Early weight loss in behavioral weight-management programs predicts long-term success
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Adults who lose weight in the first 4 weeks of a behavioral weight-management program are more likely to have successful medium-term weight loss, according to a speaker at the European Association for the Study of Diabetes annual meeting.
“Currently, many providers may offer more intensive therapies to every patient, as they don’t believe behavioral programs are effective, when they are for many people,” Jennifer Logue, MD, professor of metabolic medicine at Lancaster University, U.K., told Healio. “Other providers leave patients struggling in a behavioral program and they will disengage, reinforcing self-stigma. Our research shows that achieving 0.5% weight loss just 4 weeks into a program is predictive of long-term success; people who don’t achieve that may need extra support or alternative therapies.”
Researchers conducted a longitudinal study of 1,658 adults with obesity and type 2 diabetes who attended the Greater Glasgow and Clyde Weight Management Service in the U.K. (mean age, 57.8 years; 60% women). Data were obtained from electronic health records collected by the National Health Service (NHS) Greater Glasgow and Clyde health board. Successful short-term weight loss was defined as attending seven of nine weight-management sessions over 16 weeks and achieving body weight loss of more than 5%. Medium-term weight loss was defined as losing more than 5% body weight at 3 years and also previously achieving successful short-term weight loss.
Of the study cohort, 20% had successful short-term weight loss, and of 1,152 adults with medium-term outcome data, 12.1% achieved medium-term weight loss. Each 1% of body weight lost in the first three program sessions was associated with a greater likelihood for successful short-term weight loss (OR = 2.86; 95% CI, 2.5-3.23). Losing 0.5% of body weight in the first three sessions predicted short-term weight loss with a sensitivity of 90.4% and specificity of 53.6%.
Each 1% of body weight lost in the first three weight-management program sessions was also associated with a greater likelihood for successful medium-term weight loss (OR = 2.22; 95% CI, 1.92-2.56). A loss of 0.5% body weight in the first three sessions predicted successful medium-term weight loss with a sensitivity of 89.9% and a specificity of 50.5%. No other demographics or clinical variables were associated with successful short-term or medium-term weight loss.
“We were surprised by how simple the model was, but the overall idea is based on published evidence from a range of weight-management interventions,” Logue said. “Even for surgery and medications, there is little about a person prior to the intervention that predicts outcomes, but early response in the first few months is associated with success. Being able to know as early as 4 weeks is advantageous as it allows you to intervene before the person has disengaged — we know that many people living with obesity do not want to attend health care appointments after a perceived ‘failure’ of a weight-loss intervention.”
Logue said future research is needed to examine why people do not have success in weight-management programs to determine alternative interventions.
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Al-Abdullah L, et al. SO 523. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 19-23, 2022; Stockholm (hybrid meeting).
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