Background: Many traditional lifestyle interventions use calorie prescriptions, but most individuals have difficulty sustaining calorie tracking and thus weight loss. In contrast, whole food plant-based diets (WFPBDs) have previously shown significant weight loss without this issue. However, most WFPBD interventions are face-to-face and time-intensive, and do not leverage gold standard behavioral strategies for health behavior change.
Objective: This open pilot trial was the first to evaluate the feasibility of a fully featured, remotely delivered behavioral weight loss intervention using an ad libitum WFPBD.
Methods: Over 12 weeks, participants (N=15) with overweight or obesity received a newly designed program that integrated behavioral weight loss and a WFPBD prescription via weekly web-based modules and brief phone coaching calls. Assessments were performed at baseline, midtreatment (6 weeks), and after treatment (12 weeks).
Results: The intervention was rated as highly acceptable (mean 4.40 out of 5, SE 0.18), and attrition was low (6.7%). In all, intention-to-treat analyses revealed that 69% (10.4/15) of the participants lost 5% of their weight (mean -5.89, SE 0.68 kg). Predefined benchmarks for quality of life were met.
Conclusions: A pilot digital behavioral weight loss intervention with a non-energy-restricted WFPBD was feasible, and the mean acceptability was high. Minimal contact time (80-150 minutes of study interventionist time per participant over 12 weeks) led to clinically relevant weight loss and dietary adherence for most participants (10.4/15, 69% and 11.8/15, 79%, respectively), and quality of life improvements (reliable change indices >1.53). We hope that this work will serve as a springboard for future larger scale randomized controlled studies evaluating the efficacy of such programs for weight loss, dietary change, and quality of life.
Trial registration: ClinicalTrials.gov NCT04892030; https://clinicaltrials.gov/ct2/show/NCT04892030.
Keywords: behavioral intervention; eHealth; overweight; vegan diet; vegetarian diet.
©Christina Chwyl, Nicholas Wright, Gabrielle M Turner-McGrievy, Meghan L Butryn, Evan M Forman. Originally published in JMIR Formative Research (https://formative.jmir.org), 23.06.2022.