High and Low Responders in a Comprehensive Lifestyle Program for Weight Loss - Secondary Analysis of a Randomized Controlled Trial

Abstract

Background/Objectives: Unhealthy lifestyle is often related to overweight and obesity and thus to chronic diseases. Web-based programs might be an option for a comprehensive approach to improving long-term weight management. Data from a randomized controlled trial (RCT) evaluating the impact of a lifestyle program on weight reduction were used for a secondary analysis. The objectives were (a) to identify potential predictors for marked weight loss, (b) to explore associations of weight reduction with changes in health-related variables, and (c) to evaluate whether self-monitoring of the daily lifestyle is associated with weight loss. Methods: 67 subjects with a body mass index of 28-35 who underwent the 1-year ‘Individual Health Management' (IHM) program were included in the analysis (mean age 49.8 years, 79% female). Two subgroups (high response: ≥7.5% weight reduction vs. low response: <7.5%) were compared in terms of sociodemographic data, baseline values, and pre-post changes of various risk and protective factors. A logistic regression was performed to identify potential predictors of weight loss. Results: 70% of the subjects fulfilled the criterion of high response. There were no statistically significant differences between the two subgroups with respect to sociodemographic and baseline data. Regression analysis failed to identify any predictors for the amount of weight reduction. Subjects with high response showed a more distinct improvement in life satisfaction and neurovegetative stability. The findings indicated an association between the level of self-monitoring and weight loss. Conclusions: More research is needed to establish optimal strategies for maximizing the longer-term maintenance of weight loss and prevention effects. For weight reduction, support strategies like feedback learning through self-monitoring, reporting systems, and self-performance measurement with questionnaires might ameliorate high-intensity lifestyle modification programs.

Self‐Monitoring via Digital Health in Weight Loss Interventions: A Systematic Review Among Adults with Overweight or Obesity

“…We identified 4,248 records in our database and hand searches. After the deduplication and screening stages, 53 papers describing 39 unique RCTs met all inclusion criteria (32‐84).…”

“…Supporting Information Table S2 describes the results of the risk of bias assessment. Thirty‐three trials were low risk (33‐35,40,41,44‐50,52‐57,59,60,62,69‐71,73,76‐82,84), and six trials were medium risk (32,42,66,68,74,83). No trials presented a high risk of bias.…”

“…Fourteen studies described weight outcomes by engagement level (33‐35,40,43,46,57,59,64,71,75,76,83,84), such as by reporting percent weight loss outcomes separately for low versus high self‐monitoring categories. Seven studies compared self‐monitoring outcomes by weight loss threshold (45,49,51,54,56,65,71), such as by showing self‐monitoring frequencies between participants with ≥ 5% versus < 5% weight loss.…”

How to Become an Agent of One's Own Healing Processes: Self-Management for Chronically Ill Patients in Integrative Health Care

“…Melchart's [17] self-managed lifestyle interventions coach people individually to prevent diseases. In this study, his group analyzed patients who dropped out from the intervention in order to find out which persons do not benefit from the approach of daily feedback [18].…”

The TALENT II study: a randomized controlled trial assessing the impact of an individual health management (IHM) on stress reduction

“…Main objective and target parameter of the study will be stress-reduction, although the basic concept of IHM (Individual Health Management) is very broad and multifaceted [ 10 ]. The sustainability of IHM has already been proven due to an all-embracing change in lifestyle [ 11 , 12 ].…”