Multiple issues, including genetic, physiological, psychological and environmental factors, influence the development of obesity, and make it difficult for people with obesity (PwO) to reach and/or maintain a clinically significant weight loss. To identify individual factors that may contribute to successful weight loss, we investigated the attitudes of PwO who had a successful weight loss outcome (WLO; ≥5% body weight loss maintained for ≥1 year) using data from the ACTION-IO study (NCT03584191).


An online survey was completed by adults with obesity in 11 countries. A successful WLO was defined as ≥5% body weight loss in the past 3 years that was maintained for ≥1 year.


The survey was completed by 14,502 PwO. Most common weight loss methods tried were general improvements in diet (51%) and exercise (40%). A successful WLO was reported by 1,559 PwO (11%). More PwO who had a successful WLO (compared with those who had not) responded: they know how to lose weight (55% vs 44%); they know how to keep the weight off (48% vs 34%); and if they lost weight it would be easy for them to keep the weight off (31% vs 23%). In addition, more PwO who had a successful WLO stated they were motivated to lose weight than those who had not (57% vs 47%). The top weight loss goal for all PwO was to reduce the risks associated with excess weight or to prevent a health condition (48% and 46%). Fewer PwO who had a successful WLO reported worrying about the impact of their weight on their future health (46%) than PwO who had not had a successful WLO (56%).


A greater proportion of PwO who had a successful WLO appeared to be motivated and confident about their ability to achieve and maintain weight loss. It is unclear if their motivation and confidence is because they had lost weight or if it is the reason they lost weight. These data may suggest that increasing self-efficacy and self-concept could improve WLOs, but more research is needed.