From last supper to self‐initiated weight loss: Pretreatment weight change may be more important than previously thought

Abstract

Objective Evaluate the association between pre-treatment and during-treatment weight change. Evaluate differences in self-regulation between those who gain weight, remain weight stable, and lose weight pre-treatment. Methods Data from the first six months of a behavioral weight loss study were used. Participants (n=283) were weighed at two assessment points (screening visit and baseline) prior to the start of treatment and at every treatment session. Participants were divided into those who gained weight, remained weight stable, or lost weight between screening visit and the first treatment session. Results Pre-treatment weight change was not significantly associated with during-treatment change. Weight change from screening visit to month six was significantly different by category, with losses of 11% and 7% for those who lost and gained weight pre-treatment respectively. Weight change from first treatment session to month six was not different by category. Poorer self-regulation was associated with pre-treatment weight gain and better self-regulation with pre-treatment weight loss. Conclusions Pre-treatment weight change may not relate to success during behavioral weight loss treatment. Researchers should carefully consider when the “baseline” assessment takes place to reduce bias introduced by weight change during pre-treatment. Poorer self-regulation may place individuals at risk for weight gain prior to treatment.

Early weight loss predicts weight loss treatment response regardless of binge‐eating disorder status and pretreatment weight change

“…In contrast to an initial report (West et al, ), this is the second study to report no significant relationship between The Last Supper and weight loss outcomes (Kerrigan et al, ). The current data, in combination with the previous two last supper studies (West et al, ), highlight the importance of obtaining a true pre‐treatment weight at the first treatment appointment as individuals' weight can change dramatically between their initial screening/assessment appointment and when they actually start treatment (Kerrigan et al, ). Similarly, despite current participants reporting a wide range of Weight Suppression (0 to −92 pounds) and Pretreatment Weight Trajectories (from 37 pounds lost to 99 pounds gained in the year preceding treatment), neither variable was related to weight loss outcomes.…”

“…Even very early treatment nonadherence may be a signal for changing weight loss treatment approach (Unick et al, 2015). In contrast to an initial report (West et al, 2011), this is the second study to report no significant relationship between The Last Supper and weight loss outcomes (Kerrigan et al, 2016). The current data, in combination with the previous two last supper studies (West et al, 2011), highlight the importance of obtaining a true pre-treatment weight at the first treatment appointment as individuals' weight can change dramatically between their initial screening/assessment appointment and when they actually start treatment (Kerrigan et al, 2016).…”

“…Individuals who lost weight during the last supper time period lost significantly more weight during treatment compared with participants who either gained weight or had no weight change between intake assessment and their first treatment session (West et al, ). Recently, another weight loss trial utilizing similar methods found no weight loss treatment response differences among participants who gained, lost, or maintained weight between intake and first treatment appointments (Kerrigan et al, ). Thus, it is unclear whether the last supper is related to weight loss treatment outcomes.…”

“…Further, pretreatment weight trajectory may be differentially related to eating behaviors based on BED status (Ivezaj et al, 2014). The last supper was even first characterized among individuals with BED and overweight/obesity (Eldredge et al, 1994), yet neither outcome paper examined the potential impact of a BED diagnosis (Kerrigan et al, 2016;West et al, 2011), nor did the literature testing the relationship between early weight loss and treatment outcomes (Carels et al, 2003;Feig & Lowe, 2017;Fujioka et al, 2016;Unick et al, 2015;Waring et al, 2014).…”

Sociodemographic Characteristics Associated with Pretreatment Weight Change in a Behavioral Weight Loss Intervention

“…Three previous studies found that many participants experienced significant pretreatment weight change, between the initial screening visit (SV) and first baseline visit (BV), before beginning behavioral weight loss interventions [1,2,3]. Importantly, one study indicated that pretreatment weight change was associated with in-treatment outcomes [2].…”