Trajectories of Weight Change and Predictors Over 18-Month Weight Loss Treatment

Authors

  • Yaguang Zheng PhD, MSN, RN,

    Corresponding author
    1. Assistant Professor, Boston College, Connell School of Nursing, Chestnut Hill, MA, USA
    • Correspondence

      Dr. Yaguang Zheng, Connell School of Nursing, Boston College, Maloney Hall 369A, 140 Commonwealth Avenue, Chestnut Hill, MA 02467. E-mail: yaguang.zheng@bc.edu.

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  • Susan M. Sereika PhD,

    1. Professor; Director, Center for Research and Evaluation, University of Pittsburgh School of Nursing, Health & Community Systems, and Departments of Biostatistics and Epidemiology in the Graduate School of Public Health, Pittsburgh, PA, USA
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  • Cynthia A. Danford PhD, CRNP, PPCNP-BC, CPNP-PC,

    1. Assistant Professor, University of Pittsburgh School of Nursing, Health Promotion & Development, Pittsburgh, PA, USA
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  • Christopher C. Imes PhD, RN,

    1. Assistant Professor, University of Pittsburgh School of Nursing, Acute & Tertiary Care, Pittsburgh, PA, USA
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  • Rachel Woodson Goode MSW,

    1. PhD Candidate, University of Pittsburgh, School of Social Work, Pittsburgh, PA, USA
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  • Juliet Mancino MS, RDN,

    1. Clinical Research Coordinator, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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  • Lora E. Burke PhD, MPH, FAHA, FAAN

    1. Professor, University of Pittsburgh School of Nursing, Health & Community Systems and Department of Epidemiology in the Graduate School of Public Health, Pittsburgh, PA, USA
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Abstract

Background

Obesity research has typically focused on weight change patterns using the whole sample in randomized clinical trials (RCTs), ignoring subsets of individuals with varying weight change trajectories (e.g., continuing to lose, or maintaining weight). The purpose was to explore possible trajectories of weight change and their associated predictors.

Methods

We conducted a secondary analysis of data from two RCTs using standard behavioral treatment for weight loss. Group-based trajectory modeling was used to identify distinct classes of percent weight change trajectories over 18 months.

Results

The sample (N = 338) was primarily female (85.2%), White (73.7 %), 45.7 ± 9.0 years old, with 15.6 ± 2.8 years of education. Three trajectory groups were identified: good responders (>15% weight loss), fair responders (5%–10% weight loss), and poor responders (<5% weight loss). The good responders had a significantly larger decrease in perceived Barriers to Healthy Eating subscale scores than the fair and poor responders (p < .01). Compared to the poor responders, there was a significant decrease in fat gram intake in the good responders (p = .01).

Conclusions

Good responders differed from poor responders in decreasing their perceived barriers to healthy eating (e.g., managing emotions, social support, and daily mechanics of adopting a healthy diet) and reducing fat intake. Good responders differed from fair responders in perceived barriers to healthy eating.

Clinical Relevance

Clinicians need to focus on how we can assist those who are being unsuccessful in adopting some of the behaviors observed among those who have experienced successful weight loss and maintainers.

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