Authors
Joshua Bernal, Jo A Wick, Byron Gajewski, K Allen Greiner, Jianzheng Wu, Christie Befort
Published in
Obesity (Silver Spring, Md.). Jul 08, 2026. Epub Jul 08, 2026.
Abstract
Patients with obesity report experiencing weight stigma resulting in poor self-esteem. Based on baseline self-esteem, this paper explores recommendations for group versus individual visits for lifestyle components of comprehensive obesity treatment in primary care.
Participants (n = 1220) were rural primary care patients in a 24-month cluster randomized controlled trial that demonstrated superior weight loss with group versus individual treatment. Baseline weight-related self-esteem scores (0-100), as measured by the Impact of Weight on Quality of Life-Lite (IWQOL-L), were used. A Bayesian normal dynamic linear model with a changepoint parameter estimates the relationship between self-esteem and weight loss across group versus individual treatment at the 24-month primary endpoint.
The posterior probability that patients receiving group lost more weight than those receiving individual visits remained 0.999 for patients with self-esteem scores greater than 60. Those with the highest self-esteem (scores 80-100) receiving group visits lost 6.7 kg (95% CI, -8.15 to -5.20) at 24 months compared to 3.9 kg (95% CI, -5.45 to -2.39) for those receiving individual visits.
People may benefit more from group than individual intervention if their self-esteem is above an IWQOL-L score of 60 when starting an intensive behavioral intervention for weight loss.
ClinicalTrials.gov identifier: NCT02456636.
PMID:
42420235
Bibliographic data and abstract were imported from PubMed on 09 Jul 2026.
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