Evaluation of early weight loss thresholds for identifying nonresponders to an intensive lifestyle intervention

Obesity (Silver Spring). 2014 Jul;22(7):1608-16. doi: 10.1002/oby.20777. Epub 2014 Apr 28.

Abstract

Objective: Weight losses in lifestyle interventions are variable, yet prediction of long-term success is difficult. The utility of using various weight loss thresholds in the first 2 months of treatment for predicting 1-year outcomes was examined.

Methods: Participants included 2327 adults with type 2 diabetes (BMI:35.8 ± 6.0) randomized to the intensive lifestyle intervention (ILI) of the Look AHEAD trial. ILI included weekly behavioral sessions designed to increase physical activity and reduce caloric intake. 1-month, 2-month, and 1-year weight changes were calculated.

Results: Participants failing to achieve a ≥2% weight loss at Month 1 were 5.6 (95% CI:4.5, 7.0) times more likely to also not achieve a ≥10% weight loss at Year 1, compared to those losing ≥2% initially. These odds were increased to 11.6 (95% CI:8.6, 15.6) when using a 3% weight loss threshold at Month 2. Only 15.2% and 8.2% of individuals failing to achieve the ≥2% and ≥3% thresholds at Months 1 and 2, respectively, go on to achieve a ≥10% weight loss at Year 1.

Conclusions: Given the association between initial and 1-year weight loss, the first few months of treatment may be an opportune time to identify those who are unsuccessful and utilize rescue efforts.

Trial registration: clinicaltrials.gov Identifier: NCT00017953.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Behavior Therapy / methods*
  • Body Mass Index
  • Confidence Intervals
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / therapy*
  • Energy Intake
  • Female
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / therapy*
  • Odds Ratio
  • Patient Education as Topic / methods
  • Treatment Outcome
  • Weight Loss*
  • Weight Reduction Programs / methods*

Associated data

  • ClinicalTrials.gov/NCT00017953

Grant support