Evaluation of early weight loss thresholds for identifying nonresponders to an intensive lifestyle intervention.
OBJECTIVE
Weight losses in lifestyle interventions are variable, yet prediction of long-term success is difficult. The utility of using various weight loss thresholds in the first 2 months of treatment for predicting 1-year outcomes was examined.


METHODS
Participants included 2327 adults with type 2 diabetes (BMI:35.8 ± 6.0) randomized to the intensive lifestyle intervention (ILI) of the Look AHEAD trial. ILI included weekly behavioral sessions designed to increase physical activity and reduce caloric intake. 1-month, 2-month, and 1-year weight changes were calculated.


RESULTS
Participants failing to achieve a ≥2% weight loss at Month 1 were 5.6 (95% CI:4.5, 7.0) times more likely to also not achieve a ≥10% weight loss at Year 1, compared to those losing ≥2% initially. These odds were increased to 11.6 (95% CI:8.6, 15.6) when using a 3% weight loss threshold at Month 2. Only 15.2% and 8.2% of individuals failing to achieve the ≥2% and ≥3% thresholds at Months 1 and 2, respectively, go on to achieve a ≥10% weight loss at Year 1.


CONCLUSIONS
Given the association between initial and 1-year weight loss, the first few months of treatment may be an opportune time to identify those who are unsuccessful and utilize rescue efforts.


BACKGROUND
clinicaltrials.gov Identifier: NCT00017953.
Weight Control and Diabetes Research Center, The Miriam Hospital and Brown Medical School, Providence, Rhode Island, USA.
Jessica L
JL
Unick
Patricia E
PE
Hogan
Rebecca H
RH
Neiberg
Lawrence J
LJ
Cheskin
Gareth R
GR
Dutton
Gina
G
Evans-Hudnall
Robert
R
Jeffery
Abbas E
AE
Kitabchi
Julie A
JA
Nelson
F Xavier
FX
Pi-Sunyer
Delia Smith
DS
West
Rena R
RR
Wing
D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D002149:Energy Intake; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000628:therapy*; D016017:Odds Ratio; D010353:Patient Education as Topic / Q000379:methods; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*