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United States Department of Agriculture

Agricultural Research Service

Research Project: Dietary Guidelines Adherence and Healthy Body Weight Maintenance Title: Evaluation of early weight loss thresholds for identifying nonresponders to an intensive lifestyle intervention

Author
item Raatz, Susan

Submitted to: Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: April 13, 2014
Publication Date: July 1, 2014
Citation: Raatz, S.K. 2014. Evaluation of early weight loss thresholds for identifying nonresponders to an intensive lifestyle intervention. Obesity. 22(7):1608-1616.

Interpretive Summary: Prediction of long-term weight loss success lifestyle interventions is difficult. We evaluated the utility of using weight loss thresholds in the first 2 months of treatment for predicting 1-year outcomes. Participants included 2,327 adults with type 2 diabetes (BMI:35.866.0) randomized to the intensive lifestyle intervention (ILI) of the Look AHEAD trial. Those participants failing to achieve a 2% weight loss at Month 1 were 5.6 times more likely to also not achieve a 10% weight loss at Year 1, compared to those losing 2% initially. The first few months of treatment may be an opportune time to identify those who are unsuccessful and utilize rescue efforts.

Technical 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 2,327 adults with type 2 diabetes (BMI:35.866.0) 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 [1]2% weight loss at Month 1 were 5.6 (95% CI:4.5, 7.0) times more likely to also not achieve a [1]10% weight loss at Year 1, compared to those losing [1]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 [1]2% and [1]3% thresholds at Months 1 and 2, respectively, go on to achieve a [1]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.

Last Modified: 11/23/2014
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