While studies show that most people are not able to keep weight loss for the long-term, probably due to the lack of motivation, recent studies show that the effective choice and implementation of motivational strategies are fundamental to building up positive-thinking and long-term motivation, as well as succeeding at habit-formation. This manuscript provides qualitative research on the effect of motivation as a factor in behavioral interventions to reduce overweight or obesity, highlighting the importance of self- determination for succeeding in long-term weight loss and maintenance programs.

Obesity is an increasing epidemic that requires urgent public health solutions.^1–3 Efforts to decrease obesity or overweight rates have focused on interventions at multiple levels, including policy, environment, community, as well as approaches at an individual level.^4–6 The degree of weight loss and maintenance success depends on several factors, such as program completion, social support, and motivation for behavior change.^7–9 An analysis at the individual level is important because the motivation for weight loss is extremely effective,⁶ and can be used as a predictor for controlling weight successfully.^7,10,11

Studies have shown that approximately 80% of people are not able to keep weight loss for the long-term. This is likely due to the lack of motivation over time. Recent studies^6,12 have clinically and scientifically proved that the effective implementation of motivational strategies, such as: any choice of food/activity (personal preference vs pre-established diets/routines) and simple rewarding strategies, are very important to building up positive- thinking and long-term motivation, as well as successful habit-formation.

Motivation for weight loss programs has been mostly studied using quantitative approaches.^13–14 Further, theories such as the Self-Determination Theory (SDT),¹⁵ which offers a broad framework for understanding the factors that promote human motivation and psychological blooming, have been strongly supported for weight loss and maintenance programs at the individual level.⁶ Thus, SDT, which considers the mechanisms for behavior change, may enhance the success of weight loss and maintenance interventions.

A single individual was subjected to a case study. The participant showed to have a strong commitment to improving both physical and mental health rather than physical appearance. The values of the Body Mass Index (Normal category: 18.5–25) were transformed into ideal weights, based on height and weight, and further sub-categorized into three categories.⁶ A comprehensive bibliographic review, regarding the best psychological approaches used for weight management and motivational programs, was conducted, and the most informative parameters were incorporated into a mobile app.

This study suggests that "Innate internal motivation", the one coming from inside a person, not sustained by external rewards, can lead to long-lasting life-changing improvements. "External motivation", however, such as compliments, trying to fit into a smaller body-size, or winning a karate competition, for example, might be ok for a start, but long-term motivation rather depends on the person values and determination to achieving goals. When it comes to weight loss and health, internal motivation involves giving more importance to the current health and happiness status than giving it to superficial ideas, such as physical image. Positive thinking, such as reaching a "healthy weight", is more important in the long run than a simple image of being better good looking, although the second will finally be a collateral side effect, rather than the major focus of motivation. Vague thoughts about future looks, for example, are less motivating than the truly measurable post-workout feelings of happiness produced by the release of endorphins.

The internal motivation to lose weight and be healthy might not come naturally to everyone, but fortunately, it can be acquired and implemented. Successful factors include: Competence, Autonomy and Relatedness, the main self-determination factors involved in building up motivation and engagement (Figure 1), together with other factors such as: Understanding the reasons to be healthy; Sticking to a plan; Rational thinking; Self- analysis; Avoid self-sabotaging; The selection of smart goals and strategy; Implementing healthy habits; Ensuring success; Establishing third-party contracts; Being patience; Taking breaks (coffee/tea); Exercising (walk/run); Mindfulness (a few minutes is better than nothing); Finding inspiration; Socializing; Balancing failure; and/or Measuring and celebrating progress.

Figure 1 Self-determination theory and weight loss/maintenance success.

The mobile app: “weight loss motivator”

Given the importance of motivation to effectively implement any weight management program, it would be interesting to evaluate the level of motivation before implementing any strategy and to monitor progress. The “weight loss motivator” app,¹⁶ evaluates an individual level of motivation, providing a list of recommendations to help boosting motivation, warrantying long-term weight loss and maintenance success (Figure 2). Based on 14 habits and psychological questions (see methods), the app: 1) Calculate the level of Weight loss/Maintenance Motivation; 2) Give advice to boost motivation; and 3) Provides useful information and tips for future actions.

Figure 2 Weight loss motivator screenshots.

This manuscript provides support for the effect of motivation as a factor in behavioral interventions to reduce overweight or obesity and further weight maintenance, highlighting the importance of self-determination for succeeding in long-term weight loss and maintenance programs. If an individual fully endorses weight loss-related behavioral goals and feels more competent and autonomous (self-determination theory), this effort is more likely to result in long-lasting behavior change. Self-determination and continuous motivation is the key to success. Even if people sometimes have to face different trials during weight loss/maintenance, such as metabolic adaptations or temporarily lost control because of, for example, holiday periods, it is easy to go back on track as long as the motivation is there. Understanding the motivation for behavior change and completion is essential to reach goals effectively and sustaining weight loss and maintenance. Enhancing the motives for weight loss may help to improve outcomes in weight-loss and maintenance programs. Furthermore, a wide implementation of modern technologies, such as the “weight loss motivator” mobile app (16) or traditional approaches, aiming to measure and enhance intrinsic internal motivation for weight loss and maintenance purposes may be beneficial.¹⁷

Supported by institutional resources.

The author declares that there is no conflict of interest.

None.

1. Friedrich MJ. Global obesity epidemicworsening. JAMA. 2017;18(7):603.
2. Mann T, Tomiyama AJ, Ward A. Promoting public health in the context of the “obesity epidemic” false starts and promising new directions. Perspect Psychol Sci. 2015;10(6):706–710.
3. Nestle M, Jacobson MF. Halting the obesity epidemic: a public health policy approach. Public Health Rep. 2000;115(1):12–24.
4. Milliron BJ. An Ecological Approach to Investigating the Influences of Obesity. Arizona State University. 2010.
5. Waters E, Gao Y, Tamara B, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2019;7(7):CD001871.
6. Jose M Peregrin-Alvarez. Self-experiencing “The healthiest weight”. J Obes OverWeight Manag Control. 2017;3(1):101.
7. Elfhag K, Rössner S. Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obesity Rev. 2005;6:67–85.
8. Ortner HadŽiabdić M, Mucalo I, Hrabač P, et al. Factors predictive of drop-out and weight loss success in weight management of obese patients. Randamoized controlled trial. 2015;28 suppl 2:24–32.
9. Teixeira PJ, Marques MM, Rutter H, et al. Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators. BMC Medicine. 2015;13:84.
10. Teixeira PJ, Silva MN, Mata J, et al. Motivation, self-determination, and long-term weight control. Int J Behav Nutr Phys Activit. 2012;9:1–13.
11. Teixeira PJ, Going SB, Sardinha LB, et al. A review of psychosocial pre-treatment predictors of weight control. Obesity Rev. 2005;6(1):43–65.
12. Jose M Peregrin-Alvarez. Consistent Weight Loss linked to higher meal frequency. Adv Obes Weight Manag Control. 2019;9(1):12‒14.
13. Teixeira PJ, Carraça EV, Markland D, et al. Exercise, physical activity, and self-determination theory: a systematic review. Int J Behav Nutr Phys Activit. 2012;9:78.
14. Levesque CS, Williams GC, Elliot D, et al. Validating the theoretical structure of the treatment self-regulation questionnaire (TSRQ) across three different health behaviors. Health Educ Res. 2007;22(5):691–702.
15. Ryan RM, Deci EL. Self-determination theory: Basic psychological needs in motivation, development, and wellness. The Guilford Press. 2018.
16. Virtual Personal Trainer. “Weight loss motivator” mobile app.
17. Martinez M, Salazar-Collier CL, Pena J, et al. Motivation for weight loss among completers of a free community-based weight loss program in a US-Mexico border region: A self-determination theory perspective. Front Public Health. 2022;10:652271.