Patterns of weight change in black Americans: Pooled analysis from three behavioral weight loss trials

Abstract

ObjectiveDifferentiating trajectories of weight change and identifying associated baseline predictors can provide insights for improving behavioral obesity treatment outcomes.Design and MethodsSecondary, observational analyses using growth mixture models were conducted in pooled data for 604 black American, primarily female adults in three completed clinical trials. Covariates of identified patterns were evaluated.ResultsThe best fitting model identified three patterns over 2 years: 1) mean weight loss of approximately 2 kg (n=519); 2) mean weight loss of approximately 3 kg at 1 year, followed by ~ 4 kg regain (n=61); and 3) mean weight loss of approximately 20 kg at 1 year followed by ~ 4 kg regain (n=24, with 23 from one study). In final multivariate analyses, higher BMI predicted having pattern 2 (OR[95% CI]) 1.10[1.03, 1.17]) or 3 (OR[95% CI] 1.42[1.25, 1.63]), and higher dietary fat score was predictive of a lower odds of having patterns 2 (OR[95% CI] 0.37[0.15, 0.94]) or 3 (OR[95% CI] 0.23[0.07, 0.79]).ConclusionsFindings were consistent with moderate, clinically non-significant weight loss as the predominant pattern across all studies. Results underscore the need to develop novel and more carefully targeted and tailored approaches to facilitating weight loss in black American adults.

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.…”

“…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%). Another study , examining weight loss outcomes over 2 years, also supported three similar weight loss trajectories in a large sample of African‐American women across multiple lifestyle interventions. Although percent weight loss was not recorded, three distinct weight loss trajectories were supported: modest loss and regain, modest and consistent loss, and substantial and consistent loss.…”

Longitudinal Weight Loss Patterns and their Behavioral and Demographic Associations

“…and length (1 to 4 yrs.) of behavioral interventions, health status of participants, and type of analytic approaches applied (cluster, principle component, or latent profile analysis) (4–7). Despite differences in intervention length, frequency of contact, type of diet etc., several previous studies have identified distinct patterns of weight change over time, in general agreement with our results; however, the exact patterns of weight change vary across studies.…”

“…However, the literature on this topic is limited and has employed a variety of approaches to identify weight change patterns, diverse samples, and considered a limited number of behavioral factors. These include cluster analysis (4), principal components analysis (5, 6), and latent class analysis (7) over time frames ranging from 12 weeks (4) to 2 years (7). Samples have been comprised of African American women (7), individuals with type 2 diabetes (5, 6), or in a high proportion of individuals with pre-diabetes and/or metabolic syndrome (4).…”

“…These include cluster analysis (4), principal components analysis (5, 6), and latent class analysis (7) over time frames ranging from 12 weeks (4) to 2 years (7). Samples have been comprised of African American women (7), individuals with type 2 diabetes (5, 6), or in a high proportion of individuals with pre-diabetes and/or metabolic syndrome (4). Previous studies have generally focused on the impact of baseline participant characteristics such as weight, personality traits or other psychosocial variables (i.e., self-efficacy, intentions, etc.)…”