Social Network Formation in an 18-Month Adult Behavioral Weight loss Interventions: Using Social Integration as a Predictor of Treatment Adherence and Efficacy
Alena Borgatti, Gareth DuttonObesity continues to impact millions of people across the world through its effects on physical and mental health. While research suggests that obesity may spread through social networks, it can also become a defining characteristic that involuntarily constrains one’s social ties and social capital. Societal perceptions of obesity are increasingly negative, with recent studies indicating that individuals in larger bodies experience discrimination, stigmatization, increased social isolation, and less social support relative to their average weight peers. As social support consistently predicts health-related quality of life, healthy eating behaviors, and weight loss, insufficient social support may be especially problematic for those experiencing obesity.
Recent studies of family-based interventions for childhood obesity indicate that behavioral treatments can foster supportive social networks, which may enable individuals to make and maintain healthy lifestyle changes. However, the majority of these studies evaluated networks across relatively brief interventions for lower-income families, which may not generalize to social networks formed in adult weight loss programs. Perhaps more importantly, few of these studies evaluated the effect of social networks on treatment outcomes and program attrition.
The present study examined changes in social networks formed among adult participants of a 12-month behavioral weight loss program followed by a 6-month observational period. 65 participants (91% female, 60% African-American) completed social network surveys at four time points. Participants were asked to list group members they liked most, interacted with most, and from whom they solicited advice and emotional support. Interventionists recorded participants’ weights and treatment attendance weekly. Across multiple networks, preliminary analyses revealed that several reciprocated, unreciprocated, and incoming social ties at months 2 and 6 significantly predicted attendance and weight loss at months 6 and 12. Network density and outgoing social ties did not appear to impact group weight loss, attendance, or program attrition. Moreover, individuals with higher BMIs had fewer nominations from peers across multiple networks, potentially limiting early integration into their weight loss group. These findings suggest that even among a group of adults with obesity attempting to lose weight, those with higher BMIs may still receive less social support from peers. Additional analyses pending final data collection will consider the relative stability of the network by the intervention and follow-up endpoints, the effect of post-intervention social connectedness on weight loss maintenance, and the impact of group social networks on treatment outcomes.
This study is the first to address the importance of social network formation in a group-based weight loss intervention for adults. The findings to date suggest that social networks could potentially be leveraged to improve program attendance and increase intervention efficacy among patients attempting to make healthy lifestyle changes. As these findings are preliminary and were collected on a small sample of participants, the presentation will highlight limitations, future directions, and the importance of further evaluating social networks within adult obesity interventions.