Impact of the built, social, and food environment on long‐term weight loss within a behavioral weight loss intervention

Abstract Background Behavioral weight loss interventions can lead to an average weight loss of 5%–10% of initial body weight, however there is wide individual variability in treatment response. Although built, social, and community food environments can have potential direct and indirect influences on body weight (through their influence on physical activity and energy intake), these environmental factors are rarely considered as predictors of variation in weight loss. Objective Evaluate the association between built, social, and community food environments and changes in weight, moderate‐to‐vigorous physical activity (MVPA), and dietary intake among adults who completed an 18‐month behavioral weight loss intervention. Methods Participants included 93 adults (mean ± SD; 41.5 ± 8.3 years, 34.4 ± 4.2 kg/m2, 82% female, 75% white). Environmental variables included urbanicity, walkability, crime, Neighborhood Deprivation Index (includes 13 social economic status factors), and density of convenience stores, grocery stores, and limited‐service restaurants at the tract level. Linear regressions examined associations between environment and changes in body weight, waist circumference (WC), MVPA (SenseWear device), and dietary intake (3‐day diet records) from baseline to 18 months. Results Grocery store density was inversely associated with change in weight (β = −0.95; p = 0.02; R2 = 0.062) and WC (β = −1.23; p