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. 2023 Sep;31(9):2272-2282.
doi: 10.1002/oby.23854. Epub 2023 Aug 8.

Initial weight loss and early intervention adherence predict long-term weight loss during the Promoting Successful Weight Loss in Primary Care in Louisiana lifestyle intervention

Christoph Höchsmann  1   2 , Corby K Martin  2 , John W Apolzan  2 , James L Dorling  3 , Robert L Newton Jr  2 , Kara D Denstel  2 , Emily F Mire  2 , William D Johnson  2 , Dachuan Zhang  2 , Connie L Arnold  4 , Terry C Davis  4 , Vivian Fonseca  5 , Tina K Thethi  5 , Carl J Lavie  6 , Benjamin Springgate  7 , Peter T Katzmarzyk  2 ; PROPEL Research Group
Affiliations

Initial weight loss and early intervention adherence predict long-term weight loss during the Promoting Successful Weight Loss in Primary Care in Louisiana lifestyle intervention

Christoph Höchsmann et al. Obesity (Silver Spring). 2023 Sep.

Abstract

Objective: This study tested whether initial weight change (WC), self-weighing, and adherence to the expected WC trajectory predict longer-term WC in an underserved primary-care population with obesity.

Methods: Data from the intervention group (n = 452; 88% women; 74% Black; BMI 37.3 kg/m2 [SD: 4.6]) of the Promoting Successful Weight Loss in Primary Care in Louisiana trial were analyzed. Initial (2-, 4-, and 8-week) percentage WC was calculated from baseline clinic weights and daily at-home weights. Weights were considered adherent if they were on the expected WC trajectory (10% at 6 months with lower [7.5%] and upper [12.5%] bounds). Linear mixed-effects models tested whether initial WC and the number of daily and adherent weights predicted WC at 6, 12, and 24 months.

Results: Percentage WC during the initial 2, 4, and 8 weeks predicted percentage WC at 6 (R2 = 0.15, R2 = 0.28, and R2 = 0.50), 12 (R2 = 0.11, R2 = 0.19, and R2 = 0.32), and 24 (R2 = 0.09, R2 = 0.11, and R2 = 0.16) months (all p < 0.01). Initial daily and adherent weights were significantly associated with WC as individual predictors, but they only marginally improved predictions beyond initial weight loss alone in multivariable models.

Conclusions: These results highlight the importance of initial WC for predicting long-term WC and show that self-weighing and adherence to the expected WC trajectory can improve WC prediction.

Trial registration: ClinicalTrials.gov NCT02561221.

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Conflict of interest statement

Competing Interests: Louisiana State University, Pennington Biomedical Research Center, and Montclair State University have interest in, and patent applications related to, the intellectual property surrounding the weight graph that was used in the intervention, and Dr. Martin, among others, is an inventor of the technology. Licensing of that technology results in financial benefits to Louisiana State University, Pennington Biomedical Research Center, Montclair State University, and the inventors. Dr. Martin further reports grants from WW, the Academy of Nutrition and Dietetics, ABGIL, Lilly, and Evidation, as well as personal fees from Wondr Health, the Academy of Nutrition and Dietetics, and ABGIL. Dr. Apolzan reports grants from WW International, Inc. and non-financial support from Health and Nutrition Technology and Nutrisystem. Dr. Arnold reports a subcontract with Pennington Biomedical Research Center during the conduct of the study. Dr. Fonseca reports grants from Bayer, Boehringer Ingelheim, and Gilead; personal fees from Takeda, Novo Nordisk, Sanofi-Aventis, Eli Lilly, Abbott, AstraZeneca, and Intarcia; and stock options from Microbiome Technologies, Insulin Algorithms, BRAVO4Health, and Amgen. Dr. Thethi reports personal fees from Novo Nordisk. Dr. Lavie reports personal fees from Amgen, AstraZeneca, Esperion, Sanofi, Regeneron, and PAI Health. Dr. Katzmarzyk reports grants from PCORI and non-financial support from Health and Nutrition Technology and Nutrisystem. All other authors report no conflicts of interest. The work related to this article occurred before Dr. Price-Haywood’s appointment to the Patient-Centered Outcomes Research Institute Board of Governors.

Figures

Figure 1.
Figure 1.
Association between initial weight change and medium-to-long-term weight change. Panels A-C show the associations between initial weight change at 2 weeks (A), 4 weeks (B), and 8 weeks (C) and 6-month weight change. Panels D-F show the associations between initial weight change at 2 weeks (D), 4 weeks (E), and 8 weeks (F) and 12-month weight change. Panels G-I show the associations between initial weight change at 2 weeks (G), 4 weeks (H), and 8 weeks (I) and 24-month weight change.
See this image and copyright information in PMC

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