title: Late successful weight reduction and maintenance among overweight and obese adults--a two-year retrospective study.
abstract: OBJECTIVE
  Our purpose was to identify those factors associated with successful late weight reduction and maintenance among overweight and obese adults who failed to achieve initial weight reduction success.
  
  
  METHODS
  Medical computerized files of 5254 participants, who failed to achieve ≥ 5% weight reduction after an initial 6-month period, were retrospectively analyzed to identify predictors associated with late successful weight reduction and maintenance (≥ 5% during the first and second years, respectively). Over 40 independent variables were analyzed. The main outcome was the percentage of weight change.
  
  
  RESULTS
  Significant predictors of late success in weight reduction were as follows: more visits to a dietitian, higher baseline BMI, and any initial weight reduction (0-5%) (OR=3.69, compared with participants who initially gained weight). The use of insulin (OR=0.499) and the presence of hypertension (OR=0.75) were significantly correlated with failure to reduce weight. Predictors of late maintenance were as follows: more visits to a dietitian, higher baseline BMI, any initial weight reduction, a younger age, not being treated with insulin (OR=0.316), and more weighings (OR=1.68).
  
  
  CONCLUSIONS
  A substantial sub-group of obese and overweight patients was able to reduce their weight at a slower rate than the defined successful time of 6 months. Significant specific predictors were identified. Diabetic and hypertensive patients are at a significantly higher risk of failure to reduce and maintain weight. Using regression models, we calculated the probability of successful late weight reduction. This calculation could serve as a clinical tool for a professional team.
authors.affiliation: Human Population Biology Research Unit, Department of Anatomy and Anthropology, Tel Aviv University, Tel Aviv, Israel; Sharon-Shomron District, Clalit Health Services, Netanya, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Bachar
authors.affiliation: Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sharon-Shomron District, Clalit Health Services, Netanya, Israel. Electronic address: doronh@clalit.org.il.
authors.forename: D
authors.initials: D
authors.lastname: Hermoni
authors.affiliation: Human Population Biology Research Unit, Department of Anatomy and Anthropology, Tel Aviv University, Tel Aviv, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Livshits
authors.affiliation: Department of Nutrition, Faculty of Health Science, Ariel University, Ariel, Israel. Electronic address: ruthb@ariel.ac.il.
authors.forename: R
authors.initials: R
authors.lastname: Birk
mesh_terms: D000328:Adult; D001835:Body Weight; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000534:rehabilitation*; D050177:Overweight / Q000534:rehabilitation*; D012189:Retrospective Studies; D013997:Time Factors; D015431:Weight Loss
keywords: Hypertension; Insulin; Obesity; Overweight; Weight loss