Effectiveness of a digital weight management program on weight-bias internalization, self-compassion, quality of life, well-being, and body appreciation: secondary outcomes from a randomized controlled trial

Background While evidence suggests psychosocial support benefits well-being, physical health, and weight management, the impact of psychosocial health within digital behavioral weight management programs (compared to traditional in-person models) remains underexplored. Purpose To evaluate the effectiveness of a digital commercial program (DCP) compared to standard nutrition guidance (SNG) on some weight-related psychosocial outcomes: weight-bias internalization (WBI), self-compassion, weight-related quality of life (WQOL), well-being, and body appreciation (BA). Methods A 6-month randomized controlled trial (NCT05648344) was conducted among 376 US adults living with overweight/obesity. n = 187 were randomized to a DCP (WeightWatchers®), and n = 189 received SNG. Intention-to-treat analyses using analysis of covariance (ANCOVA), adjusted for sex, age, race, ethnicity, education, body mass index (BMI), and baseline values, were completed to assess changes in outcomes. Results Mean ± SD age was 47.7 ± 12.2 years; 7.4% self-identified as Asian; 13.8% Black; 6.4% Other; 9.6% Hispanic; 20.7% male; 17.8% experienced food insecurity; BMI = 33.6 ± 4.7 kg/m2. At 6 months, DCP relative to SNG, participants lowered their WBI by a mean difference ± SE of −0.3 ± 0.1; and increased their self-compassion by 0.2 ± 0.1; BA by 0.2 ± 0.1; well-being by 6.4 ± 1.7, and WQOL by 5.6 ± 1.2, all P<.01. Conclusions Relative to SNG, participants in the DCP showed increased self-compassion, BA, well-being, and WQOL, and decreased WBI, highlighting that DCPs may deliver favorable changes in psychosocial outcomes. These findings should be interpreted with caution due to the short follow-up period and the question of whether the observed differences are clinically meaningful.