Towards a personalised approach for obesity treatment: one size does not fit all.

Achieving and maintaining weight loss is notoriously difficult, but also incredibly important. Obesity is associated with numerous long-term health consequences, including malignancy, respiratory conditions, musculoskeletal stress, chronic pain, depression and cardiovascular disease.1 One of the challenges of weight loss interventions is the substantial heterogeneity of treatment response. This variability has been demonstrated across lifestyle, pharmacological and surgical treatments. Behavioural strategies, such as diet and exercise regimens, can have widely disparate effects among individuals, ranging from completely ineffective to leading to long-term weight loss.2 Even randomised trials of weight loss medications or types of bariatric surgery can show significant variability in treatment response.3 While many weight management strategies have been tried, few have focused specifically on predictors of response to a given intervention. Tijssen et al 4 address this critical gap in the evidence by characterising weight loss in the Randomised Evaluation of Secondary Prevention by Outpatient Nurse Specialists-2 (RESPONSE-2) Trial, and by identifying predictors of success. RESPONSE-2 was a multicentre clinical trial conducted in the Netherlands that randomised patients with recent hospitalisation or revascularisation for coronary artery disease to usual care versus one or more interventions for smoking cessation, increasing physical activity or weight loss.5 Participants were referred by a nurse and offered free participation in these widely available community-based programmes based on their risk profiles and …