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

Abstract

ObjectiveResponse early in weight loss treatment predicts long-term weight change. Weight variability, independent of absolute early weight change, may also relate to long-term outcomes. This study examined whether weight variability early in treatment predicted later weight loss and maintenance.MethodsParticipants were 183 completers of a yearlong behavioral weight loss program (M age = 51, 81% female, 69% white, M body mass index = 35 kg/m2). Weight variability was calculated using weights from the first 6 and 12 weekly treatment sessions. Multiple linear regressions examined whether weight variability predicted subsequent weight change 6, 12, and 24 months later.ResultsWeight variability over 6 and 12 weeks predicted less subsequent weight loss at 12 (6-week: β = 0.18, p = 0.02; 12-week: β = 0.33, p < 0.01) and 24 (6-week: β = 0.17, p = 0.03; 12-week: β = 0.15, p = 0.05) months. Relationships held adjusting for covariates. Weight variability was more strongly associated with 6-month weight change in men than women (β = 0.27, p = 0.01).ConclusionsElevated weight variability early in a weight loss program predicted poor long-term outcomes, possibly reflecting inconsistent weight control behaviors. Tracking weight variability could prove useful for improving treatment outcome.

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

“…While the average weight loss was relatively small, effect sizes for both intervention conditions were medium to medium‐large and there was much variability, with approximately 25% of participants receiving treatment reaching a clinically meaningful weight loss of 5% or more by 3‐month follow‐up (Barnes et al, ). The current data support previously published trials examining Early Weight Loss (Carels et al, ; Feig & Lowe, ; Fujioka et al, ; Nackers et al, ; Unick et al, ; Waring et al, ) and extend them to individuals diagnosed with BED. The findings maintained through post‐treatment regardless of how weight loss outcomes were calculated.…”

“…The findings maintained through post-treatment regardless of how weight loss outcomes were calculated. We note, however, that to our knowledge, this is only the second paper to examine "subsequent" weight loss (i.e., calculated currently as "Weight Loss-Subsequent" (Feig & Lowe, 2017)), and that the remaining research reports did not specify whether or not there was overlap between the calculation of Early Weight Loss and weight loss outcome variables (i.e., calculated currently as "Weight Loss-Overall"; Carels et al, 2003;Fujioka et al, 2016;Nackers et al, 2010;Unick et al, 2015;Waring et al, 2014).…”

“…Closer examination of factors related to Early Weight Loss also will be important for future research. Based on previous studies, variables of interest include a more consistent pattern of initial weight loss (Feig & Lowe, 2017) and treatment adherence (Nackers et al, 2010;Unick et al, 2015). Even very early treatment nonadherence may be a signal for changing weight loss treatment approach (Unick et al, 2015).…”

“…"Early Weight Loss," or participants' initial weight loss in treatment, may be predictive of weight loss treatment outcomes (Carels, Cacciapaglia, Douglass, Rydin, & O'Brien, 2003;Nackers, Ross, & Perri, 2010) as far as one (Fujioka et al, 2016;Waring et al, 2014) to two (Feig & Lowe, 2017) years and up to four and eight years (Unick et al, 2015) following treatment. Studies of early weight loss suggest that participants who lose more weight initially during treatment will continue to lose significantly more weight compared with individuals who do not.…”

“…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).…”