Continued Weight Loss More Likely for Those Who Lose the Most Weight

BOSTON — A review of medical records from more than 177 000 people showed that those who lost the most weight were the most likely to keep losing weight after 2 years and the least likely to “cycle” between periods of weight loss and weight gain.

Additionally, those people who lost the least amount of weight were also the most likely to regain at least 50% of the weight they lost.

Researchers reviewed records of adults with a BMI of 30 or greater who had no medical conditions associated with unintentional weight loss and who had at least 4 BMI measurements per year for at least 5 years. Patients were categorized into 4 weight groups based on their amount of weight change during a 6-month period (Table 1).

Table 1: Weight loss groups

	Change in BMI	Population (%)
Stable weight	<5% of index BMI	151 236 (85.1%)
Modest weight loss	≥5% to <10% of index BMI lost	16 559 (9.3%)
Moderate weight loss	≥10% to <15% of index BMI lost	4017 (2.3%)
High weight loss	≥15% of index BMI lost	5931 (3.3%)

Researchers followed participants for 2 years. Weight maintenance over this follow-up period was 23.1% in the modest weight loss group, 14.1% in the moderate weight loss group, and 19.4% in the high weight loss group.

These data underscore the difficulty of maintaining weight loss, according to Joanna Huang, PharmD, senior manager of health economics and outcome research with Novo Nordisk, who presented the data at ENDO 2016.

“Focusing on the highest weight loss group, only 20% were able to maintain their initial weight loss after 2 years,” Dr Huang said. “Maintenance of the weight loss is very difficult to achieve.”

Over 2 years, however, the high weight loss group was significantly more likely than the other 2 groups to continue losing weight after the first quarter (Table 2). 

Table 2: Ongoing weight loss (%)

	1st quarter	8th quarter
Modest weight loss	7.2%	2.0%
Moderate weight loss	13.3%	4.1%
High weight loss	18.8%	11.1%

The high weight loss group was also less likely to regain the weight lost. Only 18.6% of that group regained at least 50% of weight lost, compared with 40.0% of the modest weight loss group and 35.9% of the moderate weight loss group.

“There is an inverse relationship between the amount of weight loss and the amount of patients who regained that initial weight loss,” Dr Huang noted. “Looking at the modest weight loss group, they lost the least amount of weight, but that group had the most people who regained 50% or 75% or even 100% of their weight.”

However, of those in the high weight loss group who did regain the weight, they did so in just 12 months compared with 14 months in the modest weight loss group and 15.2 months in the moderate weight loss group.

Dr Huang said that people in the high weight loss group were less likely to become “cyclers,” people who did not consistently lose, maintain, or gain weight in each quarter. Overall, about 60% of the population were classified as cyclers after 2 years, 58.3% in the high weight loss group, 71.5% in the modest weight loss group, and 74.1% in the moderate weight loss group.

“Weight loss maintenance, even in the moderate and high weight loss groups, is very difficult to achieve,” she said. “Successful and sustained clinically meaningful weight loss requires chronic and effective weight management strategies.”

Reference

1. Huang J, Buchs S, DerSarkissian M, et al. OR07-2: Patterns of Weight Loss, Maintenance, and Gain in Patients with Obesity. Presented at: ENDO 2016; April 1-4, 2016; Boston, MA.