Long-Term Weight Loss Effects of a Behavioral Weight Management Program: Does the Community Food Environment Matter?

Abstract

This study examined whether community food environments altered the longer-term effects of a nationwide behavioral weight management program on body mass index (BMI). The sample was comprised of 98,871 male weight management program participants and 15,385 female participants, as well as 461,302 and 37,192 inverse propensity-score weighted matched male and female controls. We measured the community food environment by counting the number of supermarkets, convenience stores, and fast food restaurants within a 1-mile radius around each person’s home address. We used difference-in-difference regression models with person and calendar time fixed effects to estimate MOVE! effects over time in sub-populations defined by community food environment attributes. Among men, after an initial decrease in BMI at 6 months, the effect of the program decreased over time, with BMI increasing incrementally at 12 months (0.098 kg/m2, p < 0.001), 18 months (0.069 kg/m2, p < 0.001), and 24 months (0.067 kg/m2, p < 0.001). Among women, the initial effects of the program decreased over time as well. Women had an incremental BMI change of 0.099 kg/m2 at 12 months (p < 0.05) with non-significant incremental changes at 18 months and 24 months. We found little evidence that these longer-term effects of the weight management program differed depending on the community food environment. Physiological adaptations may overwhelm environmental influences on adherence to behavioral regimens in affecting longer-term weight loss outcomes.

Long-term effect of a dietary intervention with two-healthy dietary approaches on food intake and nutrient density in coronary patients: results from the CORDIOPREV trial

“…It is possible that COR-DIOPREV trial participants were aware of their coronary problems and its relationship with poor food habits, and thus firmly motivated to comply with dietary advices. Contrary to our results, other studies have reported that improvements in diet quality appears in the short term, declining after a long follow-up period [27][28][29]. All of these studies are pointing out a trend toward worsening diet quality across follow-up.…”

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Environmental Domain

“…Some more recent studies are longitudinal, examining the long‐term effects of environmental factors on weight and related behaviors, or alternatively among individuals who move from one environment to another or among those otherwise exposed to environmental changes (e.g., pedestrian infrastructure improvements, opening new food stores) . The ADOPT environmental domain subgroup was only aware of a limited number of published reports that examine the association of environmental factors with weight‐loss or maintenance among adult weight‐management trial participants (e.g., Mendez et al and Zenk et al ).…”

Impact of neighbourhood food environment on diet and obesity in China: a systematic review

“…The neighbourhood food environment has received increasing attention from researchers, policy makers, and various stakeholders (40)(41)(42) . The existing literature predominantly investigated neighbourhood food environment in relation to diet and obesity in developed countries (35,37,43,44) , whereas its potential influence among the Chinese population has been under-studied.…”