Short-term weight changes in community-dwelling older adults: the Health, Aging, and Body Composition Weight Change Substudy
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Objective The Swedish Obese Subjects (SOS) study was designed to compare outcomes in patients with obesity treated by bariatric surgery and a matched control group given usual care. The aim of this study was to analyze self‐reported weight‐loss methods and weight changes over 10 years in the SOS control group. Methods Self‐reported weight‐loss methods in the control group ( n = 2,037; 71% women; 48.7 ± 6.3 years; BMI 40.1 ± 4.7 kg/m 2 ) were analyzed at baseline and after 0.5, 1, 2, 3, 4, 6, 8, and 10 years of follow‐up and studied in relation to weight changes. Results The average 10‐year weight change was +2.1% (95% CI: 1.4%‐2.8%). At every follow‐up, 82.7% (95% CI: 81.3%‐84.1%) of participants reported weight‐loss attempts. At 10 years, 12.5% of the participants had ≥ 10% weight loss and 22.3% had ≥ 10% weight gain. Participants who lost or gained weight reported similar usage of weight‐loss methods. Conclusions Over 10 years, the majority of the participants of the SOS control group reported continuous efforts to lose weight. These results illustrate the constant struggle individuals with severe obesity are facing and that, on average, the results of long‐term weight loss and weight maintenance were discouraging.
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Little is known about the transition in behaviors from short-term weight loss to maintenance of weight loss. We wanted to determine how short-term and long-term weight loss and patterns of weight change were associated with intervention behavioral targets. This analysis includes overweight/obese participants in active treatment (n = 507) from the previously published PREMIER trial, an 18-month, multicomponent lifestyle intervention for blood pressure reduction, including 33 intervention sessions and recommendations to self-monitor food intake and physical activity daily. Associations between behaviors (attendance, recorded days/week of physical activity, food records/week) and weight loss of ≥5% at 6 and 18 months were examined using logistic regression. We characterized the sample using 5 weight change categories (weight gained, weight stable, weight loss then relapse, late weight loss, and weight loss then maintenance) and analyzed adherence to the behaviors for each category, comparing means with ANOVA. Participants lost an average of 5.3 ± 5.6 kg at 6 months and 4.0 ± 6.7 kg (4.96% of body weight) by 18 months. Higher levels of attendance, food record completion, and recorded days/week of physical activity were associated with increasing odds of achieving 5% weight loss. All weight change groups had declines in the behaviors over time; however, compared to the other four groups, the weight loss/maintenance group (n = 154) had statistically less significant decline in number of food records/week (48%), recorded days/week of physical activity (41.7%), and intervention sessions attended (12.8%) through 18 months. Behaviors associated with short-term weight loss continue to be associated with long-term weight loss, albeit at lower frequencies. Minimizing the decline in these behaviors may be important in achieving long-term weight loss.
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Objectives: In this study, we examined compliance and progress factors associated with weight loss and maintenance, individual patterns of weight trends following weight loss, and impact of early weight loss on longer-term weight change. Methods: We conducted secondary analysis of pre-post data. Participants were 8769 persons (mean age = 47.63 ± 13.78 years; 77.74% women; mean weight = 97.20 ± 22.82 kilograms; BMI = 34.09 ± 6.84) in a commercial weight management program. We carried out multiple regression analyses on weight change and percentage, and used ANOVA and the Pearson chi-square test to examine participant characteristics, weight change patterns, and early weight loss success. Results: Participants were active in the program for 222 ± 158 days, completed 15 ± 13 appointments, achieving -8.53 ± 7.87 kilograms lost (-8.61% ± 7.64%). Greater weight loss was associated with appointment frequency (β = -0.46) and total spending (β = -2.89) (p < .01). We identified 5 weight change patterns (F = 37.56, p < .001) (total weight loss for each group was: Stable = -10.4% [N=2036]; Minimal Regain = -10.5% [N=3766]; Modest Regain = -8.8% [N=1476]; Large Regain = -7.3% [N=753]; No Loss/Gain = +3.7% [N=737]; all p < .05). Over 5000 participants achieved early weight loss (losing > 5%) within the first 2 months resulting in significantly greater final weight loss (-8.43% to -14.56% vs -1.18% to -3.15%). Conclusions: We identified several weight patterns; increased health coaching attendance was associated with greater weight loss.
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This study examined factors associated with weight change in 535 residents in 32 long term care homes where 3-month weight records were available. Trained researchers and standardized measures (e.g., nutrition status, food intake, home characteristics) were used to collect data; weight change was defined as ±2.5%. Just over 25% of the sample lost and 21% gained weight. Weight stability was compared to loss or gain. Weight loss was associated with being male, malnourished (MNA-SF or BMI <25), energy and protein intake and oral nutritional supplement use, while weight gain was associated with being female, and a physically (e.g., less noise) and socially supportive dining room. Weight stability was associated with better cognition. A high proportion of residents had a significant weight change in 3 months. Modifiable factors associated with weight stability or gain suggest focusing interventions that promote food intake and improve the mealtime environment.
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Weigh Forward was a prospective clinical audit, aimed to assess the use and efficacy of 12-week weight management program in general practice. Twenty-eight practitioners participated in the audit, with a total of 258 patients observed. Of these, 147 (57%) were retained to 24 weeks. Practices were asked to implement a structured 12-week weight loss program, and encouraged to utilize relevant weight management guidelines as necessary. Patients were followed up regularly, and comprehensively assessed at baseline, 12 and 24 weeks. Evaluations were made of patient weight loss, practitioner willingness to utilize available weight loss interventions, practitioner set weight loss goals and the appropriateness of such goals. Overall, the 57% of completing patients lost an average of 6.1% ± 0.5% body weight, with 27.2% losing ≥10% body weight. Practitioners were hesitant to intensify treatment, and those with comorbidities were less likely (odds ratio 1.8; 95% CI 1.4-2.4) to receive intensified treatment than those without. Practitioners also tended to set high weight loss goals, with a mean goal of 17.3% body-weight loss. The clinically significant mean weight loss demonstrates that practitioners are able to generate meaningful weight loss in primary care settings, however, could benefit from increased use of available interventions.
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Background: Weight loss, though difficult to attain and sustain over time, remains the cornerstone of non-alcoholic fatty liver disease (NAFLD) treatment. We aimed to describe weight changes among NAFLD patients. Methods: This was a retrospective, cohort study of consecutively-identified NAFLD patients with >2 clinic visits from March2007–April2018. Weight changes from baseline were categorized into weight gain, weight loss, and no change. Baseline liver and metabolic biochemistries and non-invasive liver fibrosis tests were correlated with the final weight changes. Succeeding weight changes after the initial follow-up visits were used to determine sustainability of weight loss. Results: Of the 240 patients included, 123 (51.2%), 93 (38.8%), and 24 (10%) had weight gain, weight loss, and no change, respectively. Only 12.5% had >5% weight loss. Duration of follow-up was significantly longer for patients with weight loss (p<0.001). None of the baseline demographic and laboratory data were associated with weight loss. Patients with weight loss also did not have significant changes to their biochemistries and non-invasive liver fibrosis tests compared to patients with weight gain/no change. Compared to patients with weight gain after the initial follow-up, where only 11.8% were able to lose weight on the final visit, 73.1% of patients who lost weight after the initial follow-up were able to sustain their weight loss on the final visit. Conclusions: Weight loss is achieved in only a third of NAFLD patients. Although 73% of patients who lost weight initially were able to sustain it, patients who gained weight after the 1st follow-up were unlikely to lose weight on further follow-up. Key words: Non-alcoholic fatty liver disease, weight loss, sustainability
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