Short- and Long-Term Changes in Health-Related Quality of Life with Weight Loss: Results from a Randomized Controlled Trial

Abstract

Objective: The objective of this study was to determine the effects of weight loss and weight loss maintenance (WLM) on weight-specific health-related quality of life in a 66-week trial.

Methods: Adults with obesity (N = 137, 86.1% female, 68.6% black, mean age = 46.1 years) who had lost ≥ 5% of initial weight in a 14-week intensive lifestyle intervention/low-calorie diet (LCD) program were randomly assigned to lorcaserin or placebo for an additional 52-week WLM program. The Impact of Weight on Quality of Life-Lite (IWQOL-Lite) scale (including five subscales), Patient Health Questionnaire-9 (depression), and Perceived Stress Scale were administered at the start of the 14-week LCD program, randomization, and week 52 of the randomized controlled trial (i.e., 66 weeks total).

Results: Significant improvements in all outcomes, except weight-related public distress, were found following the 14-week LCD program (P values < 0.05). Improvements were largely maintained during the 52-week randomized controlled trial, despite weight regain of 2.0 to 2.5 kg across treatment groups. Participants who lost ≥ 10% of initial weight achieved greater improvements in physical function, self-esteem, sexual life, and the IWQOL-Lite total score than those who lost < 5% and did not differ from those who lost 5% to 9.9%.

Conclusions: Improvements in weight-specific health-related quality of life were achieved with moderate weight loss and were sustained during WLM.

Trial registration: ClinicalTrials.gov NCT02388568.

Figure 1

Changes in IWQOL – Lite scores by percent weight loss Note. Analyses of covariance showed significant differences for the IWQOL-Lite total score, as well as the physical function, self-esteem, and sexual life subscales, controlling for all covariates (p values < 0.04; p values > 0.05 for work and public distress subscales). Change scores were significantly smaller for participants who lost < 5% of their weight (n = 32) in comparison to those who lost ≥ 10% (n = 34). IWQOL-Lite total change scores were significantly greater for patients who lost 5–9.9% (n = 23) than for those who lost <5% of their weight (p = 0.04). Scores did not differ between participants who lost ≥ 5% vs. ≥ 10% of their starting weight. IWQOL = Impact of Weight on Quality of Life.