Goal language is associated with attrition and weight loss on a digital program: Observational study

Abstract

Behavioral weight loss reduces risk of weight-related health complications. Outcomes of behavioral weight loss programs include attrition and weight loss. There is reason to believe that individuals' written language on a weight management program may be associated with outcomes. Exploring associations between written language and these outcomes could potentially inform future efforts towards real-time automated identification of moments or individuals at high risk of suboptimal outcomes. Thus, in the first study of its kind, we explored whether individuals' written language in actual use of a program (i.e., outside of a controlled trial) is associated with attrition and weight loss. We examined two types of language: goal setting (i.e., language used in setting a goal at the start of the program) and goal striving (i.e., language used in conversations with a coach about the process of striving for goals) and whether they are associated with attrition and weight loss on a mobile weight management program. We used the most established automated text analysis program, Linguistic Inquiry Word Count (LIWC), to retrospectively analyze transcripts extracted from the program database. The strongest effects emerged for goal striving language. In striving for goals, psychologically distanced language was associated with more weight loss and less attrition, while psychologically immediate language was associated with less weight loss and higher attrition. Our results highlight the potential importance of distanced and immediate language in understanding outcomes like attrition and weight loss. These results, generated from real-world language, attrition, and weight loss (i.e., from individuals' natural usage of the program), have important implications for how future work can better understand outcomes, especially in real-world settings.