Abstract 07: Trajectories of Weight Change and Their Association with Barriers to Healthy Eating during 18-month Weight Loss Treatment

Abstract

Introduction: Obesity research has typically focused on the overall weight change pattern in randomized clinical trials (RCTs), ignoring the clustering of individuals with distinct weight change patterns (e.g., continuing to lose, maintain weight loss, or regain weight). The study aim was to identify trajectories of weight change and their associated predictors. Methods: This was a secondary analysis of longitudinal weight data pooled from two RCTs using standard behavioral treatment for weight loss. Weight was measured using a digital scale at baseline, 6, 12 and 18 mos. Group-based trajectory modeling was used to identify distinct classes of trajectories of percent weight change. Percent change in Barriers to Healthy Eating (BHE) subscale scores (emotions, daily mechanics and social support) were simultaneously added in the final trajectory model to examine their associations with weight change trajectories. Results: The pooled sample included 338 adults, which was mostly female (85.2%), White (73.7 %), 45.7±9.0 years old with 15.6±2.8 years of education, and a BMI of 33.9±4.3 kg/m2. As shown in the graph, three trajectory groups were identified: maintainers, regainers, and non-responders. Percent weight change was associated with BHE emotions (b=.053, p<.001) as well as social support (b=0.029, p=.003) for maintainers, emotions for regainers (b=0.071, p<.001), and daily mechanics for nonresponders (b=0.059, p <.001). Conclusions: This is the first study to identify distinct weight loss trajectories during active weight loss treatment for adults. What distinguished the maintainers from the regainers was the level of perceived barriers related to managing emotions and the availability of social support, while the group that was unsuccessful at achieving a clinically significant weight loss was challenged by the daily mechanics of adopting a healthy diet. The dimensions of barriers to healthy eating associated with weight change trajectories vary and should be considered in future weight loss programs.