Short-term weight loss patterns, baseline predictors, and longer-term follow-up within a randomized controlled trial

Authors

  • Veronica Yank,

    Corresponding author
    1. Department of Medicine, Stanford University School of Medicine, California, USA
    2. Department of Health Services Research, Palo Alto Medical Foundation Research Institute, California, USA
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    • Veronica Yank and Lan Xiao contributed equally to this work.

  • Lan Xiao,

    Corresponding author
    1. Department of Health Services Research, Palo Alto Medical Foundation Research Institute, California, USA
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    • Veronica Yank and Lan Xiao contributed equally to this work.

  • Sandra R. Wilson,

    1. Department of Medicine, Stanford University School of Medicine, California, USA
    2. Department of Health Services Research, Palo Alto Medical Foundation Research Institute, California, USA
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  • Randall S. Stafford,

    1. Department of Health Services Research, Palo Alto Medical Foundation Research Institute, California, USA
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  • Lisa Goldman Rosas,

    1. Department of Health Services Research, Palo Alto Medical Foundation Research Institute, California, USA
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  • Jun Ma

    1. Department of Medicine, Stanford University School of Medicine, California, USA
    2. Department of Health Services Research, Palo Alto Medical Foundation Research Institute, California, USA
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  • Funding agencies: The E-LITE study was supported by grant R34DK080878 from the National Institute of Diabetes and Digestive and Kidney Diseases, a Scientist Development Grant award (0830362N) from the American Heart Association, and internal funding from the Palo Alto Medical Foundation Research Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases or the American Heart Association. No sponsor or funding source had a role in the design or conduct of the study; collection, management, analysis or interpretation of the data; or preparation, review or approval of the manuscript.

  • Disclosure: Dr. Stafford reports that he has provided consulting services to Mylan Pharmaceuticals in the past. The remaining authors have no conflicts to disclose.

Abstract

Objective

To examine weight loss patterns and predictors among participants in a primary care-based translation study of the Diabetes Prevention Program lifestyle intervention.

Design and Methods

Cluster analysis identified short-term (12-week) weight loss patterns among 72 intervention participants. Analysis of variance assessed cluster differences in weight loss maintenance at 15-month follow-up. Discriminant analysis identified baseline characteristics that best differentiated between clusters.

Results

Participants had baseline mean (SD) age of 55.0 (10.8) years and BMI of 31.9 (5.2) kg/m2. Cluster analysis identified three short-term weight loss patterns: modest (n = 15; 21%), moderate-and-steady (n = 43; 60%), and substantial-and-early (n = 14; 19%). Only participants with the latter two patterns achieved clinically significant (≥5%) short-term weight loss and maintained it at 15 months. On discriminant analysis, the modest cluster was most differentiated from other clusters by high friend encouragement for dietary change, high obesity-related problems, and low physical well-being. The moderate-and-steady cluster was differentiated by lower physical activity, family encouragement, and depression symptoms.

Conclusion

Results provided insight into the heterogeneity of response to an effective lifestyle intervention by identifying short-term weight loss patterns and their baseline predictors and relationship to 15-month success. If replicated, results may help tailor strategies for participant subgroups in weight loss programs.

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