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Early weight fluctuations predict poor weight-loss results at 12 months
Participants in a yearlong behavioral weight-loss program who experienced greater weight variability in the initial 6 to 12 weeks of the intervention were more likely to experience poor long-term outcomes when compared with those who sustained stable weight loss, according to study findings published in Obesity.
“Finding behaviors people can stick with are key for long-term weight loss,” Emily H. Feig, PhD, of the department of psychology at Drexel University in Philadelphia, told Endocrine Today. “The idea is that when someone starts an extreme diet or exercise plan, it may work well for a little bit, but it is very difficult to maintain over time. This leads to frequent weight losses and regains. If someone can find behaviors to control their weight that they are able to do consistently, they will be much more likely to maintain their weight losses over time.”
Feig and Michael R. Lowe, PhD, professor of psychology at Drexel University, analyzed data from 183 healthy adults with a BMI between 27 kg/m² and 45 kg/m² recruited to participate in a 12-month behavioral weight-loss program at two Philadelphia universities (mean age, 51 years; 81% women; 69% white; mean BMI, 35 kg/m²). Enrolled participants were randomly assigned to one of three treatment conditions: standard behavioral treatment (self-monitoring, calorie monitoring and increasing physical activity); standard treatment plus two meal replacements daily for the first 6 months; and standard treatment plus modification of food intake, including increased protein and fiber intake. Researchers calculated weight variability using weights from the first 6 and 12 weekly treatment sessions and used multiple linear regression analyses to examine whether weight variability predicted subsequent weight change at 6, 12 and 24 months.
Researchers observed that weight variability at 6 weeks and 12 weeks was correlated (P < .01) and that weight variability at 6 weeks and 12 weeks was positively correlated with baseline BMI (P < .01); however, weight variability was not associated with the number of first sessions missed or with the initial percent weight change.
Weight variability at both 6 and 12 weeks was positively associated with weight change at 12 and 24 months; however, weight variability at 6 and 12 weeks was not associated with subsequent weight change during active treatment at 6 months. Results persisted after controlling for total weight change over the weight variability. In adjusted models, weight variability at 12 months predicted 3- to 12-month and 3- to 24-month percent weight change and was not related to 3- to 6-month percent weight change.
While weight variability did not predict weight change at 6 months, researchers observed a sex-by-weight variability interaction with 6-week weight variability on weight change from 1.5 to 6 months, showing that weight variability was more associated with 6-month weight change in men vs. women (P = .01).
In a press release, Lowe said the study highlights a potential method for sticking to weight-loss goals.
“Settle on a weight-loss plan that you can maintain week in and week out, even if that means consistently losing three-fourths of a pound each week,” Lowe said in the release.
“Research is still needed to test whether weight variability causes poor outcomes later, or whether it’s reflective of something else going on,” Feig said. “Also, research should aim to replicate these findings and should clarify whether measuring weight variability adds to interventionists’ ability to identify individuals unlikely to achieve sustainable weight loss.” – by Regina Schaffer
For more information:
Emily H. Feig, PhD, can be reached at Drexel University, Department of Psychology, 3141 Chestnut Street, Philadelphia, PA, 19104; email: emily.feig@gmail.com.
Disclosures: Feig reports no relevant financial disclosures. Lowe reports he received compensation from funded users of the Power of Food Scale.