores on a scale STANDARD_DEVIATION 0.8 |
| Sex: Female, Male Female | 61 Participants | 32 Participants | 29 Participants |
| Sex: Female, Male Male | 11 Participants | 4 Participants | 7 Participants |
| Waist Circumference | 117.0 centimeters STANDARD_DEVIATION 14.1 | 119.1 centimeters STANDARD_DEVIATION 15.3 | 114.9 centimeters STANDARD_DEVIATION 12.6 |
| Weight | 109.8 kilograms STANDARD_DEVIATION 22.6 | 112.4 kilograms STANDARD_DEVIATION 24 | 107.2 kilograms STANDARD_DEVIATION 21.2 |
| Weight Bias | 3.7 scores on a scale STANDARD_DEVIATION 0.6 | 3.7 scores on a scale STANDARD_DEVIATION 0.7 | 3.7 scores on a scale STANDARD_DEVIATION 0.6 |
| Weight Bias Internalization | 5.1 scores on a scale STANDARD_DEVIATION 0.7 | 5.0 scores on a scale STANDARD_DEVIATION 0.7 | 5.2 scores on a scale STANDARD_DEVIATION 0.7 |
| Weight-Related Quality of Life | 55.3 scores on a scale STANDARD_DEVIATION 16.5 | 56.3 scores on a scale STANDARD_DEVIATION 16.7 | 54.2 scores on a scale STANDARD_DEVIATION 16.5 |
| Weight Self-Stigma Questionnaire (WSSQ) WSSQ-FNE | 19.4 scores on a scale STANDARD_DEVIATION 4.7 | 18.8 scores on a scale STANDARD_DEVIATION 4.6 | 20.1 scores on a scale STANDARD_DEVIATION 4.8 |
| Weight Self-Stigma Questionnaire (WSSQ) WSSQ-SD | 19.2 scores on a scale STANDARD_DEVIATION 4.1 | 19.1 scores on a scale STANDARD_DEVIATION 4.2 | 19.2 scores on a scale STANDARD_DEVIATION 3.9 |
| Weight Self-Stigma Questionnaire (WSSQ) WSSQ-Total | 38.6 scores on a scale STANDARD_DEVIATION 6.7 | 37.9 scores on a scale STANDARD_DEVIATION 6.6 | 39.3 scores on a scale STANDARD_DEVIATION 6.9 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 36 | 0 / 36 |
| other Total, other adverse events | 3 / 36 | 7 / 36 |
| serious Total, serious adverse events | 0 / 36 | 1 / 36 |
Outcome results
Primary
Weight Bias Internalization
Estimated mean change score on the Weight Bias Internalization Scale (scale scoring 1-7; higher scores indicate greater weight bias internalization)
Time frame: Baseline to week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Weight Bias Internalization | -1.3 scores on a scale | Standard Error 0.2 |
| Standard BWL | Weight Bias Internalization | -1.0 scores on a scale | Standard Error 0.2 |
p-value: 0.22Mixed Models Analysis
Secondary
Blood Pressure
Estimated mean change in blood pressure (systolic blood pressure and diastolic blood pressure; mmHg), controlling for blood pressure medication.
Time frame: Baseline to week 26
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Blood Pressure | Systolic Blood Pressure | -2.6 change in mmHg | Standard Error 1.6 |
| BWL + BIAS | Blood Pressure | Diastolic Blood Pressure | -1.5 change in mmHg | Standard Error 1.2 |
| Standard BWL | Blood Pressure | Systolic Blood Pressure | -2.4 change in mmHg | Standard Error 1.6 |
| Standard BWL | Blood Pressure | Diastolic Blood Pressure | -2.2 change in mmHg | Standard Error 1.1 |
Comparison: Systolic Blood Pressurep-value: 0.94Mixed Models Analysis
Comparison: Diastolic Blood Pressurep-value: 0.64Mixed Models Analysis
Secondary
Depression
Estimated mean change score on the Patient Health Questionnaire - 9 (summed 0-27; higher scores indicate more symptoms of depression)
Time frame: Baseline to week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Depression | -3.4 scores on a scale | Standard Error 0.8 |
| Standard BWL | Depression | -2.5 scores on a scale | Standard Error 0.8 |
p-value: 0.4Mixed Models Analysis
Secondary
Depression
Estimated mean change score on the Patient Health Questionnaire - 9 (summed 0-27; higher scores indicate more symptoms of depression)
Time frame: Baseline to week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Depression | -2.9 scores on a scale | Standard Error 0.8 |
| Standard BWL | Depression | -2.9 scores on a scale | Standard Error 0.8 |
p-value: 0.98Mixed Models Analysis
Secondary
Eating Self-Efficacy
Estimated mean change score on the Weight and Lifestyle Efficacy - Short Form (summed 0-80; higher scores indicate greater self-efficacy)
Time frame: Baseline to week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Eating Self-Efficacy | 11.3 scores on a scale | Standard Error 3.1 |
| Standard BWL | Eating Self-Efficacy | 10.2 scores on a scale | Standard Error 3.1 |
p-value: 0.8Mixed Models Analysis
Secondary
Eating Self-Efficacy
Estimated mean change score on the Weight and Lifestyle Efficacy - Short Form (summed 0-80; higher scores indicate greater self-efficacy)
Time frame: Baseline to week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Eating Self-Efficacy | 12.0 scores on a scale | Standard Error 3.1 |
| Standard BWL | Eating Self-Efficacy | 8.9 scores on a scale | Standard Error 3.1 |
p-value: 0.49Mixed Models Analysis
Secondary
Exercise Self-Efficacy
Estimated mean change score on the Self-Efficacy for Exercise Scale (summed 0-90; higher scores indicate greater self-efficacy)
Time frame: Baseline to week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Exercise Self-Efficacy | 5.8 scores on a scale | Standard Error 4.6 |
| Standard BWL | Exercise Self-Efficacy | -6.3 scores on a scale | Standard Error 4.5 |
p-value: 0.06Mixed Models Analysis
Secondary
Exercise Self-Efficacy
Estimated mean change score on the Self-Efficacy for Exercise Scale (summed 0-90; higher scores indicate greater self-efficacy)
Time frame: Baseline to week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Exercise Self-Efficacy | 4.0 scores on a scale | Standard Error 4.6 |
| Standard BWL | Exercise Self-Efficacy | -5.7 scores on a scale | Standard Error 4.5 |
p-value: 0.14Mixed Models Analysis
Secondary
Perceived Stress
Estimated mean change score on the Perceived Stress Scale (summed 0-40; higher scores indicate greater perceived stress)
Time frame: Baseline to week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Perceived Stress | -3.2 scores on a scale | Standard Error 1.2 |
| Standard BWL | Perceived Stress | -0.1 scores on a scale | Standard Error 1.2 |
p-value: 0.08Mixed Models Analysis
Secondary
Perceived Stress
Estimated mean change score on the Perceived Stress Scale (summed 0-40; higher scores indicate greater perceived stress)
Time frame: Baseline to week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Perceived Stress | -3.9 scores on a scale | Standard Error 1.2 |
| Standard BWL | Perceived Stress | -1.0 scores on a scale | Standard Error 1.2 |
p-value: 0.1Mixed Models Analysis
Secondary
Percent Weight Change
Estimated mean change in percent weight change. Weight measured in kilograms (kg).
Time frame: Baseline to week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Percent Weight Change | -4.5 percent weight change | Standard Error 1 |
| Standard BWL | Percent Weight Change | -5.9 percent weight change | Standard Error 1 |
p-value: 0.31Mixed Models Analysis
Secondary
Waist Circumference
Estimated mean change in waist circumference (cm).
Time frame: Baseline to week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Waist Circumference | -4.3 change in cm | Standard Error 0.9 |
| Standard BWL | Waist Circumference | -5.1 change in cm | Standard Error 0.9 |
p-value: 0.54Mixed Models Analysis
Secondary
Weight Bias
Estimated mean change score on the Fat Phobia Scale (scale scoring 1-5; higher scores indicate greater weight bias)
Time frame: Baseline to week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Weight Bias | -0.5 scores on a scale | Standard Error 0.1 |
| Standard BWL | Weight Bias | -0.2 scores on a scale | Standard Error 0.1 |
p-value: 0.09Mixed Models Analysis
Secondary
Weight Bias
Estimated mean change score on the Fat Phobia Scale (scale scoring 1-5; higher scores indicate greater weight bias)
Time frame: Baseline to week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Weight Bias | -0.5 scores on a scale | Standard Error 0.1 |
| Standard BWL | Weight Bias | -0.2 scores on a scale | Standard Error 0.1 |
p-value: 0.12Mixed Models Analysis
Secondary
Weight Bias Internalization
Estimated mean change score on the Weight Bias Internalization Scale (scale scoring 1-7; higher scores indicate greater weight bias internalization)
Time frame: Baseline to week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Weight Bias Internalization | -1.5 scores on a scale | Standard Error 0.2 |
| Standard BWL | Weight Bias Internalization | -1.3 scores on a scale | Standard Error 0.2 |
p-value: 0.45Mixed Models Analysis
Secondary
Weight-Related Quality of Life
Estimated mean change score on the Impact of Weight on Quality of Life Questionnaire-Lite for Total score and five subscales of Physical Function, Self Esteem, Sexual Life, Work, and Public Distress (transformed scores 0-100; higher scores indicate better quality of life)
Time frame: Baseline to week 26
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Weight-Related Quality of Life | Physical Function | 13.7 scores on a scale | Standard Error 2.9 |
| BWL + BIAS | Weight-Related Quality of Life | Self Esteem | 19.1 scores on a scale | Standard Error 3.4 |
| BWL + BIAS | Weight-Related Quality of Life | Total | 12.5 scores on a scale | Standard Error 2.1 |
| BWL + BIAS | Weight-Related Quality of Life | Sexual Life | 7.0 scores on a scale | Standard Error 3.6 |
| BWL + BIAS | Weight-Related Quality of Life | Work | 8.6 scores on a scale | Standard Error 3.1 |
| BWL + BIAS | Weight-Related Quality of Life | Public Distress | 9.9 scores on a scale | Standard Error 2.6 |
| Standard BWL | Weight-Related Quality of Life | Work | 6.8 scores on a scale | Standard Error 3 |
| Standard BWL | Weight-Related Quality of Life | Physical Function | 14.2 scores on a scale | Standard Error 2.8 |
| Standard BWL | Weight-Related Quality of Life | Sexual Life | 14.0 scores on a scale | Standard Error 3.5 |
| Standard BWL | Weight-Related Quality of Life | Public Distress | 11.2 scores on a scale | Standard Error 2.6 |
| Standard BWL | Weight-Related Quality of Life | Total | 14.1 scores on a scale | Standard Error 2.1 |
| Standard BWL | Weight-Related Quality of Life | Self Esteem | 18.5 scores on a scale | Standard Error 3.3 |
Comparison: Estimated mean change score on the Impact of Weight on Quality of Life Questionnaire-Lite for Total scorep-value: 0.58Mixed Models Analysis
Comparison: Estimated mean change score on the Physical Function Subscale of the Impact of Weight on Quality of Life Questionnaire-Litep-value: 0.89Mixed Models Analysis
Comparison: Estimated mean change score on the Self Esteem Subscale of the Impact of Weight on Quality of Life Questionnaire-Litep-value: 0.9Mixed Models Analysis
Comparison: Estimated mean change score on the Sexual Life Subscale of the Impact of Weight on Quality of Life Questionnaire-Litep-value: 0.16Mixed Models Analysis
Comparison: Estimated mean change score on the Work Subscale of the Impact of Weight on Quality of Life Questionnaire-Litep-value: 0.68Mixed Models Analysis
Comparison: Estimated mean change score on the Public Distress Subscale of the Impact of Weight on Quality of Life Questionnaire-Litep-value: 0.72Mixed Models Analysis
Secondary
Weight-Related Quality of Life
Estimated mean change score on the Impact of Weight on Quality of Life Questionnaire-Lite for Total score and five subscales of Physical Function, Self Esteem, Sexual Life, Work, and Public Distress (transformed scores 0-100; higher scores indicate better quality of life)
Time frame: Baseline to week 12
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Weight-Related Quality of Life | Work | 4.8 scores on a scale | Standard Error 3.1 |
| BWL + BIAS | Weight-Related Quality of Life | Total | 8.3 scores on a scale | Standard Error 2.1 |
| BWL + BIAS | Weight-Related Quality of Life | Physical Function | 9.8 scores on a scale | Standard Error 2.9 |
| BWL + BIAS | Weight-Related Quality of Life | Self Esteem | 12.9 scores on a scale | Standard Error 3 |
| BWL + BIAS | Weight-Related Quality of Life | Sexual Life | 5.5 scores on a scale | Standard Error 3.6 |
| BWL + BIAS | Weight-Related Quality of Life | Public Distress | 5.7 scores on a scale | Standard Error 2.6 |
| Standard BWL | Weight-Related Quality of Life | Physical Function | 8.8 scores on a scale | Standard Error 2.8 |
| Standard BWL | Weight-Related Quality of Life | Work | 6.9 scores on a scale | Standard Error 3 |
| Standard BWL | Weight-Related Quality of Life | Public Distress | 7.7 scores on a scale | Standard Error 2.6 |
| Standard BWL | Weight-Related Quality of Life | Sexual Life | 9.5 scores on a scale | Standard Error 3.5 |
| Standard BWL | Weight-Related Quality of Life | Total | 8.9 scores on a scale | Standard Error 2 |
| Standard BWL | Weight-Related Quality of Life | Self Esteem | 9.2 scores on a scale | Standard Error 3 |
Comparison: Estimated mean change score on the Impact of Weight on Quality of Life Questionnaire-Lite for Total scorep-value: 0.84Mixed Models Analysis
Comparison: Estimated mean change score on the Physical Function Subscale of the Impact of Weight on Quality of Life Questionnaire-Litep-value: 0.82Mixed Models Analysis
Comparison: Estimated mean change score on the Self Esteem Subscale of the Impact of Weight on Quality of Life Questionnaire-Litep-value: 0.39Mixed Models Analysis
Comparison: Estimated mean change score on the Sexual Life Subscale of the Impact of Weight on Quality of Life Questionnaire-Litep-value: 0.42Mixed Models Analysis
Comparison: Estimated mean change score on the Work Subscale of the Impact of Weight on Quality of Life Questionnaire-Litep-value: 0.64Mixed Models Analysis
Comparison: Estimated mean change score on the Public Distress Subscale of the Impact of Weight on Quality of Life Questionnaire-Litep-value: 0.59Mixed Models Analysis
Secondary
Weight Self-Stigma Questionnaire (WSSQ)
Estimated mean change score for Total score (WSSQ-Total, summed 12-60) and two subscales of Self-Devaluation (WSSQ-SD) and Fear of Enacted Stigma (WSSQ-FNE) (summed 6-30); higher scores indicate greater weight self-stigma
Time frame: Baseline to week 26
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-FNE | -2.9 scores on a scale | Standard Error 0.9 |
| BWL + BIAS | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-Total | -7.1 scores on a scale | Standard Error 1.5 |
| BWL + BIAS | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-SD | -4.1 scores on a scale | Standard Error 0.8 |
| Standard BWL | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-FNE | -2.1 scores on a scale | Standard Error 0.9 |
| Standard BWL | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-Total | -3.6 scores on a scale | Standard Error 1.5 |
| Standard BWL | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-SD | -1.5 scores on a scale | Standard Error 0.8 |
Comparison: WSSQ-Totalp-value: 0.11Mixed Models Analysis
Comparison: WSSQ-SDp-value: 0.03Mixed Models Analysis
Comparison: WSSQ-FNEp-value: 0.53Mixed Models Analysis
Secondary
Weight Self-Stigma Questionnaire (WSSQ)
Estimated mean change score for Total score (WSSQ-Total, summed 12-60) and two subscales of Self-Devaluation (WSSQ-SD) and Fear of Enacted Stigma (WSSQ-FNE) (summed 6-30); higher scores indicate greater weight self-stigma
Time frame: Baseline to week 12
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-SD | -3.6 scores on a scale | Standard Error 0.8 |
| BWL + BIAS | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-Total | -6.0 scores on a scale | Standard Error 1.4 |
| BWL + BIAS | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-FNE | -2.3 scores on a scale | Standard Error 0.8 |
| Standard BWL | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-SD | -1.0 scores on a scale | Standard Error 0.8 |
| Standard BWL | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-Total | -1.6 scores on a scale | Standard Error 1.3 |
| Standard BWL | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-FNE | -0.7 scores on a scale | Standard Error 0.8 |
Comparison: WSSQ-Totalp-value: 0.03Mixed Models Analysis
Comparison: WSSQ-SDp-value: 0.02Mixed Models Analysis
Comparison: WSSQ-FNEp-value: 0.19Mixed Models Analysis
Other Pre-specified
Anxiety
Estimated mean change score on the Generalized Anxiety Disorder-7 Questionnaire (summed 0-21; higher scores indicate greater anxiety)
Time frame: Baseline to Week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Anxiety | -1.6 scores on a scale | Standard Error 0.8 |
| Standard BWL | Anxiety | -0.8 scores on a scale | Standard Error 0.8 |
p-value: 0.16Mixed Models Analysis
Other Pre-specified
Anxiety
Estimated mean change score on the Generalized Anxiety Disorder-7 Questionnaire (summed 0-21; higher scores indicate greater anxiety)
Time frame: Baseline to Week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Anxiety | -1.8 scores on a scale | Standard Error 0.8 |
| Standard BWL | Anxiety | -0.7 scores on a scale | Standard Error 0.8 |
p-value: 0.32Mixed Models Analysis
Other Pre-specified
Anxiety
Estimated mean change score on the Generalized Anxiety Disorder-7 Questionnaire (summed 0-21; higher scores indicate greater anxiety)
Time frame: Baseline to Week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Anxiety | -1.5 scores on a scale | Standard Error 0.9 |
| Standard BWL | Anxiety | -0.3 scores on a scale | Standard Error 0.9 |
p-value: 0.11Mixed Models Analysis
Other Pre-specified
Blood Pressure
Estimated mean change in blood pressure (systolic blood pressure and diastolic blood pressure; mmHg), controlling for blood pressure medication.
Time frame: Baseline to week 52
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Blood Pressure | Systolic Blood Pressure | -5.7 change in mmHg | Standard Error 2.5 |
| BWL + BIAS | Blood Pressure | Diastolic Blood Pressure | -1.1 change in mmHg | Standard Error 1.3 |
| Standard BWL | Blood Pressure | Systolic Blood Pressure | -4.3 change in mmHg | Standard Error 2.5 |
| Standard BWL | Blood Pressure | Diastolic Blood Pressure | -1.8 change in mmHg | Standard Error 1.3 |
Comparison: Systolic Blood Pressurep-value: 0.71Mixed Models Analysis
Comparison: Diastolic Blood Pressurep-value: 0.72Mixed Models Analysis
Other Pre-specified
Body Dissatisfaction
Estimated mean change score on the Body Areas Satisfaction Subscale of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (scale scoring 1-5; higher scores indicating greater satisfaction)
Time frame: Baseline to Week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Body Dissatisfaction | 0.6 scores on a scale | Standard Error 0.1 |
| Standard BWL | Body Dissatisfaction | 0.5 scores on a scale | Standard Error 0.1 |
p-value: 0.24Mixed Models Analysis
Other Pre-specified
Body Dissatisfaction
Estimated mean change score on the Body Areas Satisfaction Subscale of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (scale scoring 1-5; higher scores indicating greater satisfaction)
Time frame: Baseline to Week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Body Dissatisfaction | 0.4 scores on a scale | Standard Error 0.1 |
| Standard BWL | Body Dissatisfaction | 0.4 scores on a scale | Standard Error 0.1 |
p-value: 0.53Mixed Models Analysis
Other Pre-specified
Body Dissatisfaction
Estimated mean change score on the Body Areas Satisfaction Subscale of the Multidimensional Body-Self Relations Questionnaire-Appearance Scales (scale scoring 1-5; higher scores indicating greater satisfaction)
Time frame: Baseline to Week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Body Dissatisfaction | 0.5 scores on a scale | Standard Error 0.1 |
| Standard BWL | Body Dissatisfaction | 0.4 scores on a scale | Standard Error 0.1 |
p-value: 0.33Mixed Models Analysis
Other Pre-specified
Body Esteem
Estimated mean change score on the Body Appreciation Scale (scale scoring 1-5; higher scores indicate greater body appreciation)
Time frame: Baseline to Week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Body Esteem | 0.8 scores on a scale | Standard Error 0.1 |
| Standard BWL | Body Esteem | 0.4 scores on a scale | Standard Error 0.1 |
p-value: 0.07Mixed Models Analysis
Other Pre-specified
Body Esteem
Estimated mean change score on the Body Appreciation Scale (scale scoring 1-5; higher scores indicate greater body appreciation)
Time frame: Baseline to Week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Body Esteem | 0.6 scores on a scale | Standard Error 0.1 |
| Standard BWL | Body Esteem | 0.3 scores on a scale | Standard Error 0.1 |
p-value: 0.13Mixed Models Analysis
Other Pre-specified
Body Esteem
Estimated mean change score on the Body Appreciation Scale (scale scoring 1-5; higher scores indicate greater body appreciation)
Time frame: Baseline to Week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Body Esteem | 0.8 scores on a scale | Standard Error 0.1 |
| Standard BWL | Body Esteem | 0.5 scores on a scale | Standard Error 0.1 |
p-value: 0.13Mixed Models Analysis
Other Pre-specified
Coping Behaviors in Response to Weight Stigma
Estimated mean change score on the Coping with Weight Stigma Questionnaire for Full scale and four subscales of Negative Affect, Maladaptive Eating, Healthy Lifestyle, and Exercise Avoidance (scale scoring 0-4 for Full scale and all subscales); higher scores indicate greater endorsement of coping strategies
Time frame: Baseline to week 12
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Negative Affect | -1.1 scores on a scale | Standard Error 0.1 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Healthy Lifestyle | 0.0 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Maladaptive Eating | -0.7 scores on a scale | Standard Error 0.1 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Exercise Avoidance | -0.8 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Full Scale | -0.7 scores on a scale | Standard Error 0.1 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Exercise Avoidance | -0.5 scores on a scale | Standard Error 0.2 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Full Scale | -0.8 scores on a scale | Standard Error 0.1 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Negative Affect | -1.2 scores on a scale | Standard Error 0.1 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Maladaptive Eating | -0.7 scores on a scale | Standard Error 0.1 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Healthy Lifestyle | 0.1 scores on a scale | Standard Error 0.2 |
Comparison: Full Scalep-value: 0.58Mixed Models Analysis
Comparison: Negative Affectp-value: 0.49Mixed Models Analysis
Comparison: Maladaptive Eatingp-value: 0.96Mixed Models Analysis
Comparison: Healthy Lifestylep-value: 0.71Mixed Models Analysis
Comparison: Exercise Avoidancep-value: 0.41Mixed Models Analysis
Other Pre-specified
Coping Behaviors in Response to Weight Stigma
Estimated mean change score on the Coping with Weight Stigma Questionnaire for Full scale and four subscales of Negative Affect, Maladaptive Eating, Healthy Lifestyle, and Exercise Avoidance (scale scoring 0-4 for Full scale and all subscales); higher scores indicate greater endorsement of coping strategies
Time frame: Baseline to Week 52
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Negative Affect | -1.2 scores on a scale | Standard Error 0.1 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Maladaptive Eating | -0.6 scores on a scale | Standard Error 0.1 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Exercise Avoidance | -0.7 scores on a scale | Standard Error 0.3 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Full Scale | -0.7 scores on a scale | Standard Error 0.1 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Healthy Lifestyle | -0.2 scores on a scale | Standard Error 0.2 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Healthy Lifestyle | 0.0 scores on a scale | Standard Error 0.2 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Negative Affect | -0.8 scores on a scale | Standard Error 0.1 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Full Scale | -0.6 scores on a scale | Standard Error 0.1 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Maladaptive Eating | -0.6 scores on a scale | Standard Error 0.1 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Exercise Avoidance | -0.6 scores on a scale | Standard Error 0.3 |
Comparison: Full Scalep-value: 0.52Mixed Models Analysis
Comparison: Negative Affectp-value: 0.02Mixed Models Analysis
Comparison: Maladaptive Eatingp-value: 0.63Mixed Models Analysis
Comparison: Exercise Avoidancep-value: 0.74Mixed Models Analysis
Comparison: Healthy Lifestylep-value: 0.49Mixed Models Analysis
Other Pre-specified
Coping Behaviors in Response to Weight Stigma
Estimated mean change score on the Coping with Weight Stigma Questionnaire for Full scale and four subscales of Negative Affect, Maladaptive Eating, Healthy Lifestyle, and Exercise Avoidance (scale scoring 0-4 for Full scale and all subscales); higher scores indicate greater endorsement of coping strategies
Time frame: Baseline to week 26
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Negative Affect | -1.3 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Healthy Lifestyle | -0.2 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Maladaptive Eating | -0.8 scores on a scale | Standard Error 0.1 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Exercise Avoidance | -0.9 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Coping Behaviors in Response to Weight Stigma | Full Scale | -0.8 scores on a scale | Standard Error 0.1 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Exercise Avoidance | -0.9 scores on a scale | Standard Error 0.2 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Negative Affect | -1.2 scores on a scale | Standard Error 0.2 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Maladaptive Eating | -0.8 scores on a scale | Standard Error 0.1 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Healthy Lifestyle | 0.0 scores on a scale | Standard Error 0.2 |
| Standard BWL | Coping Behaviors in Response to Weight Stigma | Full Scale | -0.9 scores on a scale | Standard Error 0.1 |
Comparison: Full Scalep-value: 0.61Mixed Models Analysis
Comparison: Negative Affectp-value: 0.73Mixed Models Analysis
Comparison: Maladaptive Eatingp-value: 0.94Mixed Models Analysis
Comparison: Healthy Lifestylep-value: 0.47Mixed Models Analysis
Comparison: Exercise Avoidancep-value: 0.99Mixed Models Analysis
Other Pre-specified
Depression
Estimated mean change score on the Patient Health Questionnaire - 9 (summed 0-27; higher scores indicate more symptoms of depression)
Time frame: Baseline to week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Depression | -2.9 scores on scale | Standard Error 0.9 |
| Standard BWL | Depression | -2.4 scores on scale | Standard Error 0.9 |
p-value: 0.7Mixed Models Analysis
Other Pre-specified
Dietary Monitoring
Estimated mean change in number of days recording caloric intake
Time frame: Baseline to Week 26
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Dietary Monitoring | 85.6 number of days | Standard Error 9.5 |
| Standard BWL | Dietary Monitoring | 95.8 number of days | Standard Error 9.2 |
p-value: 0.44Mixed Models Analysis
Other Pre-specified
Dietary Monitoring
Estimated mean change in number of days recording caloric intake
Time frame: Baseline to Week 12
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Dietary Monitoring | 52.9 number of days | Standard Error 3.4 |
| Standard BWL | Dietary Monitoring | 55.5 number of days | Standard Error 3.4 |
p-value: 0.59Mixed Models Analysis
Other Pre-specified
Disordered Eating
Estimated mean change score on the Eating Disorders Examination Questionnaire for Global score and four subscales of Eating Restraint, Eating Concern, Weight Concern, and Shape Concern (scale scoring 0-6 for Global score and all subscales; higher scores indicate greater pathology)
Time frame: Baseline to Week 52
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Disordered Eating | Eating Concern | -0.6 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Disordered Eating | Weight Concern | -1.0 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Disordered Eating | Eating Restraint | 1.0 scores on a scale | Standard Error 0.3 |
| BWL + BIAS | Disordered Eating | Shape Concern | -1.1 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Disordered Eating | Global | -0.4 scores on a scale | Standard Error 0.1 |
| Standard BWL | Disordered Eating | Shape Concern | -0.7 scores on a scale | Standard Error 0.2 |
| Standard BWL | Disordered Eating | Global | -0.2 scores on a scale | Standard Error 0.1 |
| Standard BWL | Disordered Eating | Eating Restraint | 0.7 scores on a scale | Standard Error 0.3 |
| Standard BWL | Disordered Eating | Eating Concern | -0.3 scores on a scale | Standard Error 0.2 |
| Standard BWL | Disordered Eating | Weight Concern | -0.7 scores on a scale | Standard Error 0.2 |
Comparison: Globalp-value: 0.35Mixed Models Analysis
Comparison: Eating Restraintp-value: 0.46Mixed Models Analysis
Comparison: Eating Concernp-value: 0.33Mixed Models Analysis
Comparison: Weight Concernp-value: 0.18Mixed Models Analysis
Comparison: Shape Concernp-value: 0.16Mixed Models Analysis
Other Pre-specified
Disordered Eating
Estimated mean change score on the Eating Disorders Examination Questionnaire for Global score and four subscales of Eating Restraint, Eating Concern, Weight Concern, and Shape Concern (scale scoring 0-6 for Global score and all subscales; higher scores indicate greater pathology)
Time frame: Baseline to Week 26
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Disordered Eating | Shape Concern | -1.4 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Disordered Eating | Global | -0.5 scores on a scale | Standard Error 0.1 |
| BWL + BIAS | Disordered Eating | Eating Restraint | 1.2 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Disordered Eating | Eating Concern | -0.7 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Disordered Eating | Weight Concern | -1.2 scores on a scale | Standard Error 0.2 |
| Standard BWL | Disordered Eating | Weight Concern | -0.8 scores on a scale | Standard Error 0.2 |
| Standard BWL | Disordered Eating | Eating Concern | -0.6 scores on a scale | Standard Error 0.2 |
| Standard BWL | Disordered Eating | Global | -0.3 scores on a scale | Standard Error 0.1 |
| Standard BWL | Disordered Eating | Shape Concern | -1.0 scores on a scale | Standard Error 0.2 |
| Standard BWL | Disordered Eating | Eating Restraint | 1.0 scores on a scale | Standard Error 0.2 |
Comparison: Globalp-value: 0.3Mixed Models Analysis
Comparison: Eating Restraintp-value: 0.69Mixed Models Analysis
Comparison: Eating Concernp-value: 0.7Mixed Models Analysis
Comparison: Weight Concernp-value: 0.26Mixed Models Analysis
Comparison: Shape Concernp-value: 0.18Mixed Models Analysis
Other Pre-specified
Disordered Eating
Estimated mean change score on the Eating Disorders Examination Questionnaire for Global score and four subscales of Eating Restraint, Eating Concern, Weight Concern, and Shape Concern (scale scoring 0-6 for Global score and all subscales; higher scores indicate greater pathology)
Time frame: Baseline to Week 12
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Disordered Eating | Global | -0.2 scores on a scale | Standard Error 0.1 |
| BWL + BIAS | Disordered Eating | Eating Concern | -0.4 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Disordered Eating | Weight Concern | -0.7 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Disordered Eating | Eating Restraint | 1.7 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Disordered Eating | Shape Concern | -1.1 scores on a scale | Standard Error 0.2 |
| Standard BWL | Disordered Eating | Eating Restraint | 1.5 scores on a scale | Standard Error 0.2 |
| Standard BWL | Disordered Eating | Eating Concern | -0.7 scores on a scale | Standard Error 0.2 |
| Standard BWL | Disordered Eating | Shape Concern | -0.9 scores on a scale | Standard Error 0.2 |
| Standard BWL | Disordered Eating | Global | -0.2 scores on a scale | Standard Error 0.1 |
| Standard BWL | Disordered Eating | Weight Concern | -0.7 scores on a scale | Standard Error 0.2 |
Comparison: Globalp-value: 0.83Mixed Models Analysis
Comparison: Eating Restraintp-value: 0.69Mixed Models Analysis
Comparison: Eating Concernp-value: 0.3Mixed Models Analysis
Comparison: Weight Concernp-value: 0.99Mixed Models Analysis
Comparison: Shape Concernp-value: 0.36Mixed Models Analysis
Other Pre-specified
Eating Behaviors
Estimated mean change score on the Eating Inventory Questionnaire for three subscales of Dietary Restraint (summed 0-21), Disinhibition (summed 0-16), and Hunger (summed 0-14); higher values indicate greater restraint/disinhibition/hunger
Time frame: Baseline to Week 12
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Eating Behaviors | Dietary Restraint | 6.3 scores on a scale | Standard Error 0.7 |
| BWL + BIAS | Eating Behaviors | Disinhibition | -2.8 scores on a scale | Standard Error 0.6 |
| BWL + BIAS | Eating Behaviors | Hunger | -3.2 scores on a scale | Standard Error 0.5 |
| Standard BWL | Eating Behaviors | Disinhibition | -1.9 scores on a scale | Standard Error 0.6 |
| Standard BWL | Eating Behaviors | Dietary Restraint | 5.9 scores on a scale | Standard Error 0.7 |
| Standard BWL | Eating Behaviors | Hunger | -1.4 scores on a scale | Standard Error 0.5 |
Comparison: Dietary Restraintp-value: 0.69Mixed Models Analysis
Comparison: Disinhibitionp-value: 0.28Mixed Models Analysis
Comparison: Hungerp-value: 0.02Mixed Models Analysis
Other Pre-specified
Eating Behaviors
Estimated mean change score on the Eating Inventory Questionnaire for three subscales of Dietary Restraint (summed 0-21), Disinhibition (summed 0-16), and Hunger (summed 0-14); higher values indicate greater restraint/disinhibition/hunger
Time frame: Baseline to Week 26
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Eating Behaviors | Hunger | -3.9 scores on a scale | Standard Error 0.5 |
| BWL + BIAS | Eating Behaviors | Dietary Restraint | 6.4 scores on a scale | Standard Error 0.8 |
| BWL + BIAS | Eating Behaviors | Disinhibition | -3.0 scores on a scale | Standard Error 0.6 |
| Standard BWL | Eating Behaviors | Disinhibition | -2.2 scores on a scale | Standard Error 0.6 |
| Standard BWL | Eating Behaviors | Dietary Restraint | 5.2 scores on a scale | Standard Error 0.8 |
| Standard BWL | Eating Behaviors | Hunger | -1.4 scores on a scale | Standard Error 0.5 |
Comparison: Dietary Restraintp-value: 0.29Mixed Models Analysis
Comparison: Disinhibitionp-value: 0.34Mixed Models Analysis
Comparison: Hungerp-value: 0.001Mixed Models Analysis
Other Pre-specified
Eating Behaviors
Estimated mean change score on the Eating Inventory Questionnaire for three subscales of Dietary Restraint (summed 0-21), Disinhibition (summed 0-16), and Hunger (summed 0-14); higher values indicate greater restraint/disinhibition/hunger
Time frame: Baseline to Week 52
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Eating Behaviors | Dietary Restraint | 3.5 scores on a scale | Standard Error 0.9 |
| BWL + BIAS | Eating Behaviors | Disinhibition | -1.8 scores on a scale | Standard Error 0.5 |
| BWL + BIAS | Eating Behaviors | Hunger | -2.9 scores on a scale | Standard Error 0.6 |
| Standard BWL | Eating Behaviors | Dietary Restraint | 3.2 scores on a scale | Standard Error 0.9 |
| Standard BWL | Eating Behaviors | Disinhibition | -1.2 scores on a scale | Standard Error 0.6 |
| Standard BWL | Eating Behaviors | Hunger | -0.7 scores on a scale | Standard Error 0.6 |
Comparison: Dietary Restraintp-value: 0.82Mixed Models Analysis
Comparison: Disinhibitionp-value: 0.45Mixed Models Analysis
Comparison: Hungerp-value: 0.007Mixed Models Analysis
Other Pre-specified
Eating Self-Efficacy
Estimated mean change score on the Weight and Lifestyle Efficacy - Short Form (summed 0-80; higher scores indicate greater self-efficacy)
Time frame: Baseline to week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Eating Self-Efficacy | 8.3 scores on scale | Standard Error 3.4 |
| Standard BWL | Eating Self-Efficacy | 1.0 scores on scale | Standard Error 3.4 |
p-value: 0.14Mixed Models Analysis
Other Pre-specified
Exercise Self-Efficacy
Estimated mean change score on the Self-Efficacy for Exercise Scale (summed 0-90; higher scores indicate greater self-efficacy)
Time frame: Baseline to week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Exercise Self-Efficacy | -3.1 scores on a scale | Standard Error 4.9 |
| Standard BWL | Exercise Self-Efficacy | -6.8 scores on a scale | Standard Error 4.8 |
p-value: 0.59Mixed Models Analysis
Other Pre-specified
Perceived Stress
Estimated mean change score on the Perceived Stress Scale (summed 0-40; higher scores indicate greater perceived stress)
Time frame: Baseline to week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Perceived Stress | -2.4 scores on scale | Standard Error 1.3 |
| Standard BWL | Perceived Stress | -0.1 scores on scale | Standard Error 1.2 |
p-value: 0.2Mixed Models Analysis
Other Pre-specified
Percent Weight Change
Estimated mean change in percent weight change. Weight measured in kilograms (kg)
Time frame: Baseline to week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Percent Weight Change | -3.1 percent weight change | Standard Error 1 |
| Standard BWL | Percent Weight Change | -4.0 percent weight change | Standard Error 1 |
p-value: 0.53Mixed Models Analysis
Other Pre-specified
Self-Reported Self-Monitoring Behaviors
Estimated mean change in self-reported frequency of tracking of: weight, food/drink, calories, and physical activity; 0-4 rating for each of the four behaviors (higher scores indicate greater self-reported frequency of self-monitoring behavior)
Time frame: Baseline to Week 12
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Self-Reported Weighing | 0.9 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Track Food/Drink | 2.7 scores on a scale | Standard Error 0.3 |
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Track Calories | 2.0 scores on a scale | Standard Error 0.3 |
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Track Activity | 1.6 scores on a scale | Standard Error 0.3 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Track Activity | 0.8 scores on a scale | Standard Error 0.3 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Self-Reported Weighing | 1.1 scores on a scale | Standard Error 0.2 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Track Calories | 1.7 scores on a scale | Standard Error 0.3 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Track Food/Drink | 2.0 scores on a scale | Standard Error 0.3 |
Comparison: Self-Reported Weighingp-value: 0.46Mixed Models Analysis
Comparison: Track Food/Drinkp-value: 0.12Mixed Models Analysis
Comparison: Track Caloriesp-value: 0.42Mixed Models Analysis
Comparison: Track Activityp-value: 0.03Mixed Models Analysis
Other Pre-specified
Self-Reported Self-Monitoring Behaviors
Estimated mean change in self-reported frequency of tracking of: weight, food/drink, calories, and physical activity; 0-4 rating for each of the four behaviors (higher scores indicate greater self-reported frequency of self-monitoring behavior)
Time frame: Baseline to Week 52
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Self-Reported Weighing | 0.9 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Track Food/Drink | 0.8 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Track Calories | 1.2 scores on a scale | Standard Error 0.3 |
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Track Activity | 0.8 scores on a scale | Standard Error 0.3 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Track Activity | 0.3 scores on a scale | Standard Error 0.3 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Self-Reported Weighing | 0.5 scores on a scale | Standard Error 0.2 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Track Calories | 1.3 scores on a scale | Standard Error 0.3 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Track Food/Drink | 0.7 scores on a scale | Standard Error 0.2 |
Comparison: Self-Reported Weighingp-value: 0.23Mixed Models Analysis
Comparison: Track Food/Drinkp-value: 0.48Mixed Models Analysis
Comparison: Track Caloriesp-value: 0.89Mixed Models Analysis
Comparison: Track Activityp-value: 0.3Mixed Models Analysis
Other Pre-specified
Self-Reported Self-Monitoring Behaviors
Estimated mean change in self-reported frequency of tracking of: weight, food/drink, calories, and physical activity; 0-4 rating for each of the four behaviors (higher scores indicate greater self-reported frequency of self-monitoring behavior)
Time frame: Baseline to Week 26
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Self-Reported Weighing | 1.0 scores on a scale | Standard Error 0.2 |
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Track Food/Drink | 1.6 scores on a scale | Standard Error 0.3 |
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Track Calories | 1.7 scores on a scale | Standard Error 0.3 |
| BWL + BIAS | Self-Reported Self-Monitoring Behaviors | Track Activity | 1.3 scores on a scale | Standard Error 0.3 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Track Activity | 0.9 scores on a scale | Standard Error 0.3 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Self-Reported Weighing | 0.6 scores on a scale | Standard Error 0.2 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Track Calories | 1.4 scores on a scale | Standard Error 0.3 |
| Standard BWL | Self-Reported Self-Monitoring Behaviors | Track Food/Drink | 1.6 scores on a scale | Standard Error 0.3 |
Comparison: Self-Reported Weighingp-value: 0.23Mixed Models Analysis
Comparison: Track Food/Drinkp-value: 0.9Mixed Models Analysis
Comparison: Track Caloriesp-value: 0.36Mixed Models Analysis
Comparison: Track Activityp-value: 0.29Mixed Models Analysis
Other Pre-specified
Treatment Acceptability Ratings
To assess treatment acceptability, participants in both groups rated (1-7) the BWL treatment, as well as the stigma intervention (i.e., BIAS component) or recipe exchange, on how helpful they found each component of the program, how much they liked the components, and how much they learned new skills or information from each component. Scores for these three items were averaged (1-7) separately for the BWL treatment, BIAS component, and recipe exchange. Higher scores indicate greater treatment acceptability.
Time frame: Week 26
Population: Participants randomized to the BWL + BIAS group did not receive (and thus did not rate) the recipe exchange component of treatment. Participants in the Standard BWL group did not receive (and did not rate) the BIAS treatment component.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Treatment Acceptability Ratings | BWL component | 6.5 scores on a scale | Standard Error 0.9 |
| BWL + BIAS | Treatment Acceptability Ratings | BIAS component | 6.3 scores on a scale | Standard Error 1 |
| Standard BWL | Treatment Acceptability Ratings | BWL component | 6.3 scores on a scale | Standard Error 1 |
| Standard BWL | Treatment Acceptability Ratings | Recipe exchange | 5.4 scores on a scale | Standard Error 1.5 |
Comparison: BWL componentp-value: 0.32ANOVA
Other Pre-specified
Treatment Acceptability Ratings
To assess treatment acceptability, participants rated (1-7) 5 items to indicate the extent to which they found the program (as a whole) to be helpful and acceptable, and how much they liked, were satisfied with, and would recommend the program to others. Scores are averaged 1-7, with higher scores indicating greater treatment acceptability.
Time frame: Week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Treatment Acceptability Ratings | 6.5 scores on a scale | Standard Error 0.6 |
| Standard BWL | Treatment Acceptability Ratings | 6.2 scores on a scale | Standard Error 0.9 |
p-value: 0.14ANOVA
Other Pre-specified
Waist Circumference
Estimated mean change in waist circumference (cm)
Time frame: Baseline to week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Waist Circumference | -4.4 change in cm | Standard Error 1 |
| Standard BWL | Waist Circumference | -4.4 change in cm | Standard Error 1 |
p-value: 0.99Mixed Models Analysis
Other Pre-specified
Weight Bias
Estimated mean change score on the Fat Phobia Scale (scale scoring 1-5; higher scores indicate greater weight bias)
Time frame: Baseline to week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Weight Bias | -0.4 scores on scale | Standard Error 0.1 |
| Standard BWL | Weight Bias | -0.2 scores on scale | Standard Error 0.1 |
p-value: 0.21Mixed Models Analysis
Other Pre-specified
Weight Bias Internalization
Estimated mean change score on the Weight Bias Internalization Scale (scale scoring 1-7; higher scores indicate greater weight bias internalization)
Time frame: Baseline to week 52
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| BWL + BIAS | Weight Bias Internalization | -1.5 scores on scale | Standard Error 0.2 |
| Standard BWL | Weight Bias Internalization | -1.2 scores on scale | Standard Error 0.2 |
p-value: 0.25Mixed Models Analysis
Other Pre-specified
Weight-Related Quality of Life
Estimated mean change score on the Impact of Weight on Quality of Life Questionnaire-Lite for Total score and five subscales of Physical Function, Self Esteem, Sexual Life, Work, and Public Distress (transformed scores 0-100; higher scores indicate better quality of life)
Time frame: Baseline to week 52
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Weight-Related Quality of Life | Sexual Life | 13.3 scores on scale | Standard Error 3.7 |
| BWL + BIAS | Weight-Related Quality of Life | Total | 14.3 scores on scale | Standard Error 2.5 |
| BWL + BIAS | Weight-Related Quality of Life | Work | 12.1 scores on scale | Standard Error 3.1 |
| BWL + BIAS | Weight-Related Quality of Life | Self Esteem | 20.0 scores on scale | Standard Error 3.9 |
| BWL + BIAS | Weight-Related Quality of Life | Public Distress | 12.6 scores on scale | Standard Error 2.7 |
| BWL + BIAS | Weight-Related Quality of Life | Physical Function | 12.4 scores on scale | Standard Error 3.1 |
| Standard BWL | Weight-Related Quality of Life | Public Distress | 7.6 scores on scale | Standard Error 2.7 |
| Standard BWL | Weight-Related Quality of Life | Physical Function | 13.2 scores on scale | Standard Error 3.1 |
| Standard BWL | Weight-Related Quality of Life | Self Esteem | 17.7 scores on scale | Standard Error 3.9 |
| Standard BWL | Weight-Related Quality of Life | Sexual Life | 11.6 scores on scale | Standard Error 3.6 |
| Standard BWL | Weight-Related Quality of Life | Work | 11.8 scores on scale | Standard Error 3.1 |
| Standard BWL | Weight-Related Quality of Life | Total | 13.4 scores on scale | Standard Error 2.5 |
Comparison: Totalp-value: 0.81Mixed Models Analysis
Comparison: Physical Functionp-value: 0.86Mixed Models Analysis
Comparison: Self Esteemp-value: 0.87Mixed Models Analysis
Comparison: Sexual Lifep-value: 0.73Mixed Models Analysis
Comparison: Workp-value: 0.95Mixed Models Analysis
Comparison: Public Distressp-value: 0.19Mixed Models Analysis
Other Pre-specified
Weight Self-Stigma Questionnaire (WSSQ)
Estimated mean change score for Total score (WSSQ-Total, summed 12-60) and two subscales of Self-Devaluation (WSSQ-SD) and Fear of Enacted Stigma (WSSQ-FNE) (summed 6-30); higher scores indicate greater weight self-stigma
Time frame: Baseline to week 52
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BWL + BIAS | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-Total | -5.6 scores on scale | Standard Error 1.6 |
| BWL + BIAS | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-SD | -2.9 scores on scale | Standard Error 0.8 |
| BWL + BIAS | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-FNE | -2.7 scores on scale | Standard Error 1 |
| Standard BWL | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-Total | -3.1 scores on scale | Standard Error 1.6 |
| Standard BWL | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-SD | -1.2 scores on scale | Standard Error 0.8 |
| Standard BWL | Weight Self-Stigma Questionnaire (WSSQ) | WSSQ-FNE | -2.0 scores on scale | Standard Error 1 |
Comparison: WSSQ-Totalp-value: 0.27Mixed Models Analysis
Comparison: WSSQ-SDp-value: 0.13Mixed Models Analysis
Comparison: WSSQ-FNEp-value: 0.65Mixed Models Analysis