Small weight gains during obesity treatment: normative or cause for concern?

Abstract

SummaryObjectivesThe objectives of the study are to characterize the frequency and size of small weight gains during behavioural weight loss treatment and to evaluate the relationship between small weight gains and weight loss outcomes.MethodsParticipants (n = 281) in a year‐long behavioural weight loss programme were weighed at treatment sessions, and between‐session weight gains were classified into several categories based on size. The occurrence of different gain magnitudes and their relation to weight loss were examined during both the active weight loss (months 1–6) and weight loss maintenance (months 7–12) phases of treatment.ResultsWeight gains were common during both phases of treatment, with smaller gains occurring more frequently than larger gains. Greater frequency of all gain magnitudes was associated with lesser weight loss during both phases. Additionally, participants who had just one or two weight gains of the smallest size examined (1.0–1.9 lb) lost less weight than those who had no gains.ConclusionsSmall gains appear to reflect true weight gain due to poor adherence to behavioural recommendations and are associated with worse weight loss outcomes, even when limited in number. Future research should examine how best to prevent small weight gains from occurring and how clinicians and participants should respond when a weight gain does occur to promote weight control success.

Associations between self-monitoring and weight change in behavioral weight loss interventions.

“…This may have led participants to avoid self-monitoring, which might remind them of poor outcomes and associated unpleasant emotions (Tanenbaum et al, 2016). Although the current finding requires replication, it suggests that interventionists delivering in-person, group-based treatments should be aware that minor (month-to-month) weight loss failures can have problematic consequences (Schumacher et al, 2016). Future research may evaluate evidence-based strategies specific to coping with weight loss failure during BWL treatment.…”

“…should be aware that minor (month-to-month) weight loss failures can have problematic consequences (Schumacher et al, 2016). Future research may evaluate evidence-based strategies specific to coping with weight loss failure during BWL treatment.…”

Variability in Weight Change Early in Behavioral Weight Loss Treatment: Theoretical and Clinical Implications

“…For example, even one small weight gain during treatment has been shown to predict poorer outcomes. 25 Weight loss programs may be able to increase efficacy by placing a higher focus on consistency in weight losses week to week, but a better understanding of the importance of a steady weight trajectory is needed.…”