Longitudinal Weight Loss Patterns and their Behavioral and Demographic Associations

Abstract

Background Identification of weight change patterns may allow tailored interventions to improve long-term weight loss. Purpose To identify patterns of weight change over 18 mos., and assess participant characteristics and intervention adherence factors associated with weight change patterns in a sample of 359 overweight/obese adults. Methods Weight loss (0–6 mos.) was achieved with reduced energy intake and increased physical activity (PA). Maintenance (7–18 mos.) provided adequate energy to maintain weight and continued PA. Results Latent profile analysis identified 3 weight change profiles. During weight loss/maintenance, participants in profiles 2 and 3 (18 mos. weight loss ~14%) attended more behavioral sessions, and performed more PA, compared with profile 1 (18 mo. weight loss <1%). Self-efficacy for both weight management and exercise barriers were higher in profiles 2 and 3 compared with profile 1 following weight loss and during maintenance. Conclusion Weight change patterns can be identified and are associated with both participant characteristics and intervention adherence.

Characteristics of Weight Loss Trajectories in a Comprehensive Lifestyle Intervention

“…Many of the past studies reviewed earlier also supported three patterns of weight loss over time: modest loss, moderate loss, and substantial loss . The current investigation used a larger number of parameters to derive groups, but the latent class analyses similarly supported a three‐group model.…”

“…Similar trajectories have been evidenced by examining weight changes over 1 year during an intensive lifestyle intervention from the Look AHEAD study . Szabo‐Reed and colleagues used latent class analyses to explore individual patterns of weight change in a sample derived from an 18‐month trial (6‐month intervention, 1‐year follow‐up). Three latent groups were derived: modest loss‐complete regain (7% loss at 6 months), intermediate loss‐minimal regain (14%), and substantial loss‐minimal regain (22%).…”

“…An important differentiation between the current investigation and the previous studies is the number of weight change data points available. For example, some studies used as few as four %WL data points in their analyses to describe weight loss trajectories , which could lead to a loss of important information about individual weight change over the course of treatment. The current study offered some additional information about intraindividual weight change.…”

“…To date, there has been no consistent baseline predictor of patients who would follow a substantial and steady weight loss pattern versus a modest weight loss/weight regain trajectory . Future studies that consistently link physiological characteristics such as microbiome composition, resting metabolic rate, or genetic factors to poorer weight loss outcomes may yield meaningful insight as to why some patients respond better than others to comprehensive lifestyle interventions.…”

Patterns of weight loss and their determinants in a sample of adults with overweight and obesity intending to lose weight

“…The profiles were described as 'modest loss-complete regain', 'intermediate loss-minimal regain' and 'substantial loss-minimal regain'. 28 These findings suggest that weight loss patterns can be observed regardless of study population and statistical method used.…”