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<front>
<journal-meta>
<journal-id journal-id-type="doi">10.1002/(ISSN)2055-2238</journal-id>
<journal-id journal-id-type="publisher-id">OSP4</journal-id>
<journal-title-group>
<journal-title xml:lang="en">Obesity Science &amp; Practice</journal-title>
<abbrev-journal-title abbrev-type="publisher" xml:lang="en">Obes Sci Pract</abbrev-journal-title>
</journal-title-group>
<issn publication-format="ppub">2055-2238</issn>
<issn publication-format="epub">2055-2238</issn>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.1002/osp4.70048</article-id>
<article-id pub-id-type="publisher-id">OSP470048</article-id>
<article-categories>
<subj-group subj-group-type="overline" xml:lang="en">
<subject>ORIGINAL ARTICLE</subject>
</subj-group>
<subj-group subj-group-type="heading" xml:lang="en">
<subject>ORIGINAL ARTICLE</subject>
</subj-group>
</article-categories>
<title-group>
<article-title xml:lang="en">An Acceptance‐Based Guided Self‐Help Program for Weight Loss Maintenance in Adults Who Have Previously Completed a Behavioral Weight Loss Program: The SWiM Feasibility Study</article-title>
</title-group>
<contrib-group>
<contrib id="osp470048-cr-0001" contrib-type="author">
<name>
<surname>Jones</surname>
<given-names>Rebecca A.</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2197-1175</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0002" contrib-type="author" corresp="yes">
<name>
<surname>Mueller</surname>
<given-names>Julia</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4939-7112</contrib-id>
<email>julia.mueller@mrc-epid.cam.ac.uk</email>
<xref ref-type="corresp" rid="correspondenceTo">*</xref>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0003" contrib-type="author">
<name>
<surname>Richards</surname>
<given-names>Rebecca</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7122-6822</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0004" contrib-type="author">
<name>
<surname>Woolston</surname>
<given-names>Jennifer</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0127-2898</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0005" contrib-type="author">
<name>
<surname>Stubbings</surname>
<given-names>Marie</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6442-8127</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0006" contrib-type="author">
<name>
<surname>Whittle</surname>
<given-names>Fiona</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5461-521X</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0007" contrib-type="author">
<name>
<surname>Hill</surname>
<given-names>Andrew J.</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3192-0427</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0008" contrib-type="author">
<name>
<surname>Hughes</surname>
<given-names>Carly A.</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9560-7873</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0009" contrib-type="author">
<name>
<surname>Duschinsky</surname>
<given-names>Robbie</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2023-5328</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0003">
<sup>3</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0010" contrib-type="author">
<name>
<surname>Sharp</surname>
<given-names>Stephen J.</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2375-1440</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0011" contrib-type="author">
<name>
<surname>Chester</surname>
<given-names>Michelle</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0009-0003-6132-2134</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0012" contrib-type="author">
<name>
<surname>Schwertel</surname>
<given-names>Carlotta</given-names>
</name>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0013" contrib-type="author">
<name>
<surname>Tait</surname>
<given-names>Struan</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-3935-9295</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0014" contrib-type="author">
<name>
<surname>Eustachio Colombo</surname>
<given-names>Patricia</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8505-116X</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0015" contrib-type="author">
<name>
<surname>Kudlek</surname>
<given-names>Laura</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0947-3640</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0016" contrib-type="author">
<name>
<surname>Boothby</surname>
<given-names>Clare E.</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9396-8333</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0017" contrib-type="author">
<name>
<surname>Bostock</surname>
<given-names>Jennifer</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9261-9350</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0004">
<sup>4</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0018" contrib-type="author">
<name>
<surname>Breeze</surname>
<given-names>Penny</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4189-8676</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0005">
<sup>5</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0019" contrib-type="author">
<name>
<surname>Brennan</surname>
<given-names>Alan</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1025-312X</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0005">
<sup>5</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0020" contrib-type="author">
<name>
<surname>Fusco</surname>
<given-names>Francesco</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5515-3977</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0003">
<sup>3</sup>
</xref>
<xref ref-type="aff" rid="osp470048-aff-0006">
<sup>6</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0021" contrib-type="author">
<name>
<surname>Lawlor</surname>
<given-names>Emma R.</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0742-0476</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0022" contrib-type="author">
<name>
<surname>Morris</surname>
<given-names>Stephen</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5828-3563</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0003">
<sup>3</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0023" contrib-type="author">
<name>
<surname>Griffin</surname>
<given-names>Simon J.</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2157-4797</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="osp470048-aff-0003">
<sup>3</sup>
</xref>
</contrib>
<contrib id="osp470048-cr-0024" contrib-type="author">
<name>
<surname>Ahern</surname>
<given-names>Amy L.</given-names>
</name>
<contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5069-4758</contrib-id>
<xref ref-type="aff" rid="osp470048-aff-0001">
<sup>1</sup>
</xref>
</contrib>
</contrib-group>
<aff id="osp470048-aff-0001">
<label>
<sup>1</sup>
</label>

<named-content content-type="organisation-division">MRC Epidemiology Unit</named-content>

<institution>University of Cambridge</institution>

<city>Cambridge</city>
 <country country="GB">UK</country>

</aff>
<aff id="osp470048-aff-0002">
<label>
<sup>2</sup>
</label>

<named-content content-type="organisation-division">Division of Psychological and Social Medicine</named-content>

<institution>School of Medicine</institution>

<institution>University of Leeds</institution>

<city>Leeds</city>
 <country country="GB">UK</country>

</aff>
<aff id="osp470048-aff-0003">
<label>
<sup>3</sup>
</label>

<named-content content-type="organisation-division">Primary Care Unit</named-content>

<named-content content-type="organisation-division">Department of Public Health and Primary Care</named-content>

<institution>University of Cambridge</institution>

<city>Cambridge</city>
 <country country="GB">UK</country>

</aff>
<aff content-type="private-address" id="osp470048-aff-0004">
<label>
<sup>4</sup>
</label>

<named-content content-type="organisation-division">Public Involvement Lead, Quality Safety Outcomes Policy Research Unit</named-content>

<institution>University of Kent</institution>

<city>Oxford and Leeds</city>
 <named-content content-type="country-part">Kent</named-content>
 <country country="GB">UK</country>

</aff>
<aff id="osp470048-aff-0005">
<label>
<sup>5</sup>
</label>

<named-content content-type="organisation-division">Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health</named-content>

<institution>University of Sheffield</institution>

<city>Sheffield</city>
 <country country="GB">UK</country>

</aff>
<aff content-type="private-address" id="osp470048-aff-0006">
<label>
<sup>6</sup>
</label>

<institution>Broadstreet Health Economics &amp; Outcomes Research</institution>

<city>Vancouver</city>
 <country country="CA">Canada</country>

</aff>
<author-notes>
<corresp id="correspondenceTo"><label>*</label>

<bold>Correspondence:</bold> Julia Mueller<break/>
(<email>julia.mueller@mrc-epid.cam.ac.uk</email>)<break/>

</corresp>
</author-notes>
<pub-date date-type="pub" publication-format="electronic"><day>22</day>
<month>03</month>
<year>2025</year>
</pub-date><pub-date date-type="pub" publication-format="print"><month>04</month>
<year>2025</year>
</pub-date><volume>11</volume>
<issue seq="20">2</issue>
<issue-id pub-id-type="doi">10.1002/osp4.v11.2</issue-id>
<elocation-id>e70048</elocation-id>
<history>

<date date-type="rev-recd">
<day>07</day>
<month>01</month>
<year>2025</year>
</date>

<date date-type="received">
<day>09</day>
<month>10</month>
<year>2024</year>
</date>

<date date-type="accepted">
<day>16</day>
<month>01</month>
<year>2025</year>
</date>

</history>
<permissions>
<copyright-statement content-type="issue-copyright">© 2025 The Author(s). <italic>Obesity Science &amp; Practice</italic> published by World Obesity and The Obesity Society and John Wiley &amp; Sons Ltd.</copyright-statement>
<copyright-statement content-type="article-copyright">© 2025 The Author(s). <italic>Obesity Science &amp; Practice</italic> published by World Obesity and The Obesity Society and John Wiley &amp; Sons Ltd.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>© 2025 The Author(s). Obesity Science &amp; Practice published by World Obesity and The Obesity Society and John Wiley &amp; Sons Ltd.</copyright-holder>
<license>
<ali:license_ref>http://creativecommons.org/licenses/by/4.0/</ali:license_ref>
<license-p>This is an open access article under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution</ext-link> License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract xml:lang="en" abstract-type="main">
<title>ABSTRACT</title>
<sec id="osp470048-sec-0001" xml:lang="en">
<title>Background</title>
<p xml:lang="en">Most weight lost during weight‐loss programmes is eventually regained. Interventions based on Acceptance and Commitment Therapy (ACT) demonstrate good evidence for long‐term weight loss, but are often costly and difficult to scale up. Guided self‐help programmes delivered using technology and non‐specialist coaches could increase scalability, but it is unclear whether delivering ACT‐based interventions in this way is feasible and acceptable.</p>
</sec>
<sec id="osp470048-sec-0002" xml:lang="en">
<title>Methods</title>
<p xml:lang="en">In this feasibility study, 61 people who recently completed a behavioral weight management intervention (BWMI) for weight management were randomly allocated to SWiM (“Supporting Weight Management”: 4‐month digital guided self‐help ACT‐based intervention for weight loss maintenance) or a standard care group (leaflet about maintaining weight loss) using a 2:1 allocation ratio. At baseline and 6 months, participants completed measures of weight, mental health, eating behavior, and other psychosocial variables. Participants completed an intervention evaluation questionnaire. At 3 and 6 months, qualitative interviews were conducted with participants from both trial arms and SWiM coaches. The analysis integrated statistics and thematic analysis, informed by the Medical Research Council (MRC) framework for process evaluations. Since this was a feasibility study, analyses focused on process outcomes instead of interpreting statistical significance.</p>
</sec>
<sec id="osp470048-sec-0003" xml:lang="en">
<title>Results</title>
<p xml:lang="en">Eighty‐eight percent (36/41) of participants allocated to SWiM completed at least the first session and 22 (54%) completed all sessions. At 6 months, mean weight change was −2.2 (+/−6.4 SD) kg in SWiM participants and +2.2 (+/−6.6) kg in standard care participants. Descriptively, eating behavior and mental health scores improved in SWiM participants but not in standard care participants. In interviews, SWiM participants noted that they reinforced their existing knowledge while acquiring new skills and strategies, which were felt to contribute to positive behavioral changes.</p>
</sec>
<sec id="osp470048-sec-0004" xml:lang="en">
<title>Conclusion</title>
<p xml:lang="en">The SWiM intervention is practical and well‐received, and shows promise in supporting weight loss maintenance, though evaluation in a larger trial is needed to assess effectiveness.</p>
</sec>
<sec id="osp470048-sec-0005" xml:lang="en">
<title>Trial Registration</title>
<p xml:lang="en">ISRCTN12685964</p>
</sec>
</abstract>
<kwd-group xml:lang="en">
<kwd id="osp470048-kwd-0001">acceptance and commitment therapy</kwd>
<kwd id="osp470048-kwd-0002">digital</kwd>
<kwd id="osp470048-kwd-0003">interventions</kwd>
<kwd id="osp470048-kwd-0004">obesity</kwd>
<kwd id="osp470048-kwd-0005">overweight</kwd>
<kwd id="osp470048-kwd-0006">weight loss maintenance</kwd>
<kwd id="osp470048-kwd-0007">weight management</kwd>
</kwd-group>
<funding-group>
<award-group id="funding-0001">
<funding-source>

<institution-wrap>
<institution>NIHR Cambridge Biomedical Research Center</institution>
<institution-id>http://dx.doi.org/10.13039/501100018956</institution-id>
</institution-wrap>

</funding-source>
<award-id>NIHR203312</award-id>
</award-group>
</funding-group>
<funding-group>
<award-group id="funding-0002">
<funding-source>

<institution-wrap>
<institution>Medical Research Council</institution>
<institution-id>http://dx.doi.org/10.13039/501100000265</institution-id>
</institution-wrap>

</funding-source>
<award-id>MC_UU_00006/6</award-id>
</award-group>
</funding-group>
<funding-group>
<award-group id="funding-0003">
<funding-source>

<institution-wrap>
<institution>National Institute for Health and Care Research</institution>
<institution-id>http://dx.doi.org/10.13039/501100000272</institution-id>
</institution-wrap>

</funding-source>
<award-id>RP‐PG‐0216–20010</award-id>
</award-group>
</funding-group>
<counts>
<fig-count count="2"/>
<table-count count="4"/>
<page-count count="13"/>
<word-count count="9308"/>
</counts>
</article-meta>
</front>
</article>