scholarly journals Long-term weight status in regainers after weight loss by lifestyle intervention: status and challenges

2014 ◽  
Vol 73 (4) ◽  
pp. 509-518 ◽  
Author(s):  
Marta Stelmach-Mardas ◽  
Marcin Mardas ◽  
Jarosław Walkowiak ◽  
Heiner Boeing
Keyword(s):  
Weight Loss ◽  
Weight Status ◽  
Dietary Intervention ◽  
Self Regulation ◽  
Energy Restriction ◽  
Behaviour Therapy ◽  
Main Determinants ◽  
The Individual

After having participated in a weight loss trial, most participants do not stabilise the obtained weight loss but return to their initial weight. The aim of this review is to describe the main determinants of continued low weight status after weight loss, and the effectiveness of physical activity (PA), energy restriction and macronutrient composition of the diet for low long-term weight regain. Studies with intervention periods of at least 3 months duration of weight reduction measures and a follow-up at least 2 years after the intervention period were considered as eligible for the review. Owing to limited data, the studies describing the role of PA in weight management were eligible with a follow-up of 1 year only. It appears that a diet with self-regulation of dietary intake seems to be given a prominent role in the strategy of successful long-term weight loss among the obese. This measure could be combined with behaviour therapy and PA and tailored to the individual situation. However, considering available evidence it is difficult to conclude regarding unambiguous measures and to recommend a specific dietary intervention. Nevertheless, interventions should be effective in promoting intrinsic motivation and self-efficacy. The harmonisation and standardisation of data collection in the follow-up period of long-term weight loss studies is a major challenge.

scholarly journals A comparison of a ketogenic diet with a LowGI/nutrigenetic diet over 6 months for weight loss and 18-month follow-up

BMC Nutrition ◽  
2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Maria Vranceanu ◽  
Craig Pickering ◽  
Lorena Filip ◽  
Ioana Ecaterina Pralea ◽  
Senthil Sundaram ◽  
...  
Keyword(s):  
Weight Loss ◽  
Ketogenic Diet ◽  
Dietary Intervention ◽  
Hdl Cholesterol ◽  
Diet Group ◽  
Keto Group ◽  
Nucleotide Polymorphisms ◽  
Metabolic Disturbances

Abstract Background Obesity and its related metabolic disturbances represent a huge health burden on society. Many different weight loss interventions have been trialled with mixed efficacy, as demonstrated by the large number of individuals who regain weight upon completion of such interventions. There is evidence that the provision of genetic information may enhance long-term weight loss, either by increasing dietary adherence or through underlying biological mechanisms. Methods The investigators followed 114 overweight and obese subjects from a weight loss clinic in a 2-stage process. 1) A 24-week dietary intervention. The subjects self-selected whether to follow a standardized ketogenic diet (n = 53), or a personalised low-glycemic index (GI) nutrigenetic diet utilising information from 28 single nucleotide polymorphisms (n = 61). 2) After the 24-week diet period, the subjects were monitored for an additional 18 months using standard guidelines for the Keto group vs standard guidelines modified by nutrigenetic advice for the low-Glycaemic Index nutrigenetic diet (lowGI/NG) group. Results After 24 weeks, the keto group lost more weight: − 26.2 ± 3.1 kg vs − 23.5 ± 6.4 kg (p = 0.0061). However, at 18-month follow up, the subjects in the low-GI nutrigenetic diet had lost significantly more weight (− 27.5 ± 8.9 kg) than those in the ketogenic diet who had regained some weight (− 19.4 ± 5.0 kg) (p < 0.0001). Additionally, after the 24-week diet and 18-month follow up the low-GI nutrigenetic diet group had significantly greater (p < 0.0001) improvements in total cholesterol (ketogenic − 35.4 ± 32.2 mg/dl; low-GI nutrigenetic − 52.5 ± 24.3 mg/dl), HDL cholesterol (ketogenic + 4.7 ± 4.5 mg/dl; low-GI nutrigenetic + 11.9 ± 4.1 mg/dl), and fasting glucose (ketogenic − 13.7 ± 8.4 mg/dl; low-GI nutrigenetic − 24.7 ± 7.4 mg/dl). Conclusions These findings demonstrate that the ketogenic group experienced enhanced weight loss during the 24-week dietary intervention. However, at 18-month follow up, the personalised nutrition group (lowGI/NG) lost significantly more weight and experienced significantly greater improvements in measures of cholesterol and blood glucose. This suggests that personalising nutrition has the potential to enhance long-term weight loss and changes in cardiometabolic parameters. Trial registration NCT04330209, Registered 01/04/2020, retrospectively registered.

scholarly journals Long-term follow-up after weight management in obese cats

2014 ◽  
Vol 3 ◽  
Author(s):  
Gabrielle Deagle ◽  
Shelley L. Holden ◽  
Vincent Biourge ◽  
Penelope J. Morris ◽  
Alexander J. German
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Weight Regain ◽  
Energy Restriction ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Kendall’S Τ ◽  
Successful Weight Loss

AbstractFeline obesity is a prevalent medical disease and the main therapeutic strategy is dietary energy restriction. However, at present there are no data regarding long-term outcome in this species. The purpose of the present study was to investigate if, as in other species, some cats regain weight following successful weight loss, and to identify any influencing factors in a cohort of client-owned cats with naturally occurring obesity. Twenty-six cats were included, all of which had successfully completed a weight management programme. After weight loss, cats were periodically monitored. The median duration of follow-up was 954 d (72–2162 d). Ten cats (39 %) maintained their completion weight (±5 %), four (15 %) lost >5 % additional weight and 12 (46 %) gained >5 % weight. Seven of the rebounding cats (58 %) regained over 50 % of their original weight lost. Older cats were less likely to regain weight than younger cats (P = 0·024); with an approximately linear negative association between the cat's age and the amount of weight regained (Kendall's τ = −0·340, P = 0·016). Furthermore, cats whose energy intake during weight loss was greater were also more likely to regain weight (P = 0·023). When the characteristics of weight regain in cats were compared with those from a similar cohort of dogs, cats that rebounded were more likely to regain >50 % of the weight they had lost. These results suggest that weight regain, after successful weight loss, is common in obese cats, and that young cats (<7 years of age) are most at risk.

Abstract P342: Associations Between Sleep Duration and Sleep Quality and Long-Term Weight Status in Post-Bariatric Surgery Patients

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Elsa Thomas ◽  
Devon Roeshot ◽  
Dympna Gallagher ◽  
Marie-Pierre St-Onge
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Weight Change ◽  
Weight Status ◽  
Post Surgery ◽  
Post Bariatric Surgery

Introduction: The prevalence of obesity continues to rise since 1980. This obesity epidemic has been paralleled by a trend of reduced sleep duration and sleep quality throughout the years. However, there is limited research on the relation between sleep duration and quality and its association with weight loss maintenance. The purpose of this study was to examine the association between sleep duration and quality and weight status in post-bariatric surgery patients at 9-y post-surgery. We tested the hypothesis that participants’ post-surgical weight change would be related to sleep duration and quality at 9-y. Methods: Sleep data were collected on a subset of participants (mean body weight = 94.1 kg ± 18.9) enrolled in an ancillary study to the Longitudinal Assessment for Bariatric Surgery trial. Self-reported hours of sleep per night and overall sleep quality were assessed once, at the 9-y visit using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Results: Complete data were available on 14 participants (10 females and 4 males, age 52.1 ± 15.6 y), current weight 94 kg ± 18.9. Average total weight loss from pre-surgery was 28.5% ± 10.6, with an average weight gain of 0.3 ± 6.2 % over the last 2 y of follow-up. Participants reported average sleep duration of 6.8 ± 2.0 h/night at the 9-y evaluation visit and an average score of 7.9 ± 3.7 on the PSQI. There was no relation between sleep duration and current weight or percent weight change after maximum weight loss, which occurred around 2-y post-surgery. However, there were trends for an association between sleep quality and percent weight change after maximum weight loss (p=0.057) and percent weight change in the last 2-y of follow-up (p=0.066). In general, participants who lost more weight over the last 2 y of the study had lower scores on the PSQI, indicating better quality of sleep. Conclusion: Our results showed no association between sleep quality or duration and long-term changes in weight for patients who underwent bariatric surgery. However, those with better sleep quality tended to have more beneficial changes in weight over the latest 2-y. It is important to note that this study cannot address causality and whether improved weight influenced sleep quality or whether sleep quality influenced weight change. Further studies should examine the temporality of these association. Sleep quality may be an important sleep metric to consider for long-term weight loss maintenance.

scholarly journals Evidence-Based Digital Tools for Weight Loss Maintenance: The NoHoW Project

Obesity Facts ◽  
2021 ◽  
pp. 1-14
Author(s):  
R. James Stubbs ◽  
Cristiana Duarte ◽  
António L. Palmeira ◽  
Falko F. Sniehotta ◽  
Graham Horgan ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behaviour Change ◽  
Digital Health ◽  
Self Regulation ◽  
Self Management ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Behavioural Science ◽  
Digital Architecture

<b><i>Background:</i></b> Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.g., provide choice). Stress management and emotion regulation techniques show potential for prevention of relapse and weight regain. Digital technologies (including networked-wireless tracking technologies, online tools and smartphone apps, multimedia resources, and internet-based support) offer attractive tools for teaching and supporting long-term behaviour change techniques. However, many digital offerings for weight management tend not to include evidence-based content and the evidence base is still limited. <b><i>The Project:</i></b> First, the project examined why, when, and how many European citizens make WL and WLM attempts and how successful they are. Second, the project employed the most up-to-date behavioural science research to develop a digital toolkit for WLM based on 2 key conditions, i.e., self-management (self-regulation and motivation) of behaviour and self-management of emotional responses for WLM. Then, the NoHoW trial tested the efficacy of this digital toolkit in adults who achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25). The primary outcome was change in weight (kg) at 12 months from baseline. Secondary outcomes included biological, psychological, and behavioural moderators and mediators of long-term energy balance (EB) behaviours, and user experience, acceptability, and cost-effectiveness. <b><i>Impact:</i></b> The project will directly feed results from studies on European consumer behaviour, design and evaluation of digital toolkits self-management of EB behaviours into development of new products and services for WLM and digital health. The project has developed a framework and digital architecture for interventions in the context of EB tracking and will generate results that will help inform the next generation of personalised interventions for effective self-management of weight and health.

Stability in Waking-Sleep States in Neonates as a Predictor of Long-Term Neurologic Outcome

PEDIATRICS ◽  
1985 ◽  
Vol 76 (1) ◽  
pp. 52-63
Author(s):  
Cesare T. Lombroso ◽  
Yoichi Matsumiya
Keyword(s):  
Statistical Significance ◽  
Observation Time ◽  
Long Term Outcomes ◽  
Newborn Period ◽  
Waking And Sleep ◽  
Total Observation Time ◽  
Total Observation ◽  
The Individual

Thirty-three full-term neonates were ranked blindly on a scale ranging from the least to the highest "risk" for future neurologic complications on the basis of available perinatal biographies, tests, and examinations performed during the newborn period. Four prolonged polygraphic-behavioral recordings were obtained one week apart beginning at ten days after birth. Five waking and sleep states were scored in each session as percentages of total observation time, giving a total of 20 scores for each baby to be subjected to analysis of variance. These measures also provided individual profile consistency or variability in maintaining waking-sleep states over the selected period of postnatal time. The whole cohort, except three infants who could not be followed adequately, was then reexamined periodically over a period ranging from 3 to 4 years (±6 months) for neurologic and developmental assessments. Except for two scores that produced a low level of statistical significance (P &lt; .05), the other 18 scores were found to be not associated with long-term outcomes. Even the first two scores were not satisfactory discriminators for the outcome of the individual babies. However, when coefficients of concordance (W) were computed from each individual baby profile, significant statistics (P &lt; .001) emerged to indicate good correlations between high or low W values in the newborn period and long-term outcomes. All 17 newborns who had W scores greater than 0.9 were found to be normal at follow-up regardless of the poor ranking given several of them during the newborn period. Among the 13 newborns who had W scores less than 0.9, 11 had a poor clinical outcome at follow-up, though several had been ranked initially as falling within the least "risk" group.

564-P: Long-Term Follow-up of Glycemic Excursion Minimization (GEM) Compared with Weight Loss in Management of Type 2 Diabetes (T2D)

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 564-P
Author(s):  
DANIEL COX ◽  
MATTHEW A. MONCRIEF ◽  
ANTHONY L. MCCALL
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Long Term Follow Up

scholarly journals Does cognitive-behavioural therapy influence the long-term outcome of generalized anxiety disorder? An 8–14 year follow-up of two clinical trials

2003 ◽  
Vol 33 (3) ◽  
pp. 499-509 ◽  
Author(s):  
R. C. DURHAM ◽  
J. A. CHAMBERS ◽  
R. R. MACDONALD ◽  
K. G. POWER ◽  
K. MAJOR
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Secondary Care ◽  
Generalized Anxiety ◽  
Behaviour Therapy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cognitive Behaviour

Background. Generalized anxiety disorder is a common condition of excessive worry and tension which tends to run a chronic course associated with significant psychiatric and medical problems. Cognitive behaviour therapy (CBT) has been shown to be of clinical value in about 50% of cases with treatment gains maintained over follow-up periods ranging from 6 to 12 months. The potential value of CBT over the longer term has not been subject to rigorous investigation.Method. Results are reported of 8–14 year follow-up of two randomized controlled trials of cognitive-behaviour therapy for generalized anxiety disorder employing structured interview with an assessor blind to initial treatment condition. Comparison groups included medication and placebo in one study based in primary care, and analytical psychotherapy in the other based in secondary care. Follow-up samples (30% and 55% of trial entrants) were broadly representative of the original cohorts.Results. Overall, 50% of participants were markedly improved of whom 30–40% were recovered (i.e. free of symptoms). Outcome was significantly worse for the study based in secondary care in which the clinical presentation of participants was more complex and severe. For a minority (30–40%), mainly from the secondary care study, outcome was poor. Treatment with CBT was associated with significantly lower overall severity of symptomatology and less interim treatment, in comparison with non-CBT conditions, but there was no evidence that CBT influenced diagnostic status, probability of recovery or patient perceptions of overall improvement.Conclusions. Both CBT and the complexity and severity of presenting problems appear to influence the long-term outcome of GAD.

scholarly journals Effects of Weight Loss on FGF-21 in Human Subjects: An Exploratory Study

2019 ◽  
Vol 16 (23) ◽  
pp. 4877
Author(s):  
Headland ◽  
Clifton ◽  
Keogh
Keyword(s):  
Weight Loss ◽  
Exploratory Study ◽  
Wound Repair ◽  
Dietary Intervention ◽  
Human Subjects ◽  
Restriction Pattern ◽  
Energy Restriction ◽  
Fibroblast Growth Factor 21 ◽  
Continuous Energy ◽  
The Impact

Fibroblast growth factor-21 (FGF-21), is a protein involved in cell growth and differentiation, development, wound repair and metabolism. Research looking at the impact of weight loss on FGF-21 levels is limited. The objective of this exploratory study was to determine changes in serum FGF-21 levels following weight loss induced by either continuous energy restriction or intermittent energy restriction. A sub cohort of participants who completed a 12-month dietary intervention trial following continuous energy restriction, or a week-on week-off energy restriction pattern, were selected for analysis. FGF-21 levels were not altered by weight loss and were not correlated with body weight or BMI at baseline or 12 months. Weight loss after 12 months either through continuous energy restriction or intermittent energy restriction was −5.9 ± 4.5 and −4.9 ± 3.4 kg, respectively. There was no change in FGF-21 levels, 0.3 ± 0.9 and 0.04 ± 0.2 ng/mL (p = 0.2). In conclusion, weight loss in healthy overweight or obesity subjects did not affect FGF-21 levels.

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