Newswise — A scalable, mobile phone-based intervention designed to slow weight regain after an initial weight loss had no significant effect on participants’ weight, according to a study published this week in PLOS Medicine by Falko Sniehotta from Newcastle University, UK and colleagues.


Obesity is a major contributor to preventable life-years lost worldwide and, while effective behavioral weight loss interventions are available, weight loss is often followed by weight regain. In the new study, researchers carried out a randomized controlled trial involving 288 people from North East England with obesity who had recently lost at least 5% of their bodyweight. The NULevel intervention consisted of a single face-to-face goal-setting meeting, self-monitoring, and personalized feedback on weight, diet, and physical activity via SMS text messages with embedded links. The control group received standard lifestyle advice via newsletter.


Overall, 264 participants completed the trial. Those participating in the intervention group weighed themselves more frequently and were more physically active. However, the mean weight gain over the 12 month study period was similar in the two groups, with an average of 1.8 kg (95% CI 0.5 to 3.1) gained in the intervention group and 1.8 kg (95% CI 0.6 to 3.0) gained in the control group. The data suggest that the intervention is unlikely to be considered cost-effective in its current form.


“We conclude that the incremental dose of the NULevel intervention over the active control condition might have been insufficient to affect weight outcomes,” the authors say. “This research should inform future intervention design decisions regarding delivery modality and intensity.”




Research Article




The study is funded by the UK National Prevention Research Initiative (NPRI) Phase 4 (grant MR/J000477/1). The NPRI includes the following Funding Partners (in alphabetical order): Alzheimer’s Research Trust, Alzheimer’s Society, Biotechnology and Biological Sciences Research Council, British Heart Foundation, Cancer Research UK, Chief Scientist Office, Scottish Government Health Directorate, Department of Health, Diabetes UK, Economic and Social Research Council, Health and Social Care Research and Development Division of the Public Health Agency (HSC & R&D Division), Medical Research Council, The Stroke Association, Wellcome Trust, Welsh Assembly Government, and World Cancer Research Fund. FFS is funded by Fuse, the Centre for Translational Research in Public Health, a UKCRC Public Health Research Centre of Excellence based on funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, and the National Institute for Health Research, under the auspices of the UK Clinical Research Collaboration. AA is funded by the National Institute of Health Research as an NIHR Research Professor. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


Competing Interests:


I have read the journal's policy and the authors of this manuscript have the following competing interests: AB declares research funding in the last 5 years from EU Horizon 2020 COFUND; Medical Research Council. AB is statistical advisor to Cambwick Healthcare for a planned proof-of-concept medical device study. All other authors have declared no competing interests exist.




Sniehotta FF, Evans EH, Sainsbury K, Adamson A, Batterham A, Becker F, et al. (2019) Behavioural intervention for weight loss maintenance versus standard weight advice in adults with obesity: A randomised controlled trial in the UK (NULevel Trial). PLoS Med 16(5): e1002793.


Image Credit: Marco Verch, Flickr



Author Affiliations:


Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom

Fuse, the UK CRC Centre for Translational Research in Public Health, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, United Kingdom

Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom

School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom

Centre for Rehabilitation, Exercise and Sport Sciences (CRESS), Teesside University, Middlesbrough, United Kingdom

Health Economics Research Centre, University of Oxford, Oxford, United Kingdom

Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada

Open Lab, School of Computing Science, Newcastle University, Newcastle upon Tyne, United Kingdom

Department of Psychology, University of Minnesota, Minneapolis, Minnesota, United States of America

Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, United Kingdom

Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge, United Kingdom


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