Sociodemographic Characteristics Associated with Pretreatment Weight Change in a U.S. Military Behavioral Weight Loss Intervention

Abstract

Participants beginning weight loss interventions commonly experience weight changes during the pretreatment period (i.e., screening to baseline visits) and some research indicates that this period impacts treatment engagement and outcomes. This study examined pretreatment weight change before a behavioral weight loss intervention among a diverse military sample to inform future trials among both military and civilian populations. Pretreatment weight categories [loss (>1.15% decrease), stable, or gain (>1.15% increase)] were compared to % weight change from both screening and baseline visits to 4 and 12 months. During pretreatment, 59.4% remained weight stable, 24.4% lost and 16.1% gained; and racial differences were found. Pretreatment weight categories did not predict baseline to four or 12-month outcomes; however, significant interactions with age were observed. Weight change category significantly predicted screening to 4-month outcome; specifically, those who lost pretreatment weight were more likely to lose weight from screening to 4 months compared to those who gained or remained weight stable. Further, pretreatment weight loss was related to increased treatment engagement. Results extend previous findings by indicating that pretreatment weight change is common in weight loss trials and impacts treatment outcomes and engagement. However, sociodemographic differences influenced the pretreatment period’s impact on treatment success.