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. 2024 Jan;48(1):1-8.
doi: 10.5993/ajhb.48.1.1.

Characterization of early non-responders within behavioral weight loss treatment

Jessica L Unick  1 , Christine A Pellegrini  2 , Shira I Dunsiger  3 , Kathryn E Demos  1 , J Graham Thomas  1 , Dale S Bond  4 , Jennifer Webster  5 , Rena R Wing  1
Affiliations

Characterization of early non-responders within behavioral weight loss treatment

Jessica L Unick et al. Am J Health Behav. 2024 Jan.

Abstract

Objective: Given that low early (4 weeks) weight loss (WL) predicts longer-term WL, the purpose of this study was to identify factors associated with poor early WL.

Methods: 438 adults with overweight/obesity participating in an Internet-delivered behavioral WL program provided weights at baseline and 4 weeks. Participants were stratified by percent WL at 4 weeks: LOW: <2% WL, MEDIUM: 2 to <4% WL, HIGH: ≥4% WL and groups were compared on baseline variables (demographics, physical activity, and psychosocial measures) and 4-week intervention adherence.

Results: 37.4%, 40.9%, and 21.7% of participants had LOW, MEDIUM, and HIGH early WL respectively. LOW was more likely to be female compared to HIGH and less likely to be non-Hispanic White compared to MEDIUM and HIGH (p's<0.05). After controlling for demographic differences, LOW had lower baseline physical activity compared to HIGH and watched fewer video lessons, self-monitored calorie intake and weight on fewer days, and were less likely to achieve the exercise goal compared to MEDIUM and HIGH (p's<0.05).

Conclusion: Findings can inform future adaptive interventions which tailor treatment based upon early WL to improve WL outcomes for more individuals.

Keywords: Stepped care; adaptive intervention; behavioral weight loss; early non-responder; obesity.

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Conflict of interest statement

Conflict of Interest Disclosure Statement Drs. Unick and Thomas are on the Scientific Advisory Board of Medifast. Dr. Thomas reports participation on the scientific advisory board and consulting fees from Lummé Health, Inc., and Dr. Wing is on the Scientific Advisory Board of NOOM. All remaining authors have no relevant financial or non-financial conflicts of interest to report.

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