Promoting Weight Loss and Psychological Well-being in patients with obesity: A Sequential Combination of Behavioral Lifestyle and Well-Being Intervention

Introduction: Behavioral lifestyle interventions focused on diet and physical activity are a cornerstone for the treatment of obesity. However, their effects vary substantially across individuals in terms of magnitude and durability. Personalized approaches that target psychological well-being may facilitate healthy behaviors and sustained weight loss. Objectives: This study aimed to explore whether the sequential combination of behavioral lifestyle and well-being intervention (BLI/WBI) may result in more favorable outcomes than behavioral lifestyle intervention alone (BLIA) in promoting weight loss (primary outcome) and improving psychological well-being, distress, dietary behaviors, and physical activity (secondary outcomes). Methods: 83 patients with obesity were randomly assigned to the BLI/WBI group (n=38) or the BLIA group (n=43). Participants in the BLIA group received a 12-week behavioral weight loss program, while those in the BLI/WBI received the same program followed by an additional 4-week well-being intervention. Data were collected at pretreatment (baseline, T1), at the end of BLI/WBI (T2), and at 6-month follow-up (T3). Results: There was a significant weight loss in both treatment groups at the end of BLI/WBI and 6-month follow-up. The BLI/WBI group showed greater improvements in anxiety symptoms (β=-1.92 [-3.66 to -0.18], p< 0.05) at the end of BLI/WBI and in depressive symptoms (β= -2.28[-4.20 to -0.37], p< 0.05) at 6-month follow-up compared to the BLIA group. Conclusions: The WBI showed no additional effect on weight loss. However, the secondary outcomes indicate that the WBI may reduce vulnerability to depressive and anxiety symptoms in obese patients. Future studies are needed to explore whether the psychological benefits of WBI can foster long-term weight loss maintenance.