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Randomized Controlled Trial
. 2020 Nov;35(11):3227-3233.
doi: 10.1007/s11606-020-06056-x. Epub 2020 Aug 17.

Lifestyle Habits Associated with Weight Regain After Intentional Loss in Primary Care Patients Participating in a Randomized Trial

Bethany Barone Gibbs  1 , Dana Tudorascu  2 , Cindy L Bryce  2 , Diane Comer  2 , Gary S Fischer  2 , Rachel Hess  3 , Kimberly A Huber  2 , Kathleen M McTigue  2 , Laurey R Simkin-Silverman  2 , Molly B Conroy  3
Affiliations
Randomized Controlled Trial

Lifestyle Habits Associated with Weight Regain After Intentional Loss in Primary Care Patients Participating in a Randomized Trial

Bethany Barone Gibbs et al. J Gen Intern Med. 2020 Nov.

Abstract

Background: Though long-term weight loss maintenance is the treatment goal for obesity, weight regain is typical and few studies have evaluated lifestyle habits associated with weight regain.

Objective: To identify dietary and physical activity habits associated with 6- and 24-month weight regain among participants in a weight loss maintenance clinical trial.

Design: Secondary analysis of randomized clinical trial data.

Participants: Adult primary care patients with recent, intentional weight loss of at least 5%.

Main measures: Lifestyle habits included consumption of low-fat foods, fish, desserts, sugary beverages, fruits, and vegetables and eating at restaurants from the Connor Diet Habit Survey; moderate-vigorous physical activity by self-report; steps recorded by a pedometer; and sedentary behavior by self-report. The outcome variable was weight change at 6 and 24 months. Linear regression models estimated adjusted associations between changes in weight and changes in dietary and physical activity habits.

Key results: Overall, participants (mean (SD): 53.4 (12.2) years old; 26% male; 88% white) maintained weight loss at 6 months (n = 178, mean (SD): - 0.02 (5.70)% change) but began to regain weight by 24 months (n = 157, mean (SD): 4.22 (9.15)% increase). When considered all together, more eating at restaurants, reduced fish consumption, and less physical activity were most consistently associated with weight regain in fully adjusted models at both 6 and 24 months of follow-up. In addition, more sedentary behavior was associated with weight regain at 6 months while reduced consumption of low-fat foods, and more desserts and sugary beverages were associated with weight regain at 24 months.

Conclusions: Consuming less fish, fewer steps per day, and more frequent restaurant eating were most consistently associated with weight regain in primary care patients. Primary care providers may consider addressing specific lifestyle behaviors when counseling patients after successful weight loss.

Trial registration: ClinicalTrials.gov Identifier: NCT01946191.

Keywords: diet; physical activity; primary care; weight loss maintenance.

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Conflict of interest statement

Dr. Barone Gibbs reports grants from AHRQ, during the conduct of the study, grants from the American Heart Association, grants from the National Institutes of Health, and grants from the Tomayko Foundation, outside the submitted work. Dr. Fischer reports grants from AHRQ, during the conduct of the study, grants from PCORI, and grants from NIH, outside the submitted work. Dr. Hess reports personal fees from Astelles, outside the submitted work. Dr. McTigue reports grants from the University of Pittsburgh, during the conduct of the study. The other authors declare that they have no conflict of interest.

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