We conducted a randomised controlled trial with 122 participants to assess the feasibility and acceptability of a remotely delivered 12-week small change intervention to prevent weight gain. Intervention participants were asked to implement a small change approach by making seven small changes that would decrease their energy intake and/or increase their energy expenditure by 100-200 kcal each day. These small changes could include eating one or two fewer chocolate biscuits or walking for an extra 10-20 minutes each day.

The feasibility and acceptability of the intervention was assessed using the number of participants randomised each month and retention at 12-week follow-up. Acceptability was assessed using the number of people who reported making seven small changes to their diet and/or physical activity throughout the invention.

Approximately 40 participants were randomised each month and 91% of participants completed 12-week follow-up. There was lot of variation in the number of small changes participants reported making, with only 18-30% reporting they made seven small changes over the course of the intervention. Most participants (62%) found a small change approach helpful for weight gain prevention, with intervention participants gaining 1.1kg (95% CI -1.7, -0.4) less than comparators at 12 weeks.

What next?

Although there was a lot of variation in the number of small changes participants made, the intervention was otherwise feasible and acceptable to participants and helped them prevent weight gain. Testing this intervention within a larger effectiveness trial may therefore be warranted, however, it should be refined to consider whether the goal of making seven small changes is appropriate. 

Citation details

Graham H, Madigan C, Daley AJ. A randomised controlled trial to investigate the feasibility and acceptability of a small change approach to prevent weight gain. Journal of Behavioral Medicine. 2023. DOI: 10.1007/s10865-023-00455-1