Abstract
Studies have shown social support can promote weight loss, specifically when support is received online through forums on weight loss websites. The goal of this study was to explore the experiences of individuals using support forums on weight loss websites. We conducted a content analysis on web-administered survey responses from members of two weight loss websites (N = 340). The findings revealed three major themes: (1) receiving advice, strategies, and mantras are helpful with weight loss; (2) support forums provide a nonjudgmental environment for losing weight; and (3) receiving social support and inspiration from someone similar is helpful with weight loss. These findings suggest online support forums can benefit individuals attempting to lose weight by offering a place to receive nonjudgmental social support from other similar users.
Over a third of individuals in the United States meet criteria for obesity (body mass index >30 kg/m2) (Hales, Carroll, Fryar, & Ogden, 2017). Obesity is problematic because it is related to health issues including diabetes and cardiovascular disease (Bastien, Poirier, Lemieux, & Després, 2014; Buchan, McLellan, Donnelly, & Arthur, 2016; Dixon, 2010; Ganz et al., 2014). Thus, there is a need for identifying strategies to reduce obesity among adults to mitigate the development of potential health risks.
Social support can play an important role in promoting weight loss and intentions to lose weight among adults (Bishop et al., 2013; Block et al., 2015; Godino et al., 2016; Leahey, Gokee LaRose, Fava, & Wing, 2011). Social support can be characterized by the reciprocity, structure, reliability, and accessibility of interpersonal relations and social ties (Williams, Barclay, & Schmied, 2004). In addition, the modality through which individuals receive social support is vastly changing with fast rises in the adoption of social media and online communities over the past decade (“Social Media Fact Sheet,” 2018).
Nearly a third of Internet users search for ways to lose weight (“Pew Internet & American Life Project 2008 Fall Tracking Survey,” 2008). Given the benefits of having a support system, social media and online communities could serve as a useful platform for facilitating social support for individuals engaging with weight loss. There are a number of weight loss websites that offer a variety of resources including online tracking tools, educational articles about weight loss, and online support forums. These websites have been found to provide an array of benefits such as convenience, social support, and little or no cost to the individual enrolling in the program (Hwang et al., 2010; Stevens et al., 2008). Likewise, these websites that include a social support component can help assist individuals in meeting their weight loss goals and maintaining weight loss (Harvey-Berino, Pintauro, Buzzell, & Gold, 2004; Hwang, Ning, Trickey, & Sciamanna, 2013). Moreover, receiving peer support during weight loss is associated with greater engagement with these support forums; however, responding to posts alone has not been found to promote weight loss (Kim, Ray, & Veluscek, 2017). Although there is research evidence to support the use of technology-driven weight loss programs in controlled trials, little is known about the social experience when participating in online social forums to lose weight. As such, the aim of this study is to qualitatively describe the social experience of individuals using online social forums to lose weight.
Method
Weight Loss Websites
3fatchicks.com is a personal website that is free to join and offers information related to weight loss and lifestyle, as well as a support forum that consists of over 200,000 active users. Members are able to create user names and post or comment on various topics related to weight loss and participate in weight loss challenges.
Loseit.com is a mobile application and website that provides articles related to weight loss. Users are also able to track food and count calories. Membership is free at the basic level and allows member to receive support through a public forum but requires a cost for additional features such as the ability to create a private support forum.
Data Collection
Each website emailed members a link to a web-administered questionnaire, which included basic demographic questions and an open-ended item regarding the users’ experience using the support forum provided by the weight loss website. Ethical approval for this study was obtained through the university’s institutional review board (IRB #41634). Informed consent was obtained prior to the beginning of the online questionnaire.
Data Analysis
We used a conventional content analysis approach to qualitatively code the responses to one open-ended question (Hsieh & Shannon, 2005; Pfeil & Zaphiris, 2010). The data were imported and analyzed using NVivo 10.0. An inductive approach was taken to develop the codes of the coding dictionary; therefore, the process was iterative (Mayring, 2000). The first author established the initial codes by reviewing the data set. These initial codes were then used to develop the first draft of a defined coding dictionary. This process was repeated until saturation was reached or no new codes emerged. Next, the defined coding dictionary was reviewed, refined, and informally agreed upon by the first and second author. The dictionary included an overview and definition of each code. The purpose of the coding dictionary was to promote consistent and objective coding. Using the coding dictionary, an initial 10% of the data set was coded by the first author. During this initial process, the coding structure was refined for any emerging codes. The remainder of the data set was coded, and throughout the process, informal reliability checks occurred regularly with the last author. Last, the final report of the coded text was checked for consistency by the last author, and the first author remediated all inconsistencies. The content of the most commonly occurring codes was analyzed and collapsed, thus resulting in the themes below.
Results
The sample included 340 adults between the ages of 18 and 84 years (M = 43.4 years, SD = 13.2), and the majority were women (85%) (see Table 1). Results are presented in three main themes relating to the participants’ social experience using online weight-related support forums. Quotations were selected to reflect the common responses provided by the participants. Responses ranged from 4 to 120 words.
Sample Demographics.
The social experience of using these online forums are presented in three themes: (1) receiving advice, strategies, and mantras are helpful with weight loss; (2) support forums provide a non-judgmental environment for losing weight; and (3) receiving social support and inspiration from someone similar is helpful with weight loss.
Theme 1: Receiving Advice, Strategies, and Mantras Are Helpful With Weight Loss
Participants reported that receiving advice regarding weight loss was helpful. The advice presented as either a strategy that a member found successful with their efforts, or by a mantra by which they choose to live. Some participants noted that this advice helped them when faced with challenges during their weight loss attempts.
There were a number of posts with helpful sayings (aphorisms) that I copied onto yellow sticky notes and posted around the house. These were about weight loss, sticking to goals, avoiding temptation—they were so helpful! Personal sharing by posters was very helpful and the “words to live by” were the best of all.
Given the challenges weight loss can present, such as initiating and continuing motivation to lose weight, members of these websites could offer social support through encouraging messages posted within forums to promote motivation (Warren, Smalley, & Barefoot, 2017).
Theme 2: Support Forums Provide a Nonjudgmental Environment for Losing Weight
A second theme that emerged was with regard to the nonjudgmental environment that support forums provide. It was commonly reported that participants found it helpful to have a community of members that are supportive in a nonjudgmental manner.
Reading other people’s experiences and talking about my own has helped me to realize that everyone is struggling just as I am and that I shouldn’t give up. I am not alone. This is helping me a lot to know that I can have a bad day and share it with people who won’t judge me or gossip.
These support forums tend to host a place that allows members to feel safe to express challenges with weight loss. Since weight loss often presents challenges with lifestyle changes, having a supportive environment can play a key role in reaching weight loss goals.
I could not have lost the 100 lbs without the support of the online community at 3FatChicks. Having a non-judgmental place to talk about all of the feelings and physical aspects of losing weight have been motivational to me.
Theme 3: Receiving Social Support and Inspiration From Someone Similar Is Helpful With Weight Loss
Receiving social support from someone similar was a major theme and the most frequently coded category pertaining to positive experiences. Participants indicated having a positive experience with using support forums because it gives users the opportunity to share their weight loss experiences with someone going through a similar process: Advice from people who have never been overweight don’t [sic] really carry much weight as those who know what I’m going through. They can’t understand the joy of seeing your collar bone or being able to reach your toes and other little things normal weight people take for granted. That said, normal weight people don’t really understand how hard it is to lose weight.
These findings show the importance of having social support from individuals who can relate to your experience. Not only did many members discuss the importance of being able to have social support from individuals who can relate to the weight loss journey, participants also shared that the social support provided on these particular forums help keep the users accountable, without limitations to geographic locations. Specifically, users indicated that these support forums promote accountability and motivate them to stay on track with their weight loss goals because they are able to see the activity of other users. For instance, if another user is active and making healthy choices, participants indicated this will motivate and challenge them to do the same: Just having friends to be accountably, and to set exercise goals and challenges with them. It really makes a difference doing it with support.
These findings lend support to previous findings suggesting that a primary motivation behind using the internet for social support is accountability (Hwang et al., 2011; Leggatt-Cook & Chamberlain, 2012; Pagoto et al., 2014). Furthermore, having support online has been reported to have a greater positive influence on weight loss efforts than support from friends and family (Pagoto et al., 2014).
Discussion
The goal of the current study was to explore members’ social experiences using online support forums from two weight loss websites and how experiences from these forums are beneficial to individuals attempting to lose weight. Overall, participants expressed that these forums provide a nonjudgmental environment where members can communicate and receive advice, strategies, and encouragement from others who are experiencing similar challenges and successes. Participants attributed their success to having the ability to be able to connect in a supportive environment with people who have similar interests and goals; suggesting that individuals may be more inclined to trust and share more personal information with individuals who share similar values, thus promoting weight loss (Wu, Chen, & Chung, 2010).
Strengths and Limitations
We acknowledge the limitations of this study. As with any web-administered survey, several concerns can arise about the sampling methods. First, we used a purposive sampling method, which can lend to external validity concerns or selection bias; therefore, we caution when generalizing these findings beyond loseit.com and 3fatchicks.com (Barratt, Ferris, & Lenton, 2015). While the sample was mostly represented by White women with a college education, this is sample is representative of behavioral weight loss programs, in which the vast majority of samples are women (Robertson et al., 2016).
The current work had strengths with inclusion of two different online websites that do not require membership costs to participate. Moreover, the examination of two different websites with similar features showed that the benefits experienced on the website are not unique to the website and could potentially be generalized to other websites. Last, the coding dictionary was refined several times by two investigators trained in qualitative research.
Implications for Practice
Our findings suggest that online support forums provide an array of social benefits. As such, weight loss websites could be a useful resource for individuals attempting to lose or maintain weight loss. Given the convenience of weight loss websites, these forums have the potential to be utilized in scalable interventions that can reach individuals who lack social support to lose weight. However, more research is needed to examine potential negative experiences when participating in these forums, in order to enhance our understanding of potential barriers to weight loss when using these websites.
Footnotes
Acknowledgements
We thank Loseit.com, 3fatchicks.com, and 
for assisting in recruiting their members for participation in this study. We thank Marissa Harrison for reviewing and giving pertinent feedback on the early drafts of this manuscript.
Authors’ Note
This research study was conducted at Penn State University at Harrisburg.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Supplement Note
This article is part of the Health Education & Behavior supplement issue, “Advancing the Science and Translation of Digital Health Information and Communication Technology.” The printing and dissemination of the supplement was supported by the Office of Behavioral and Social Sciences Research, National Institutes of Health (Contract No. HHSN276201800167P). No federal funds were used in the development of these supplement manuscripts, and the views and findings expressed in them are those of the authors and are not meant to imply endorsement or reflect the views and policies of the U.S. Government. The entire supplement is available open access at .