No abstract

Background: Weight loss programs often start with an initial phase of intensive lifestyle coaching to facilitate early weight loss, with a typical weight loss goal of ≥ 5%. While early weight loss is associated with long-term weight loss success, less is known about those who do not lose weight in the initial phase. This study examines those without initial weight loss success, but lose weight later. Methods: Analyses included 346 obese adults from the POWER Hopkins weight loss trial and 673 overweight to obese adults from the PREMIER hypertension control trial. Mutually exclusive categories are based on weight loss success (≥ 5% reduction from baseline) at 6m and 12m: continued success (success 6m and 12m); regainer (success 6m then regained 12m); no success (no success 6m or 12m); and late success (12m success only). Results: No success (NS) was the most common category among control and intervention participants in both studies (see table). There were low rates of late success (LS) in POWER (intervention 5%, control 7%, p=.25) and PREMIER (intervention 5%, control 8%, p=.75). Within the POWER intervention, LS and NS were similar in age, sex, race, and baseline weight. Coaching contact rates were similar at 1-6m (LS 64%, NS 57%, p=.49) and 7-12m (LS 45%, NS 46%, p=.89). Within the PREMIER intervention LS had a lower baseline weight than NS (89 vs 99 kg, p=.01), but were similar in age, sex, and race. Coaching contact rates are similar at 1-6m (LS 77%, NS 72%, p=.23) and 7-12m (LS 66%, NS 62%, p=.58). Conclusion: Given the small fraction of intervention participants with late success (only 5%), alternative strategies are needed to address the large fraction of persons without initial weight loss success.