Predictors of long‐term weight loss trajectories during a behavioral weight loss intervention: An exploratory analysis

• Main Authors: Danielle M. Ostendorf, Jennifer M. Blankenship, Laura Grau, Jaron Arbet, Nia S. Mitchell, Seth A. Creasy, Ann E. Caldwell, Edward L. Melanson, Suzanne Phelan, Daniel H. Bessesen, Victoria A. Catenacci
• Format: Article
• Language: English
• Published: Wiley 2021-10-01
• Series: Obesity Science & Practice
• Subjects: lifestyle modifications; obesity phenotypes; obesity treatment; psychosocial variables; race
• Online Access: https://doi.org/10.1002/osp4.530

Abstract Background Substantial interindividual variability in response to behavioral weight loss interventions remains a critical challenge in obesity treatment. An improved understanding of the complex factors that contribute to this variability may improve obesity treatment outcomes. Objective To identify weight change trajectories during a behavioral weight loss intervention and to explore differences between trajectory groups in sociodemographic, biologic, behavioral, and psychosocial factors. Methods Adults (n = 170, 40 ± 9 years, BMI 34 ± 4 kg/m2, 84% female) participated in an 18‐month behavioral weight loss intervention. Weight was measured at 0, 3, 6, 9, 12, 15, 18, and 24 months. Among participants with at least two weights after baseline (n = 140), clusters of longitudinal trajectories of changes in weight were identified using a latent class growth mixture model. The association between baseline factors or changes in factors over time and trajectory group was examined. Results Two weight change trajectories were identified: “weight regainers” (n = 91) and “weight loss maintainers” (n = 49). Black participants (90%, 19/21) were more likely than non‐Black participants to be regainers versus maintainers (p < 0.01). Maintainers demonstrated greater increases in device‐measured physical activity, autonomous motivation for exercise, diet self‐efficacy, cognitive restraint, and engagement in weight management behaviors and greater reductions in barriers for exercise, disinhibition, and depressive symptoms over 24 months versus regainers (p < 0.05). Conclusion Maintainers and regainers appear to be distinct trajectories that are associated with specific sociodemographic, behavioral, and psychosocial factors. Study results suggest potential targets for more tailored, multifaceted interventions to improve obesity treatment outcomes.