Summary:
In adults with obesity recruited from a weight management center, the Confident Moves (CM) online intervention significantly improved physical activity engagement and self-efficacy compared to usual care including existing center-based supports like meal plans and medications, though it was associated with some procedural variability in secondary feasibility measures.
| PICO | Description |
|---|---|
| Population | Adults with obesity enrolled in a local obesity care center in the United States. |
| Intervention | Confident Moves (CM) online intervention, a theory-based digital program utilizing behavior change techniques to enhance self-efficacy and promote physical activity. |
| Comparison | Usual care provided by the obesity clinic, such as meal planning, behavioral counseling, and pharmacotherapy (e.g., appetite suppressants). |
| Outcome | The CM intervention demonstrated strong feasibility, high engagement, and a promising preliminary effect size on objectively measured physical activity. Mixed results were observed for secondary feasibility outcomes, indicating areas for procedural refinement before a full-scale RCT. |
Clinical Context
Physical activity is central to obesity management, improving cardiometabolic health, weight maintenance and wellbeing, yet sustained engagement is notoriously difficult and many patients fall short of recommended levels. Self-efficacy — a person’s confidence in their ability to be active — is a well-established determinant of behaviour change and a logical target for intervention. Digital programmes are attractive because they are scalable, low-cost and can deliver structured behaviour-change techniques between clinic visits. The Confident Moves intervention is a theory-based online programme designed to build self-efficacy and increase physical activity in adults with obesity. Before committing to a large randomised trial, it is essential to establish that such a programme is feasible, acceptable and capable of shifting activity — the gap this pilot study addresses.
Clinical Pearls
- Feasible and engaging: The programme demonstrated strong feasibility and high participant engagement, key prerequisites for any digital behaviour-change tool to succeed in practice.
- Promising activity signal: A promising preliminary effect size was seen on objectively measured physical activity, lending early support to the programme’s core aim beyond self-report.
- Self-efficacy targeted: Improvements in physical activity engagement and self-efficacy align with the intervention’s theoretical basis in behaviour-change technique, suggesting the proposed mechanism is plausible.
- Mixed secondary feasibility: Secondary feasibility outcomes were mixed, with procedural variability flagged as needing refinement before progressing to a full-scale randomised controlled trial.
Practical Application
For clinicians running weight-management services, Confident Moves illustrates how a structured digital programme might supplement usual care — meal planning, behavioural counselling and pharmacotherapy — by specifically targeting physical activity and the confidence to sustain it. It is best suited to motivated, digitally capable patients who can engage with an online platform between appointments. Importantly, this is pilot-stage evidence: the programme showed feasibility and an encouraging activity signal but has not yet been shown to improve weight, cardiometabolic markers or long-term outcomes. It should therefore be viewed as a candidate adjunct under evaluation rather than an established treatment, and existing components of obesity care should continue unchanged while larger trials clarify its real-world effect.
Broader Evidence Context
The study sits within a large and growing field of digital and mobile-health interventions for physical activity and weight management, where feasibility pilots routinely precede definitive trials. Its grounding in self-efficacy and behaviour-change theory is consistent with established frameworks linking confidence and structured technique to sustained activity. Prior digital interventions have shown that engagement and short-term behaviour change are achievable, but translating these into durable weight or cardiometabolic benefit has proven harder and more variable. The Confident Moves results are in keeping with that pattern — encouraging early engagement and activity signals, tempered by the recognised challenge of maintaining effects. The findings support, rather than pre-empt, a future adequately powered trial.
Study Limitations
- This was a feasibility and acceptability pilot, not powered or designed to confirm efficacy.
- Recruitment from a single United States obesity centre limits generalisability to other settings and populations.
- The sample was small and likely self-selected toward digitally engaged, motivated participants.
- Outcomes focused on physical activity engagement and self-efficacy rather than weight, cardiometabolic markers or long-term health endpoints.
- Secondary feasibility outcomes were mixed, with procedural variability that must be resolved before a full-scale trial.
Bottom Line
The Confident Moves online programme proved feasible and engaging and produced a promising preliminary effect on objectively measured physical activity and self-efficacy in adults with obesity, alongside mixed secondary feasibility results. As pilot-stage evidence without weight or cardiometabolic outcomes, it is a credible candidate adjunct to usual obesity care rather than a proven intervention. Its main value is to justify and inform a larger randomised trial once the flagged procedural refinements are addressed.
Source: Seungmin Lee, et al. “Initial outcomes from the Confident Moves online intervention to promote physical activity in adults with obesity: a longitudinal feasibility and acceptability pilot trial.” Read article here.
