Predictors Of Successful Weight Loss Research Articles

Factors contributing to weight loss success after bariatric procedures in patient over 65 years old - a multicenter retrospective cohort study.

Although bariatric surgery in patients over 65 years of age gives comparable results to treatment in the younger population, there are still controversies regarding the indications for surgery, risk assessment and choice between different types of surgery. The study aimed to identify the factors contributing to weight loss success after bariatric surgery in patients over 65 years of age. This is a retrospective, multicenter cohort study of patients with obesity aged over 65 years undergoing primary laparoscopic bariatric surgery in the years 2008-2022. Data came from 11 bariatric centers. Patients were divided into two groups: responders (R) who achieved more than 50% EWL and non-responders (NR) who achieved less than 50% EWL. Both groups were compared. Uni- and multivariate logistic regression was used to identify predictors of weight loss success. Out of 274 analyzed patients, the average BMI before surgery was 42.9kg/m2. The most common obesity-related diseases were hypertension (85.1%) and type 2 diabetes (53.3%). Sleeve gastrectomy was the most frequently performed procedure (85.4%). Uni- and multivariate logistic regression analysis confirmed preoperative BMI (OR=0.9, 95%CI:0.82-0.98, P=0.02), duration of diabetes >10 years (OR=0.3, 95%CI:0.09-0.82, P=0.02), balloon placement (OR=10.6, 95%CI: 1.33-84.83, P=0.03), time since first visit (OR=0.9, 95%CI:0.84-0.99, P=0.04), preoperative weight loss (OR=0.9, 95%CI:0.86-0.98, P=0.01) and OAGB (OR=15.7, 95%CI:1.71-143.99, P=0.02) to have a significant impact on weight loss success 1 year after bariatric surgery. Patients with higher preoperative weight loss may have a poorer response to surgery. OAGB emerged as the most beneficial type of surgery in terms of weight loss. Intragastric balloon placement before surgery may be effective in patients above 65 years of age and may be considered as a two-stage approach.

Control of Eating Attributes and Weight Loss Outcomes over One Year After Sleeve Gastrectomy.

Sleeve gastrectomy (SG) is a commonly performed metabolic-bariatric surgery, but its effectiveness is variable and difficult to predict. Our study aimed to compare control of eating (CoE) attributes pre- and post-SG depending on the achievement of optimal weight loss target at 1year post-SG. A prospective longitudinal cohort study using the CoE Questionnaire, pre-SG, and postoperatively at 3, 6, and 12months was conducted. Total weight loss (TWL) ≥ 25% at 12months post-SG was set as an optimal weight loss target. Forty-one patients (80.5% females, mean age 41.7 ± 10.6) were included. Sex, age, baseline weight, BMI, and smoking status were all comparable. At 3months post-SG, "difficulty to control eating" score became significantly different between ≥ 25%TWL and < 25%TWL groups (7 [0-50] vs. 17 [5-63], p = 0.042). At 6months, it was followed by "feeling of fullness," "frequency of food cravings," and "difficulty to resist cravings" demonstrating significant differences between ≥ 25%TWL and < 25%TWL groups. At 12months, significant differences between groups were observed in "feeling hungry," "difficulty to resist cravings," "eating in response to cravings," and difficulty to control eating scores. Individuals with obesity who achieved a target of ≥ 25%TWL at 1year post-SG have an early improvement in overall eating control at 3months that steadily persists at 6 and 12months. Improvements in other aspects tend to follow later, at 6 and 12months. These findings may assist in identifying individuals with inadequate response to help attain optimal weight loss targets and developing a prognostic model to identify predictors of successful weight loss.

Higher degree of dysfunctional attitudes and beliefs and higher scores of frustration intolerance in women with unsuccessful weight loss

Background/Aim. Obesity is a chronic and relapsing condition, and since recently, it has been considered a global epidemic. Current guidelines for tripartite treatment of obesity emphasize a program of lifestyle modifications such as medical nutrition therapy, aerobic exercise, and behavioral intervention. The aim of the study was to evaluate whether specific psychological factors (general attitudes and beliefs and frustration tolerance) could be predictors of successful weight loss, i.e., factors that can be further addressed as part of the integrated therapy approach. Methods. A total of 84 consecutive overweight and obese female participants who were apparently healthy and homogeneous in age, level of education, and marital or employment status were prescribed the same medical nutrition therapy protocol as a single six-month therapeutic intervention. Prior to starting the therapy, the General Attitude and Belief Scale (GABS) and the Frustration Discomfort Scale (FDS) were administered. The participants were divided into two groups: successful (group A) and unsuccessful (group B). Group A, or the successful group [with the mean body mass index (BMI) ? standard deviation (SD) of 24.1 ? 5.81 kg/m2], consisted of 40 participants who have reached the corresponding loss, i.e., they lost ? 10% of the starting body weight (BW). Group B, or the unsuccessful group (with the mean BMI ? SD of 28.51 ? 2.74 kg/m2), consisted of 44 participants who have not reached the corresponding loss, i.e., they lost &lt; 10% of the starting BW. Results. Participants in group B had significantly higher scores (p &lt; 0.05) on the GABS subscales for the Need for Approval, Need for Comfort, and Other Downing. A statistically significant difference between groups (p &lt; 0.05) was shown for FDS subscales of Emotional Intolerance, Entitlement, and Achievement Frustration. Conclusion. Results of our study showed that participants who were unsuccessful in medical nutrition therapy had a higher degree of dysfunctional attitudes and beliefs and higher scores of frustration intolerance when compared to successful participants. The recommendation, based on our results, would be to include psychotherapeutic techniques in the integrative obesity treatment, aimed at cognitive changes and increasing frustration tolerance.

Factors that predict weight loss success differ by diet intervention type.

Many types of diet intervention can achieve negative energy balance and successful weight loss in persons with obesity. However, within any dietary strategy, there is large inter-individual variation in the weight loss response. The aim of this study is to determine factors that predict weight loss success for diet interventions that vary by macronutrient and caloric composition. Participants with BMI 30.0 to 49.9 kg/m2 self-selected one of three diet intervention trials for weight loss: low carbohydrate (LOW CHO), low fat (LOW FAT), or low calorie (LOW KCAL). Multivariable regression models were developed to determine the significance of predictor demographic, body composition, metabolic, clinical, and dietary variables for each diet type. Weight loss over 12-16 weeks averaging -5.1 ± 4.0 kg from baseline weight, p < 0.001, was not significantly different among diet types. Several different factors were identified that account for the inter-individual variance in weight loss success. Regardless of diet type, the most robust predictor of weight loss success was completion of the intervention, accounting for 20-30% of the variance. Factors predicting diet intervention completion were age, physical activity level, blood leptin level, blood pressure, and the amount of weight loss occurring. Differences by diet type in cardiometabolic risk factor reduction were identified with LOW CHO decreasing glycemia/insulinemia factors, LOW FAT decreasing lipidemia factors, and LOW KCAL decreasing inflammatory factors. These data provide evidence to inform more precise and personalized approaches to diet intervention for weight loss and cardiometabolic health.

1792-PUB: Predictors of Weight Loss Variability in the COVID-19 Disrupted ACT1ON Diet Pilot in Young Adults with T1D

We reported that young adults with T1D and overweight or obesity lost equivalent weight when randomized to 3 months of a hypocaloric low carb or moderate low fat diet or an ad libitum Mediterranean diet. The remainder of the 9 month study was disrupted by COVID-19. We identified predictors of weight loss variability between study enrollment and completion/dropout, accounting for % of participant study time during COVID-19. Potential predictors of % weight loss were identified a priori and included in multivariate models when univariate correlations had a p-value &amp;lt;0.2. General linear models used backward elimination. We introduced variables in groups (order: demographic and design, clinical, behavioral); the variable with the highest p-value was sequentially removed until those with p&amp;lt;0.2 remained. Crude weight changed by -0.87% (95%CI -2.6, 0.85, p=0.31, n=48) over 12 months (IQR 10.8, 12.9). Accounting for % COVID-19 time and study duration, 26.3% (model p=0.07) of weight loss variability was collectively explained by employment status (full-time lost less weight than unemployed), age at highest weight (weight loss decreased with younger age), education level (more weight loss with bachelor degree or higher than less education), and HbA1c (weight loss decreased with higher HbA1c, Table). Larger studies should confirm these findings and uncover additional predictors of weight loss success in T1D. Disclosure D.Igudesman: None. M.R.Kosorok: None. R.E.Pratley: Other Relationship; Bayer Inc., Corcept Therapeutics, Dexcom, Inc., Gasherbrum Bio, Inc., Hanmi Pharm. Co., Ltd., Hengrui (USA) Ltd., Merck Sharp &amp; Dohme Corp., Novo Nordisk, Pfizer Inc., Rivus Pharmaceuticals Inc., Sanofi, Scohia Pharma Inc., Sun Pharmaceutical Industries Ltd. D.M.Maahs: Advisory Panel; Medtronic, LifeScan Diabetes Institute, MannKind Corporation, Consultant; Abbott, Research Support; Dexcom, Inc. E.J.Mayer-davis: None. A.Addala: None. J.Crandell: None. F.R.Muntis: None. D.P.Zaharieva: Advisory Panel; Dexcom, Inc., Research Support; Hemsley Charitable Trust, International Society for Pediatric and Adolescent Diabetes, Insulet Corporation, Speaker's Bureau; American Diabetes Association, Ascensia Diabetes Care, Medtronic. J.Thomas: None. K.Corbin: None. A.Casu: None. M.Kirkman: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (1DP3DK113358-01)

Introducing zanadio-A Digitalized, Multimodal Program to Treat Obesity.

While the prevalence of overweight and obesity has been increasing annually, the accessibility of on-site treatment programs is not rising correspondingly. Digital, evidence-based obesity treatment programs could potentially alleviate this situation. The application zanadio has been developed to enable patients with obesity (BMI 30–45 kg/m2) to participate in a digital, multimodal weight reduction program based on current treatment guidelines. This article is divided into two parts: (I) it introduces zanadio, its aims and therapeutic concept, and (II) provides a first impression and demographic data on more than 11,000 patients from across the country who have used zanadio within the last 16 months, which demonstrates the demand for a digital obesity treatment. zanadio has the potential to partially close the current gap in obesity care. Future work should focus on identifying predictors of successful weight loss to further individualize digital obesity treatment, and an important next step would be to prevent obesity, i.e., to start the treatment at lower BMI levels, and to invent digital treatment programs for children and adolescents.

Long-Term Weight Loss Outcome of Laparoscopic Sleeve Gastrectomy Predicted by the Percentage of Excess Weight Loss at 6 Months in Chinese Patients with Body Mass Index ≥ 32.5 Kg/m2.

PurposeTo evaluate the predictive effect of the initial weight loss on the long-term weight loss in Chinese patients with a body mass index (BMI) ≥ 32.5 kg/m2 who underwent LSG.Patients and MethodsThe follow-up was completed via phone or WeChat for outpatients and at the hospital for inpatients. We evaluated the BMI, percentage of excess weight loss (%EWL), and type 2 diabetes mellitus, hypertension, and hyperlipidemia statuses. Linear and logistic regression analyses were performed on the relationship between the initial and long-term weight loss. The optimal cut-off value was determined by receiver operating characteristic (ROC) curve analysis.ResultsWe enrolled 307 patients, with a median preoperative BMI of 39.68 (35.68, 45.47) kg/m2. %EWL ≥ 50% was regarded as successful weight loss, and 76.55% of the patients lost their weight successfully. (Reviewer #1, comment #4) %EWL at 6 months and 5 years were positively correlated (P < 0.001). Further, the following linear equation could express the relationship: (%EWL5 years = 29.193 + 0.526 × %EWL6 months). %EWL ≥ 58.57% at 6 months was the best predictor of successful weight loss at 5 years after LSG (Reviewer #1, comment #5) (sensitivity, 73.62%; specificity, 73.61%; AUC value, 0.780). Internal verification of the prediction model revealed satisfactory results in terms of discrimination and calibration.ConclusionIn Chinese patients with BMI ≥ 32.5 kg/m2 who underwent LSG, %EWL at 6 months and 5 years were correlated. %EWL ≥ 58.57% at 6 months was a predictor of successful long-term weight loss.

The Effect of Insurance Status on Bariatric Surgery Outcomes: A Retrospective Chart Review Study.

Prior studies have shown socioeconomic factors and race to affect weight loss after bariatric surgery, but few have focused on the impact of insurance status. The purpose of this study was to determine if insurance status affects bariatric surgery patients' surgical outcomes and weight loss. A retrospective review was conducted of 408 bariatric patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or sleeve gastrectomy (SG). Patients were stratified by insurance status and surgery type to evaluate weight loss and surgical outcomes. Overall, patients experienced 71.0% excess weight loss at 1-year postoperatively. Patients undergoing LRYGB had greater percent excess weight loss (%EWL) at 1-year (74.5% vs 63.3%, P < .001) than SG patients. Upon multiple regression analysis, insurance type did not affect %EWL. Instead, younger age, female gender, LRYGB procedure, and lower initial BMI were all associated with greater %EWL. Insurance type is not a useful independent predictor of successful weight loss in bariatric surgery patients.

Predictors of successful weight loss in children treated at a community hospital-based tertiary care pediatric weight management program.

Childhood obesity is a major public health concern. However, predictors of successful outcomes for patients treated at multidisciplinary community hospital-based pediatric weight management programs remain poorly understood. We conducted a retrospective analysis to evaluate 633 pediatric patients from ages 2 to 18 at a tertiary pediatric weight management program in 2018. Predictors were evaluated in univariate comparisons, and significant variables were included in a linear regression analysis to identify factors associated with improvements in body mass index relative to the age- and sex-specific 95th percentile body mass index (%BMIp95). We found that male sex and increased number of clinical visits were independently and significantly associated with reductions in %BMIp95. Baseline %BMIp95, age, preferred language, and insurance status were not significant predictors of outcomes. A total of 398 (63%) patients experienced a decrease in %BMIp95 from baseline to follow-up. One quarter (24.8%) of patients experienced a decrease in %BMIp95 of at least 5%, a threshold associated with cardiometabolic improvements. Further, we observed significant improvements in cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, HbA1c, and waist circumference. These findings support a potential need for sex- and gender-tailored care as well as the benefits of increased access to pediatric weight management programs.

Psychological Outcomes and Predictors of Weight Loss in Adolescents With Severe Obesity Following a Reversible Endoscopic Bariatric Procedure.

Introduction: Adolescent and children obesity is a growing concern worldwide. Bariatric surgery is used as an effective treatment for adolescents with obesity and provides physical and mental health benefits. Application of alternative, minimally invasive, safe, and reversible endoscopic procedures, such as the Duodenojejunal bypass liner (DJBL), has been recently suggested as an effective treatment for adolescents with obesity. We explored specific psychological outcomes of adolescents with obesity during a year of follow-up after undergoing a reversible endoscopic bariatric procedure, and a year after removal. We were also interested in identifying psychological factors that could predict successful weight loss after the procedure.Methods: Nineteen adolescent with severe obesity undergoing DJBL procedure were psychologically assessed in an open-label, prospective clinical trial (NTC0218393), at the implantation of device and at the removal of device after 12 months. Control group of 26 adolescents with severe obesity were recruited from the same outpatient clinic undergoing only conservative treatment. In addition, adolescents from the intervention group were followed for 12 months after the removal of the device. The Youth Self Report (YSR) was used to assess adolescents' emotional and behavioural problems; The Multidimensional Body-Self Relations Questionnaire (MBSRQ) to assess body image and The Eating Disorder Examination Questionnaire (EDE-Q) to assess attitudes and behaviours related to eating disorder.Results: Significant improvements in somatic complain (F = 12.478, p = 0.001), emotional and behavioural problems (F = 7.169, p = 0.011) and food restraining (F = 9.605, p = 0.004) were found in the intervention group at device removal compared to the control group. Moreover, at the time of device removal compared to baseline, improvements in several psychological outcomes were found (F = 32.178 p = 0.000 for emotional and behavioural problems). Adolescents also became more satisfied with their appearance (F = 6.789, p = 0.019). Majority of observed changes remained stable at the next follow up a year after the device removal. Significant predictors of successful weight loss at device removal were fewer overeating episodes (B = 0.147, p = 0.022) and lower body satisfaction (B = 0.932, p = 0.013).Discussion: Following a reversible bariatric procedure, improvements of psychological (emotional and behavioural) factors were found in adolescents with severe obesity. Psychological predictors of successful weight loss were identified, showing the greatest importance of eating behaviour and body satisfaction in successful weight loss.

Preoperative Psychological Assessment and Weight Loss Outcomes in Bariatric Surgery Patients at a Military Treatment Facility: A Retrospective Profile Analysis.

Research on effectiveness of preoperative psychological measures as predictors of weight loss success and weight regain following bariatric surgery has been inconsistent. Despite mixed findings, preoperative psychological assessment instruments are used routinely, including in military medical facilities. Health concerns associated with obesity potentially impact military family readiness, with accompanying utilization of medical resources. Examining psychological factors associated with successful bariatric surgery outcomes may help to optimize care. This retrospective, observational study sought to identify characteristic elevations on two recommended preoperative psychological assessment instruments for bariatric surgery candidates: the Personality Assessment Inventory (PAI) and the Millon Behavioral Medicine Diagnostic (MBMD). Additionally, profile analysis was performed on assessment scales based on groupings of whether or not patients (N = 194) met their ideal BMI over a 60-month period. The Institutional Review Board at Madigan Army Medical Center approved this study protocol. Means and standard deviations for PAI and the MBMD are presented for this sample of benefits-eligible patients in the military health system. Measures between bariatric outcome groups were not significantly different, but characteristic elevations for bariatric surgery candidates overall were identified. The average elevations of scales were not above clinical cutoff, but still indicate characteristic trends in patients undergoing surgery at an MTF. These scales may be important to attend to with bariatric surgery candidates, especially scales which are related to psychopathology, treatment prognosis, and treatment management. Study results about scale elevations on preoperative psychological assessment instruments may help patients better manage bariatric surgery and can lead to enhanced warfighter readiness and decreased utilization of healthcare resources. Future work should examine postoperative behavioral and psychological factors, as the adjustment to lifestyle limitations of bariatric surgery is substantial.

Predictors of successful weight loss outcomes amongst individuals with obesity undergoing lifestyle interventions: A systematic review.

Understanding the predictors of weight loss with lifestyle interventions can help to ascertain the probable outcomes of individuals with obesity who undergo such interventions. This systematic review assessed the evidence of predictors of successful weight loss among individuals who are overweight or with obesity undergoing lifestyle interventions. Four electronic databases (PubMed, Cochrane Reviews, PsychInfo and Wiley) were searched to find relevant literature published in the past 20years. A total of 1351 titles were identified in the initial search, of which 23 studies were finally included. Predictors were synthesized in the domains of socio-demographic factors, anthropometric parameters, psychological and behavioural factors and intervention-based factors. The overall quality of evidence on predictors was then appraised using an adapted GRADE approach. Patient-specific factors such as being male, older in age, having existing cardiometabolic comorbidities and limited fat intake were significantly associated with weight loss success. Amongst intervention specific predictors, greater initial weight loss and higher adherence to lifestyle advice were associated with greater weight loss success. In this review, initial weight loss came out to be as the most important predictor of successful weight loss outcome.

Endoscopic intragastric balloon therapy for 15 years in Japan: Results of nationwide surveys.

Endoscopic intragastric balloon (IGB) placement has been performed in Japan since 2004. The nationwide surveys were repeatedly carried out to confirm the effectiveness and safety of IGB in Japan. We herein present the accumulated results. Twenty-six Japanese endoscopists personally imported products of the BioEnterics Intragastric Balloon (BIB)/Orbera system after completing the training courses in Japan. Mail surveys were posted to them every 2 years from 2010. This study included the accumulated data of the six surveys, and excluded data from non-Japanese patients and the Orbera365 data. Between 2004 and 2019, 399 obese Japanese patients underwent IGB treatment using the BIB/Orbera system. The incidence rates of early removal of IGB within 1week and complications due to IGB were 4.8% and 6.1%, respectively. The average percent excess weight loss (%EWL) and percent total weight loss (%TWL) at IGB removal were 46.6% and 11.5%, and successful weight loss, defined as %EWL ≥ 25% or %TWL ≥ 10%, was achieved in 65.6% or 54.5% of the patients, respectively. Multivariate analyses revealed that older age and larger saline filling volume were independent predictors of successful weight loss. At 1year after IGB removal, successful weight loss defined by the %EWL and %TWL was maintained in 44.7% and 34.1% of the patients, respectively. IGB therapy using the BIB/Orbera system has been safely and effectively performed in Japan. The successful weight loss may be associated with older age and larger saline filling volume.

Early Weight Loss Following Laparoscopic Sleeve Gastrectomy Is Predictive of Long-Term Weight Loss in Morbidly Obese Chinese.

Laparoscopic sleeve gastrectomy (LSG) is a bariatric surgical approach often used to treat Chinese individuals suffering from morbid obesity. To verify the long-term safety and efficiency of LSG and to evaluate the predictive effect of initial weight loss on long-term weight maintenance after LSG in morbidly obese Chinese. Follow-up was conducted by telephone or in hospital. We measured the body mass index (BMI), percentage of total body weight loss (%TWL), and excess weight loss (%EWL), and assessed patients for the alleviation of co-morbidities. Relationships between initial weight loss and successful weight maintenance were assessed via linear regression analyses, while optimal cutoff values were determined based on receiver operative characteristic (ROC) curves. We included 384 patients in this study. Before surgery, these patients had median weight and BMI values of 110 (91.00-130.75) kg and 38.49 (32.82-44.12) kg/m2, respectively. Successful weight loss of > 50% EWL was accomplished in 91.21%, 82.69%, and 79.37% of patients at 1, 3, and 5years after surgery. In addition, the %EWL at 6months was significantly correlated with the %EWL up to 5years (P < 0.001) in morbidly obese Chinese. Based on the ROC curve, the EWL of 56.54% at 6months was the best predictor of successful weight loss at 5years (sensitivity 72.38%, specificity 82.69%) in morbidly obese Chinese. LSG has long-term safety and efficacy for morbidly obese Chinese patients. The %EWL at 6months can be used to predict weight maintenance up to 5years after LSG.

Effectiveness of a self-regulation intervention for weight loss: A randomized controlled trial.

To evaluate effectiveness and acceptability of a novel intervention, based on self-regulation theory, for weight loss. A two-arm parallel group design was employed. Adult participants with a BMI≥30kg/m2 and the aim to lose weight were recruited and randomized to either a control or intervention group. Both groups were asked to weigh themselves daily for eight weeks. The intervention group was encouraged to use a weight tracking app, and complete daily and weekly questionnaires to prompt action planning, reflection, and evaluation of actions. Participants chose daily actions from a menu of 53 behaviours. The primary outcome was weight change after 8weeks, assessed using linear mixed effects models. At follow-up, 20 intervention group participants were interviewed regarding their experiences in the trial. 100 participants were recruited, and 98% were followed up at 8weeks. Mean weight loss was -4.18kg (SD=3.84) in the intervention compared to -1.01kg (SD=2.67) in the control group; the adjusted difference was -3.20kg (95% CI -4.49, -1.92). Participants rated the intervention's usefulness as 8.25 (SD=2.04) on a scale from 1 to 10. Adherence was a significant independent predictor of weight loss success (-1.54kg per one SD, 95% CI -2.16, -0.93), but not a mediator of the intervention effect. Participants reported that the intervention enabled them to experiment with and identify effective weight loss actions. Guiding participants through the self-regulation process was feasible, acceptable to participants, and led to significantly greater short-term weight loss than unguided self-weighing.

Laparoscopic Adjustable Gastric Banding\u2014Should a Second Chance Be Given?

BackgroundObesity is a chronic relapsing-remitting disease and a global pandemic, being associated with multiple comorbidities. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities.MethodsThe aim of this study was to evaluate the impact of weight loss following LAGB on obesity-associated comorbidities, and to identify factors that could predict better response to surgery, and patient sub-groups exhibiting greatest benefit. A total of 99 severely obese patients (81.2% women, mean age 44.19 ± 10.94 years, mean body mass index (BMI) 51.84 ± 8.77 kg/m2) underwent LAGB in a single institution. Results obtained 1, 2, and 5 years postoperatively were compared with the pre-operative values using SPPS software version 20.ResultsA significant drop in BMI was recorded throughout the follow-up period, as well as in A1c and triglycerides, with greatest improvement seen 2 years after surgery (51.8 ± 8.7 kg/m2 vs 42.3 ± 9.2 kg/m2, p < 0.05, 55.5 ± 19.1 mmol/mol vs 45.8 ± 13.7 mmol/mol, p < 0.05, and 2.2 ± 1.7 mmol/l vs 1.5 ± 0.6 mmol/l). Better outcomes were seen in younger patients, with lower duration of diabetes before surgery, and lower pre-operative systolic blood pressure.ConclusionsYounger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery can be important predictors of successful weight loss, making this group of patients the ideal candidates for LAGB.

Psychosocial and Behavioral Predictors of Successful Weight Loss in Individuals that are Obese

Psychosocial and Behavioral Predictors of Successful Weight Loss in Individuals that are Obese

Behavioural and psychological pretreatment predictors of short- and long-term weight loss among women with overweight and obesity.

This study aims at identifying behavioural and psychological pretreatment predictors of 12- and 36-month weight loss in women with overweight/obesity enrolled in a behavioural weight management intervention. A sample of 221 women participated in a randomized controlled trial on weight management (n12 month = 184; n36 month = 156). Multiple linear regressions were used to identify pretreatment predictors of successful weight loss, separately for intervention and control groups. Completers-only and baseline observation carried forward analyses were performed. This study is a secondary analysis of data from the 'Promotion of Exercise and Health in Obesity' randomized controlled trial. Fewer weight loss attempts in the last year positively predicted weight loss at 12 months in the intervention group, explaining 6% of the variance. At 36 months, in the intervention group, 20.2% of the variance in weight change was explained by lower eating disinhibition and higher weight-related quality of life in completers-only analyses, while baseline observation carried forward analyses explained only 9.8% of the variance in weight change via higher self-esteem and lower weight loss expectations. In the control group, higher exercise self-efficacy and a more internal weight locus of control predicted weight loss at 36 months, explaining 13.9% of the variance (completers-only analyses). Previous weight loss attempts were identified as the most efficient pretreatment predictor of 12-month weight loss. Eating disinhibition, weight-related quality of life, self-esteem, weight loss expectations, exercise self-efficacy, and weight locus of control seem to be key factors for long-term success. Level I, randomized controlled trial. ClinicalTrials.gov identifier NCT00513084.

Predictors of successful weight loss with relative maintenance of fat-free mass in individuals with overweight and obesity on an 8-week low-energy diet.

A low-energy diet (LED) is an effective approach to induce a rapid weight loss in individuals with overweight. However, reported disproportionally large losses of fat-free mass (FFM) after an LED trigger the question of adequate protein content. Additionally, not all individuals have the same degree of weight loss success. After an 8-week LED providing 5020 kJ/d for men and 4184 kJ/d for women (84/70 g protein/d) among overweight and obese adults, we aimed to investigate the relationship between protein intake relative to initial FFM and proportion of weight lost as FFM as well as the individual characteristics associated with weight loss success. We assessed all outcomes baseline and after the LED. A total of 286 participants (sixty-four men and 222 women) initiated the LED of which 82 % completed and 70 % achieved a substantial weight loss (defined as ≥8 %). Protein intake in the range 1·0-1·6 g protein/d per kg FFM at baseline for men and 1·1-2·2 g protein/d per kg FFM at baseline for women was not associated with loss of FFM (P = 0·632). Higher Three-Factor Eating Questionnaire (TFEQ) hunger at baseline and reductions in TFEQ disinhibition and hunger during the LED were associated with larger weight loss (all P ≤ 0·020); whereas lower sleep quality at baseline predicted less successful weight loss using intention to treat analysis (P = 0·021), possibly driven by those dropping out (n 81, P = 0·067 v. completers: n 198, P = 0·659). Thus, the protein intakes relative to initial FFM were sufficient for maintenance of FFM and specific eating behaviour characteristics were associated with weight loss success.

General psychopathology and impulsivity as the pre-treatment predictors of medical nutrition therapy outcome in the overweight and obese women

Background/Aim. Obesity is the chronic disease and health threatening condition. The number of obese people in the world has taken epidemic conditions. Medical nutritional therapy is the first choice in the treatment of obesity, but it is also accompanied with a great percentage of attrition and a significant weight regain. The aim of our study was to evaluate if psychiatric and specific psychological factors (impulsivity) could be the predictors of successful weight loss. Methods. A study sample consisted of 84 consecutive overweight/obesity women, 20 to 40 years old, who were willing to adhere to the medical nutrition therapy after the initial anthropometric measurements were performed. All participants received a personalized nutritional counseling and a daily diet treatment with 20% caloric restriction from estimated daily energy requirement. At the beginning of the study, the 90-item Symptom Check-list (SCL-90) and the 30-item Barratt Impulsiveness scale (BIS- 11) were administrated. At the end of six months of caloric restriction, the conventional diet therapy and control weight measurement, the patients were divided into two groups: the group I ? 40 participants (48%) who lost ? 10% of their initial body weight (successful group) and the group II ? 44 participants (52%) who lost &lt; 10% of their initial weight (unsuccessful). Results. There were no significant differences between groups in the demographic data (age, education level, employment, marital status), baseline anthropometric measurements, and in the general psychopathology total score. Groups I and II were significantly different in the total BIS-11 score (p &lt; 0.001) and in Factor II (motor impulsivity) (p &lt; 0.05). Conclusion. Even though the successful and unsuccessful diet responded participatnts did not differ in the general psychopathology and symptom dimensions, our results pointed out impulsivity as a discriminative factor between them. The total impulsivity and Factor II (motor impulsivity) as an indicator of binge eating were higher in the unsuccessfully responding overweight/obese women on the conventional diet treatment. A focus on impulsivity in a psychotherapeutic work might leed to better outcomes in the medical nutrition therapy.