Successful Weight Loss Research Articles

Effect of participant baseline characteristics on adherence to self-monitoring of diet, physical activity and weight in a 12-month weight loss mHealth trial

Abstract Background Self-monitoring (SM) of lifestyle behaviors is the centerpiece of standard behavioral treatment (SBT) for weight loss as SM increases one’s awareness of their behaviors. Extensive evidence demonstrates a significant relationship between adherence to SM and successful weight loss outcomes. Purpose Examine baseline characteristics of participants that are associated with higher adherence to SM of diet, physical activity (PA), and weight in a 12-month mHealth weight loss trial. Methods SMARTER was a single-site, 2-arm randomized controlled trial. We randomized 502 adults with a body mass index (BMI) 27-43 kg/m2 to diet, weight, and PA SM plus tailored feedback messages (SM+FB, n=251) or SM alone (n=251). We provided the SM+FB group feedback messages via the SMARTER app on diet daily, PA every other day and weight weekly. The study provided a wearable PA tracker and smart scale for weight and utilized a smartphone app for dietary SM. Adherence of dietary SM was defined as the % of days with ≥50% of calorie goal recorded and PA SM was % of days with ≥500 steps. Weight SM was the % of days with weight based on the scale record. Linear mixed modeling was applied to assess the monthly percent adherence to SM of diet, PA, and weight over a 12-month period. Our analysis incorporated time effects in months and polynomials of time, treatment group assignment (SM+FB vs. SM), baseline variables of interest (e.g., BMI, age, sex, race, education years, income), and the interactions between treatment and time effects with other variables. For parsimony, non-significant effects were removed. Results The sample (N=502) was 82% white (n=414), 79% female (n=399), and had a mean age of 45.0±14.4 years and BMI of 33.7±4.0 kg/m2. Over 12 months, percent adherence to SM of diet, PA, and weight declined non-linearly. Treatment groups did not demonstrate significant differences. The impact of treatment on the monthly decline in adherence to diet SM was curvilinear and varied significantly over 12 months. Older age was associated with greater adherence to the SM of diet (b=0.72, 95% CI: 0.55-0.88, P < .0001), PA (b=0.50, 95% CI: 0.35-0.66, P < .0001), and weight (b=0.71, 95% CI: 0.57-0.85, P < .0001). Conversely, higher baseline BMI was associated with lower adherence to SM of diet (b=-1.14, 95% CI: -1.73 to -0.55, P < .0001) and PA (b=-0.79, 95% CI: -1.35 to -0.22, P= .006). Other baseline variables were not significantly related to adherence. Conclusion The findings suggest that individuals with a higher BMI at baseline may need additional enhancement strategies to improve their engagement with the digital tools for SM lifestyle which could lead to improved weight outcomes.

Patient, facility, and environmental factors associated with obesity treatment in US Veterans.

Identifying patient-, facility-, and environment-level factors that influence the initiation and retention of comprehensive lifestyle management interventions (CLMI) for urban and rural Veterans could improve obesity treatment and reach at Veterans Affairs (VA) facilities. This study identified factors at these various levels that predicted treatment engagement, retention, and weight management among urban and rural Veterans. A retrospective cohort study of 631,325 Veterans was designed using VA databases to identify Veterans with class II and III obesity during 2015-2017. Primary outcomes were initiation of CLMI, bariatric surgery, or obesity pharmacotherapy within 1year of index date. Secondary outcomes included treatment retention and successful weight loss. Generalized linear mixed models were used to evaluate the relationships between factors and obesity-related outcomes, with rurality differences assessed through interaction terms. Patient characteristics associated with increased odds of initiating CLMI included female sex (p<0.001), black race (p<0.001), sleep apnea (p<0.001), mood disorder (p<0.001), and use of medications associated with weight loss (p<0.001) or weight gain (p<0.001). Facility use of telehealth was associated with greater odds of CLMI initiation in urban Veterans (p<0.001) but lower retention in both populations (p=0.003). Routine consideration of pharmacotherapy was associated with higher CLMI initiation. Environmental characteristics associated with increased odds of CLMI initiation included percent of population foreign born (OR=1.03 per 10% increase; p<0.001), percent black (p<0.001), and high walkability index (p<0.001). The relationship between total population and CLMI initiation differed by rurality, as greater population was associated with lower odds of CLMI initiation in urban areas (OR: 0.99 per 1000 population; p<0.001), but higher odds in rural areas (OR:1.01, p=0.01). Veterans in the south were less likely to initiate CLMI and had lower retention (p<0.001). Treatment and retention of CLMI among Veterans remain low, highlighting areas for improvement to expand its reach both urban and rural Veterans.

Weight management medications for chronic use in 37 veterans affairs medical centers-A medication use evaluation.

Controlled trials have demonstrated successful weight loss associated with certain weight management medications (WMMs). However, there are limited real-world data on prescribing patterns and efficacy and safety profiles of WMMs in Veterans Affairs (VA) patients. To evaluate: utilization patterns of WMMs liraglutide, naltrexone/bupropion, orlistat, phentermine, phentermine/topiramate, and semaglutide; weight loss at three, six, twelve, and more than 12 months; safety; and treatment barriers. A retrospective, cross-sectional medication use evaluation (MUE) was conducted using electronic health records of outpatient Veterans newly initiated on WMMs at 37 VA Medical Centers between 1 March 2020 and 31 March 2022. Chart review was used to identify WMM utilization and capture rates of clinical response, defined as 5% and 10% or greater weight loss at the final weight, adverse drug events (ADEs), non-adherence, and discontinuations. Site-specific surveys evaluated local practices and barriers. Among 1959 eligible Veterans, semaglutide, phentermine/topiramate, and orlistat were most frequently prescribed. The clinical response was highest among phentermine/topiramate, liraglutide, and semaglutide. Naltrexone/bupropion and phentermine demonstrated the highest and lowest ADE rates, respectively. Potential barriers to WMM utilization and successful treatment by site reports were drug shortages, patient perceptions of therapeutic course, personal preferences, and VA WMM use criteria. Smaller weight loss and higher discontinuation rates were observed relative to clinical trials. The MUE data allow for better assessment of benefits and risks for Veterans prescribed WMMs.

COVID-19 Pandemic Telemedicine Compared to Pre-pandemic In-person Delivery of the New Direction® Program for Weight Loss Success

COVID-19 Pandemic Telemedicine Compared to Pre-pandemic In-person Delivery of the New Direction® Program for Weight Loss Success

Use of liraglutide after bariatric surgery: a 36-month follow-up in a real-world setting in Chile.

Bariatric surgery has several benefits, including sustainable weight loss and improvement or resolution of metabolic comorbidities. However, despite initially successful weight loss, weight regain occurs during long-term follow-up, and many patients are unable to reach or maintain their target weight goals. Liraglutide is a therapy for obesity aimed at preventing weight regain. This retrospective, observational, single-arm, pre-post study was performed to analyze the relative change in body weight among patients receiving liraglutide after bariatric surgery in a real-world setting in Chile. Treatment with liraglutide at a median dose of 1.2 mg was associated with a mean weight loss from baseline to 3, 6, 12, 24, and 36 months of 5%, 7.7%, 7.6%, 5.8%, and 5.1%, respectively. The mean body mass index reduction was 14.8% at 36 months. Dropout rates were consistent with those of usual obesity treatments. Overall, 70% of the patients were receiving other weight-loss drugs. Liraglutide was well tolerated, but cost barriers led to several patients interrupting its use. Liraglutide is an effective and safe treatment for weight reduction after bariatric surgery in patients receiving routine clinical care in Chile.

Neighborhood Characteristics Related to Changes in Anthropometrics During a Lifestyle Intervention for Persons with Obesity.

Since obesity has emerged as a major public health concern, there is an urgent need to better understand factors related to weight gain and treatment success. This study included 118 persons with obesity who participated in a multidisciplinary combined lifestyle intervention with cognitive-behavioral therapy at the outpatient clinic ofthe Obesity Center CGG at Erasmus University Medical Center, Rotterdam, The Netherlands. Neighborhood characteristics were assessed using a 13-item questionnaire. Multiple regression analyses were performed to examine the association between perceived safety, social cohesion, and the availability of facilities on relative changes in body mass index and waist circumference changes, adjusted for corresponding neighborhood socioeconomic status scores. Higher total scores, indicating more unfavorable neighborhood perceptions, were associated with less relative improvements in BMI and waist circumference after 1.5years (β = 3.2, 95%CI 0.3-6.0; β = 3.4, 95%CI 0.3-6.6, respectively). Also, more neighborhood unsafety was associated with less relative improvements in BMI and waist circumference on the long term (β = 3.1, 95%CI 1.1-5.1; β = 2.8, 95%CI 0.6-5.1, respectively). The results indicate that living in a neighborhood perceived as less favorable may lower the chances of successful weight loss in response to combined lifestyle interventions in persons with obesity.

Healthy Lifestyle and Cardiac Rehabilitation for Weight Loss.

Considerable current interest is directed at pharmacological agents for producing significant weight loss. However, healthy lifestyle choices can also lead to clinically meaningful weight loss and improvements in cardiovascular disease (CVD) risk factors. In this review, we summarize the recent research from our PROmoting Successful Weight Loss in Primary CarE in Louisiana (PROPEL) randomized controlled trial and review previous data on the potential benefits of cardiac rehabilitation and exercise training (CRET) programs to produce weight loss and improvements in CVD risk factors. Although obesity medications are becoming extremely attractive for secondary and even primary CVD prevention, high-intensity non-pharmacological therapies with healthy lifestyle choices reviewed herein can also lead to substantial health improvements in patients with obesity, including improvements in body weight and other body composition parameters as well as overall CVD risk.

Nutritional Challenges and Treatment After Bariatric Surgery.

Bariatric surgery is an important weight loss tool in individuals with severe obesity. It is currently the most effective long-term weight loss treatment that lowers obesity-related comorbidities. It also has significant physiological and nutritional consequences that can result in gastrointestinal complications and micronutrient deficiencies. After gastric bypass, clinical events that negatively affect nutritional status include malabsorption, dumping syndrome, kidney stones, altered intestinal bile acid availability, bowel obstruction, ulcers, gastroesophageal reflux, and bacterial overgrowth. Risk factors for poor nutritional status and excessive loss of lean body mass and bone include reduced dietary quality and inadequate intake, altered nutrient absorption, and poor patient compliance with nutrient supplementation. There are unique concerns in adolescents, older individuals, and individuals who become pregnant postoperatively. With careful management, health-care professionals can assist with long-term weight loss success and minimize the risk of acute and long-term nutrition complications after bariatric surgery.

Successful Weight Loss in Adolescents with Overweight or Obesity Using a Swallowable Intragastric Balloon and Nutritional Oversight

PurposeMedical devices benefit patients living with overweight or obesity, but studies in the adolescent population are lacking. The goal of this study was to collect information on the performance and safety of a swallowable intragastric balloon program (SGBP) in adolescent patients.Materials and MethodsData were collected retrospectively on patients aged 15 to 17 years with body mass index (BMI) ≥ 27 kg/m2 who received the swallowable intragastric balloon (SGB) and associated lifestyle and nutritional change program. Patients had not responded to previous dietary and behavioral modification weight loss treatments and elected to undergo SGBP. The SGB was swallowed and filled with 550 mL of distilled water in an outpatient setting, and a multidisciplinary team delivered a lifestyle/nutritional change program. Mean % total body weight loss (%TBWL) was calculated for each patient compared with baseline.ResultsA total of 91 patients, 69 (75.8%) female and 22 (24.2%) male, underwent SGBP and completed follow-up through SGB passage at 4 months. Baseline mean ± SD age, weight, and BMI were 16.4 ± 0.77, 99.70 ± 21.33 kg, and 35.60 ± 5.59 kg/m2, respectively. After 4 months, mean weight and BMI were 86.37 ± 18.83 kg and 30.86 ± 5.16 kg/m2 respectively; %TBWL was 13.05 ± 7.64 (1-sided t-test, p < 0.0001). Most (80, 87.9%) reported no adverse events; 11/91 (12.1%) experienced an adverse event. Of these, 9/91 (9.9%) experienced nausea and/or vomiting; 1/91 (1.1%) reported abdominal pain only; 1/91 (1.1%) reported flatulence only. There were no serious adverse events or premature device removals.ConclusionThe SGBP provides safe and effective short-term weight loss in adolescents living with overweight and obesity.Graphical

Elevated Interleukin-6 Is Associated with Successful Weight Loss 3 Months Postlaparoscopic Sleeve Gastrectomy.

Bariatric surgery poses an ever-increasing importance in the effective and long-lasting treatment of obesity, a condition strongly associated with inflammation and increased risk of other diseases and health problems. In obesity-related inflammation, maintaining a balance between pro-inflammatory and anti-inflammatory cytokines is crucial. In this study, we examined early effects of laparoscopic sleeve gastrectomy (LSG) on inflammatory and anti-inflammatory cytokines in obese patients, and assessed their effect on postoperative weight loss. This prospective cohort study was conducted from September 2022 till June 2023. Fifty obese adults were enrolled for LSG. All patients underwent assessments of body measurements, as well as levels of interleukin-6 (IL-6), interleukin-10 (IL-10), and TNF-alpha at baseline and 3months postsurgery. We developed a decision tree model to predict the success of weight loss. At 3months postsurgery, patients lost 18.9 ± 6.9kg of excess body weight. A significant decrease was observed for IL-10 (p < 0.0001), simultaneously with a significant increase in IL-6 (p < 0.0001). We found that high IL-6 (> 1.169pg/mL) levels could contribute to an effective weight loss among patients with a baseline BMI less than 47.46kg/m2. Study revealed that 3months after bariatric surgery, inflammation persists, and its markers significantly influence postoperative weight loss, as indicated by BMI range. Distinct behaviors of IL-10 and IL-6 in relation to obesity underline the necessity of considering individual cytokine profiles when evaluating bariatric surgery outcomes.

Cohort profile: study design and baseline characteristics of an observational longitudinal weight loss cohort and biorepository of patients undergoing sleeve gastrectomy in the USA

PurposeWe developed a comprehensive sleeve gastrectomy (SG) weight loss study cohort and biorepository to uncover mechanisms, biomarkers and predictive factors of weight loss, weight maintenance and amelioration of obesity-related comorbidities....

Energy balance and obesity: the emerging role of glucagon like peptide-1 receptor agonists.

With obesity affecting over one billion people globally, understanding and managing this complex condition is more crucial than ever. This review explores the emerging role of GLP-1 receptor agonists (GLP-1RA) in weight management, focusing on their impact on energy balance. It highlights the necessity of this investigation due to the limited knowledge on both the short-term and long-term implications of GLP-1RA on energy expenditure (EE) and energy intake (EI). GLP-1RA, such as liraglutide and semaglutide, have shown significant efficacy in promoting weight loss by reducing appetite, cravings and consequently, EI. Newer medications such as tirzepatide have demonstrated even greater weight loss success. Emerging evidence also suggests potential effects on EE, which could explain the greater weight loss success achieved with GLP-1 RA rather than typical lifestyle changes. However, comprehensive data on the total impact of these drugs on energy balance remain limited. The findings underscore the promising role of GLP-1RA in obesity management, particularly through mechanisms influencing both EI and EE. Future research should focus on systematically measuring all components of energy balance to fully elucidate the mechanisms of GLP-1RA and optimize their therapeutic use for personalized medicine.

Nondietary psychological app program leads to sustained weight loss due to trained physiological satiety perception.

Obese people are mostly unable to maintain successful weight loss after the end of a dietary change. One reason is that conventional weight reduction concepts neglect physiological hunger and satiety perception, leading to a relapse to previous eating habits on the long run. We examined the long-term efficacy of a psychological smartphone weight loss program, which avoids any dietary instructions and aims at relearning of satiety perception. Parameters of body weight alterations and psychological features, for example, satiety perception, food cravings, and emotional eating, were explored in a nonrandomized experimental study comprising 75 obese participants. Measurements occurred at baseline, two times during program application, as well as at 6- and 12-month follow-up. Participants displayed significant weight loss during the entire study period (p = .029) and showed an improved body composition at the 6-month follow-up (p = .018). These effects were associated with increased satiety perception, as well as reduced food cravings, and emotional eating habits. Notably, all improvements in measured parameters significantly sustained between the end of the program and the 12-month follow-up (p < .005 for all). Psychological relearning of satiety perception may outclass dietary approaches in terms of long-term efficiency.

Development and Validation of the GAASThyriC Model for Predicting Patients with Suboptimal Clinical Response After Laparoscopic Sleeve Gastrectomy and a Practical Calculator: A Retrospective Cohort Study.

It might not be possible to achieve the desired outcome in every patient following bariatric surgery, even though every patient is thoroughly examined before surgery. This study aimed to develop a regression model based on parameters that affect weight loss success in patients scheduled for laparoscopic sleeve gastrectomy (LSG) and thus preoperatively predict whether the patients will have an optimal clinical response in terms of weight loss at the end of the first year. Between January 2018 and August 2022, patients who underwent LSG were analyzed retrospectively. Age, sex, comorbidities, smoking status, alcohol use status, preoperative weight, preoperative body mass index (BMI), preoperative laboratory data, weight, and total weight loss (TWL)% values at the end of the first year were recorded. At the end of the first year following LSG, patients with TWL% above 20% were defined as having an optimal clinical response in terms of weight loss. This study is designed, conducted, and reported regarding the "transparent reporting of a multivariable prediction model for individual prognosis or diagnosis" (TRIPOD) statement. The final model was used to construct an Excel-based calculator. Four hundred thirty-eight patients underwent the sleeve gastrectomy procedure, and 38 of them were excluded from the study because of a lack of 1-year follow-up information, resulting in 400 eligible patients for our study. Age, glucose, thyroid stimulating hormone (TSH), alcohol consumption, systemic immune inflammation index (SII), and tobacco were the independent predictors of optimal clinical response ( P <0.001, P <0.001, P <0.001, P =0.011, P =0.039, P =0.045, respectively). The model was called the GAASThyriC score. When the final model was tested in the validation cohort, the AUC was 0.875 (95% CI, 0.742-0.999), the sensitivity was 83.3% (95% CI, 51.6-97.9), specificity was 86.4% (95% CI, 77.4-92.8), negative likelihood ratio was 0.19 (95% CI, 0.05-0.68), and accuracy was 86% (95% CI, 77.6-92.1) when the cutoff value was set to the optimal threshold (logit = 0.8451). The GAASThyriC score can be used as an effective auxiliary tool to predict the patient population with suboptimal clinical response in terms of TWL% at the end of the first year after LSG.

Changes in Serum Metabolome Following Low-Energy Diet-Induced Weight Loss in Women with Overweight and Prediabetes: A PREVIEW-New Zealand Sub-Study.

As obesity develops, metabolic changes increase the risk of non-communicable diseases such as type 2 diabetes (T2D). Weight loss is crucial for improving health in T2D and cardiometabolic conditions. However, weight loss rates vary between individuals, even with identical diets or energy restrictions, highlighting the need to identify markers or predictors of weight loss success to enhance intervention outcomes. Using nuclear magnetic resonance (NMR) spectroscopy-based metabolomics, we investigated the change in serum polar metabolites in 28 women with overweight or obesity and prediabetes who completed an 8-week low-energy diet (LED) as part of the PREVIEW (PREVention of diabetes through lifestyle intervention and population studies in Europe and around the World) clinical trial. We aimed to characterize the metabolic shift in substrate oxidation under fixed energy intake (~4 MJ/day) and its relation to weight loss success. Nine of the thirty-four serum metabolites identified significantly changed during the LED phase: 3-hydroxybutyrate, O-acetylcarnitine, 2-hydroxybutyrate, mannose, dimethyl sulfone and isobutyrate increased, whilst choline, creatine and tyrosine decreased. These results confirmed a shift towards lipid oxidation, but no metabolites predicted the response to the LED-induced weight loss. Further studies in larger populations are required to validate these metabolites as biomarkers of diet exposure.

The effectiveness and health impact of fad diets on obese patients: a literature review

Introduction and purpose Obesity is a serious health problem nowadays and it is becoming more and more common. There are plenty of causes of obesity including bad eating habits, genetic factors, and psychological factors. A lot of obese people look for a way to lose weight. Fad diets are popular dietary strategies which are promoted as a quick way to lose weight. This article highlights some popular dietary strategies including low-carbohydrate diet, low-fat diet, Paleolithic Diet and Detox Diet. The aim of this paper is to analyse their effectiveness in the process of successful weight loss and their health impact. State of knowledge According to WHO in 2022 1 in 8 people in the world were obese. Fad diets are promoted as methods to improve health and as a quick way to lose weight. However, available research suggests a rather unfavorable impact on human health in the context of long-term adherence to these diets. Limited data suggests the beneficial long-term health impact of such diets. Moreover, dieting and weight cycling caused by the repetitive process of weight loss after dieting and weight regain afterwards may also play a role in the development of obesity. Conclusion Fad diets are not recommended as a long-term way of nutrition. The main limitation of these dietary strategies is their short-term effectiveness rather than long-term. Adherence to these diets is hard for patients. Because of their strict rules and food exclusions, the risk of weight regain is high. Moreover, they do not show many positive long-term health consequences and they are not superior to conventional healthy diets. What’s more, strict obedience to fad diets for extended periods of time may be detrimental to the dieter's health.

Exploring Determinants of Successful Weight Loss with the Use of a Smartphone Healthcare Application: Secondary Analysis of a Randomized Clinical Trial.

Dietary and physical activity interventions through smartphone healthcare applications (apps) have recently surged in popularity as effective methods for weight loss. However, the specific factors contributing to successful weight loss remain uncertain. We conducted an analysis of baseline characteristics and app usage frequencies over three months among 68 Japanese adults with overweight and obesity who were assigned to the intervention group in a previous randomized controlled trial. Logistic regression analysis revealed a negative association (OR: 0.248; p = 0.018) between having a walking habit at baseline and successful weight loss, defined as a 3% reduction in initial weight. Additionally, slower walking speeds and family medical history were identified as potential predictors of successful weight loss. These findings offer insights into the profile of individuals who achieve success in weight loss through our smartphone app, providing valuable guidance for the development of future healthcare apps.

Impact of Bariatric Surgery on metabolic health in a Uruguayan cohort and the emerging predictive role of FSTL1

Obesity poses significant challenges, necessitating comprehensive strategies for effective intervention. Bariatric Surgery (BS) has emerged as a crucial therapeutic approach, demonstrating success in weight loss and comorbidity improvement. This study aimed to evaluate the outcomes of BS in a cohort of 48 Uruguayan patients and investigate the interplay between BS and clinical and metabolic features, with a specific focus on FSTL1, an emerging biomarker associated with obesity and inflammation. We quantitatively analyzed BS outcomes and constructed linear models to identify variables impacting BS success. The study revealed the effectiveness of BS in improving metabolic and clinical parameters. Importantly, variables correlating with BS success were identified, with higher pre-surgical FSTL1 levels associated with an increased effect of BS on BMI reduction. FSTL1 levels were measured from patient plasma using an ELISA kit pre-surgery and six months after. This research, despite limitations of a small sample size and limited follow-up time, contributes valuable insights into understanding and predicting the success of BS, highlighting the potential role of FSTL1 as a useful biomarker in obesity.

Perception of Weight Loss Success Is Associated With Exercise Identity and Satisfaction of Weight Loss Experience

Perception of Weight Loss Success Is Associated With Exercise Identity and Satisfaction of Weight Loss Experience

The Effect of the Single-Anastomosis Duodeno-Ileal Bypass With Sleeve Gastrectomy (SADI-S) on Circulating Concentrations of 25-OH Vitamin D and B12 at 1 Year Postsurgery

More than 650 million adults in the world are obese. Bariatric surgery has proven to be an effective treatment; however, it is underutilized. A relatively new procedure, the single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), has shown greater weight loss success than leading procedures but little is known about its effects on nutrient deficiencies. The present review aims to explore the effects of the SADI-S on blood concentrations of 25-OH vitamin D and vitamin B12 up to 1 year postsurgery. Findings suggest that vitamin D deficiency is more prevalent than vitamin B12 deficiency in patients who have undergone the SADI-S; however, there was no clear cause and effect relationship.