Weight Change 2 Years After Termination of the Intensive Lifestyle Intervention in the Look AHEAD Study

Chao, Ariana M.; Wadden, Thomas A.; Berkowitz, Robert I.; Blackburn, George L.; Bolin, Paula; Clark, Jeanne M.; Coday, Mace; Curtis, Jeffrey M.; Delahanty, Linda M.; Dutton, Gareth R.; Evans, Mary; Ewing, Linda J.; Foreyt, John P.; Gay, Linda J.; Gregg, Edward W.; Hazuda, Helen P.; Hill, James O.; Horton, Edward S.; Houston, Denise K.; Jakicic, John M.; Jeffery, Robert W.; Johnson, Karen C.; Kahn, Steven E.; Knowler, William C.; Kure, Anne; Michalski, Katherine L.; Montez, Maria G.; Neiberg, Rebecca H.; Patricio, Jennifer; Peters, Anne L.; Pi‐Sunyer, Xavier; Pownall, Henry J.; Reboussin, David M.; Redmon, J. Bruce; Rejeski, W. Jack; Steinburg, Helmut; Walker, Martha A.; Williamson, Donald A.; Wing, Rena R.; Wyatt, Holly R.; Yanovski, Susan Z.; Zhang, Ping

doi:10.1002/oby.22769

Cited by 25 publications

(10 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Under a 5-year weight regain assumption, Look AHEAD is borderline cost-effective, but the ICER decreases when assuming a linear regain trend over time. The latter may be more appropriate and in line with recently published Look AHEAD data showing that in the 2 years after cessation of the intervention, there was no evidence of any weight regain, improving the case for cost-effectiveness further [ 30 ].…”

Section: Discussionmentioning

confidence: 56%

Cost-effectiveness of bariatric surgery and non-surgical weight management programmes for adults with severe obesity: a decision analysis model

et al. 2021

View full text Add to dashboard Cite

Objectives To determine the most cost-effective weight management programmes (WMPs) for adults, in England with severe obesity (BMI ≥ 35 kg/m2), who are more at risk of obesity related diseases. Methods An economic evaluation of five different WMPs: 1) low intensity (WMP1); 2) very low calorie diets (VLCD) added to WMP1; 3) moderate intensity (WMP2); 4) high intensity (Look AHEAD); and 5) Roux-en-Y gastric bypass (RYGB) surgery, all compared to a baseline scenario representing no WMP. We also compare a VLCD added to WMP1 vs. WMP1 alone. A microsimulation decision analysis model was used to extrapolate the impact of changes in BMI, obtained from a systematic review and meta-analysis of randomised controlled trials (RCTs) of WMPs and bariatric surgery, on long-term risks of obesity related disease, costs, quality adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) measured as incremental cost per QALY gained over a 30-year time horizon from a UK National Health Service (NHS) perspective. Sensitivity analyses explored the impact of long-term weight regain assumptions on results. Results RYGB was the most costly intervention but also generated the lowest incidence of obesity related disease and hence the highest QALY gains. Base case ICERs for WMP1, a VLCD added to WMP1, WMP2, Look AHEAD, and RYGB compared to no WMP were £557, £6628, £1540, £23,725 and £10,126 per QALY gained respectively. Adding a VLCD to WMP1 generated an ICER of over £121,000 per QALY compared to WMP1 alone. Sensitivity analysis found that all ICERs were sensitive to the modelled base case, five year post intervention cessation, weight regain assumption. Conclusions RYGB surgery was the most effective and cost-effective use of scarce NHS funding resources. However, where fixed healthcare budgets or patient preferences exclude surgery as an option, a standard 12 week behavioural WMP (WMP1) was the next most cost-effective intervention.

show abstract

Section: Discussionmentioning

confidence: 56%

Cost-effectiveness of bariatric surgery and non-surgical weight management programmes for adults with severe obesity: a decision analysis model

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Several studies have shown that while some weight is often regained in the period after intensive weight loss interventions for adults with obesity, participants typically remain below baseline weight, though these findings have been chiefly in younger adults. 7,8 Our overall weight maintenance findings align with those previously published for older adults. 9 Our findings offer encouraging evidence that technology-based interventions may address access disparities and allow for maintained weight loss for older adults in rural areas.…”

Section: Discussionsupporting

confidence: 90%

“…This was true for both those who significantly responded to the initial intervention and those who did not. Several studies have shown that while some weight is often regained in the period after intensive weight loss interventions for adults with obesity, participants typically remain below baseline weight, though these findings have been chiefly in younger adults 7,8 . Our overall weight maintenance findings align with those previously published for older adults 9 .…”

Section: Discussionsupporting

confidence: 86%

Long‐term weight change after a technology‐based weight loss intervention

Wood

Lynch

Spangler

et al. 2022

J American Geriatrics Society

View full text Add to dashboard Cite

“…We found similar associations of ILI with weight and HbA 1c for the linked sample compared with the full Look AHEAD study during and after the trial (Figure 2). During our sample period from 2012 to 2015, the linked ILI group continued to have lower weight than the control group (adjusted difference: −1.9% [95% CI, −2.6% to −1.2%] of initial body weight; P < .001). However, there was no significant difference in HbA 1c between 2012 and 2015.…”

Section: Resultsmentioning

confidence: 86%

“…We found similar associations of ILI with weight and HbA 1c for the linked sample compared with the full Look AHEAD study during and after the trial (Figure 2). 26 ; P = .89). We also estimated year-specific ILI vs control group differences in the probability of hospital admission and ED visits, Part D prescription drug costs, and total Medicare spending.…”

Section: Associations Of Ili With Weight and Hba 1c During And After mentioning

confidence: 90%

Associations of Intensive Lifestyle Intervention in Type 2 Diabetes With Health Care Use, Spending, and Disability

et al. 2020

Self Cite

View full text Add to dashboard Cite

IMPORTANCE Intensive lifestyle interventions focused on diet and exercise can reduce weight and improve diabetes management. However, the long-term effects on health care use and spending are unclear, especially for public payers. OBJECTIVE To estimate the association of effective intensive lifestyle intervention for weight loss with long-term health care use and Medicare spending. DESIGN, SETTING, AND PARTICIPANTS This ancillary study used data from the Look AHEAD randomized clinical trial, which randomized participants with type 2 diabetes to an intensive lifestyle intervention or control group (ie, diabetes support and education), provided ongoing intervention from 2001 to 2012, and demonstrated improved diabetes management and reduced health care costs during the intervention. This study compared Medicare data between study arms from 2012 to 2015 to determine whether the intervention was associated with persistent reductions in health care spending. EXPOSURE Starting in 2001, Look AHEAD's intervention group participated in sessions with lifestyle counselors, dieticians, exercise specialists, and behavioral therapists with the goal of reducing weight 7% in the first year. Sessions occurred weekly in the first 6 months of the intervention and decreased over the intervention period. The controls participated in periodic group education sessions that occurred 3 times per year in the first year and decreased to 1 time per year later in the trial. MAIN OUTCOMES AND MEASURES Outcomes included total Medicare spending, Part D prescription drug costs, Part A and Part B Medicare spending, hospital admissions, emergency department visits, and disability-related Medicare eligibility. RESULTS This study matched Medicare administrative records for 2796 Look AHEAD study participants (54% of 5145 participants initially randomized and 86% of 3246 participants consenting to linkages). Linked intervention and control participants were of a similar age (mean [SD] age, 59.6 [5.4] years vs 59.6 [5.5] years at randomization) and sex (818 [58.1%] women vs 822 [59.3%] women). There was no statistically significant difference in total Medicare spending between groups

show abstract

Weight Change 2 Years After Termination of the Intensive Lifestyle Intervention in the Look AHEAD Study

Cited by 25 publications

References 36 publications

Cost-effectiveness of bariatric surgery and non-surgical weight management programmes for adults with severe obesity: a decision analysis model

Cost-effectiveness of bariatric surgery and non-surgical weight management programmes for adults with severe obesity: a decision analysis model

Long‐term weight change after a technology‐based weight loss intervention

Associations of Intensive Lifestyle Intervention in Type 2 Diabetes With Health Care Use, Spending, and Disability

Contact Info

Product

Resources

About