Abstract P217: Dietary Habits Associated With 6- and 24-month Weight Loss Maintenance in Primary Care Patients

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Bethany Barone Gibbs ◽  
Dana Tudorascu ◽  
Cindy Bryce ◽  
Diane Comer ◽  
Gary Fischer ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Weight Gain ◽  
Primary Care Physicians ◽  
Weight Regain ◽  
Dietary Habits ◽  
Weight Loss Maintenance ◽  
Fried Foods ◽  
Primary Care Patients ◽  
Diet Habits

Introduction: Though weight loss can improve health, weight regain is common. Primary care physicians are uniquely positioned to provide counseling for weight loss maintenance given their longitudinal care of patients, yet evidence of simple lifestyle recommendations for maintaining weight loss in primary care patients is lacking. Our objective was to characterize longitudinal associations between diet habits and weight change among primary care patients with recent, intentional weight loss of at least 5%. Methods: This was a secondary analysis of data from a weight loss maintenance clinical trial in a primary care setting that compared two interventions delivered through the electronic health record: continued coaching vs. tracking only. Dietary habits [fried foods, desserts, fruits and vegetables (F&V), and sugar-sweetened beverages (SSB)] were measured by the Connor Diet Habits Survey. Linear regression models were used to evaluate associations (overall and by randomized group) between changes in dietary habits and weight separately at 6- and 24-month follow-up, adjusted for baseline diet habit, age, gender and clinic location. Results: Participants (n=192) were 74% female, 87% white and had baseline mean (SD) age of 53 (12) years, body mass index of 30.4 (5.9) kg/m 2 , and recent weight loss of 11 (8) percent. Overall, participants had mean (SD) weight loss of 0.18 (5.04) kg at 6 months (n=169) and weight gain of 3.26 (7.60) kg at 24 months (n=140). At 6 months, a 1 serving per week increase in dessert intake was associated with 0.53 kg (p=0.030) greater weight gain. Fried foods, F&V, and SSB were not associated with 6-month weight changes. However, by 24 months, an increase of 1 serving per week was associated with greater weight gain of 0.54 kg (p=0.043) for fried foods, 0.80 kg (p=0.031) for desserts, and 2.01 kg (p=0.002) for SSB. A decrease of 1 F&V serving per day was associated with a 0.82 kg (p=0.008) greater weight gain at 24 months. When stratified by randomized group, associations were stronger in the continued coaching vs. tracking only arm. Conclusions: Increased consumption of desserts was associated with weight regain at 6 and 24 months, while increased fried foods and SSB, and decreased F&V were associated with weight regain at 24 months. These data suggest that simple strategies such as improving or at least maintaining dietary intake of fried foods, desserts, F&V, and SSB could help facilitate long-term weight loss maintenance in primary care patients.

scholarly journals A systematic review of behavioural weight-loss interventions involving primary-care physicians in overweight and obese primary-care patients (1999–2011)

2012 ◽  
Vol 16 (11) ◽  
pp. 2083-2099 ◽  
Author(s):  
Sze Lin Yoong ◽  
Mariko Carey ◽  
Rob Sanson-Fisher ◽  
Alice Grady
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Weight Loss ◽  
High Intensity ◽  
Primary Care Physicians ◽  
Population Characteristics ◽  
Significant Weight Loss ◽  
Primary Care Patients ◽  
Clinically Significant ◽  
Weight Loss Interventions

AbstractObjectiveThe present review aimed to examine the effectiveness of behavioural weight-loss interventions involving primary-care physicians in producing weight loss in overweight and obese primary-care patients.DesignA systematic review was conducted by searching online databases (MEDLINE, EMBASE, Cochrane, PsycINFO and SCOPUS) from January 1999 to December 2011. All abstracts were screened and coded for eligibility. The Cochrane Effective Practice and Organisation of Care Group quality criteria were used to assess the methodological adequacy of included studies. Information related to study design, population characteristics and intervention details was extracted.SettingPrimary care.SubjectsOverweight or obese (defined as having a BMI ≥ 25·0 kg/m2) primary-care patients.ResultsSixteen different studies were included. Of these, six assessed primary-care physicians’ delivery of weight-loss counselling; nine assessed weight-loss counselling delivered by non-physician personnel with monitoring by primary-care physicians; and one assessed a multi-component intervention. Overall, high-intensity weight-loss counselling by primary-care physicians resulted in moderate but not clinically significant weight loss. High-intensity weight-loss counselling delivered by non-physicians, meal replacements delivered in conjunction with dietitian counselling and referral to commercial weight-loss centre programmes accompanied by regular monitoring by a primary-care physician were effective in producing clinically significant weight loss. Dietitian-delivered care appeared effective in producing weight loss regardless of level of intervention intensity.ConclusionsOverall, there were few studies on this topic and the methodological rigour of some included studies was poor. Additional studies assessing the effectiveness and acceptability of potential interventions are needed to confirm these findings.

scholarly journals Meal replacements, reduced energy density eating, and weight loss maintenance in primary care patients: A randomized controlled trial

Obesity ◽  
2013 ◽  
Vol 22 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Michael R. Lowe ◽  
Meghan L. Butryn ◽  
J. Graham Thomas ◽  
Maria Coletta
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Randomized Controlled Trial ◽  
Energy Density ◽  
Controlled Trial ◽  
Weight Loss Maintenance ◽  
Randomized Controlled ◽  
Primary Care Patients ◽  
Meal Replacements

scholarly journals Dietary Habits and Weight Maintenance Success in High Versus Low Exercisers in the National Weight Control Registry

2014 ◽  
Vol 11 (8) ◽  
pp. 1540-1548 ◽  
Author(s):  
Victoria Anne Catenacci ◽  
Lorraine Odgen ◽  
Suzanne Phelan ◽  
J. Graham Thomas ◽  
James Hill ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Control ◽  
Weight Regain ◽  
Dietary Habits ◽  
Dietary Restraint ◽  
Weight Maintenance ◽  
Weight Loss Maintenance ◽  
Registry Entry ◽  
Successful Weight Loss ◽  
Dietary Strategies

Background:The National Weight Control Registry (NWCR) was established to examine characteristics of successful weight loss maintainers. This study compares the diet and behavioral characteristics and weight regain trajectories of NWCR members with differing physical activity (PA) levels at baseline.Methods:Participants (n = 3591) were divided into 4 levels of self-reported PA at registry entry (< 1000, 1000 to < 2250, 2250 to < 3500, and ≥ 3500 kcals/week). We compared self-reported energy intake (EI), macronutrient composition, eating behaviors (dietary restraint, hunger, and disinhibition), weight loss maintenance strategies, and 3 year weight regain between these 4 activity groups.Results:Those with the highest PA at registry entry had lost the most weight, and reported lower fat intake, more dietary restraint, and greater reliance on several specific dietary strategies to maintain weight loss. Those in the lowest PA category maintained weight loss despite low levels of PA and without greater reliance on dietary strategies. There were no differences in odds of weight regain at year 3 between PA groups.Conclusions:These findings suggest that there is not a “one size fits all strategy” for successful weight loss maintenance and that weight loss maintenance may require the use of more strategies by some individuals than others.

Primary Care Physicians Need Weight-Loss Tools

2010 ◽  
Vol 43 (7) ◽  
pp. 27
Author(s):  
JANE ANDERSON
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Primary Care Physicians

scholarly journals A web-based intervention to increase weight loss treatment initiation: results of a cluster randomized feasibility and acceptability trial

2019 ◽  
Author(s):  
Megan A McVay ◽  
William S Yancy ◽  
Gary G Bennett ◽  
Erica Levine ◽  
Seung-Hye Jung ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Treatment Initiation ◽  
Primary Care Providers ◽  
Feasibility Trial ◽  
Care Providers ◽  
Behavioral Weight Loss ◽  
Weight Loss Treatment ◽  
Primary Care Patients ◽  
Cluster Randomized

Abstract Evidence-based behavioral weight loss treatment is under-utilized. To increase initiation of treatment, we developed a single-session, online, primary care-based intervention (“mobilization tool”). We evaluated the mobilization tool's acceptability for primary care patients with obesity, trial design feasibility, and signal of an effect of the tool on treatment initiation. In this cluster randomized feasibility trial, primary care providers (PCPs) were randomized to a mobilization tool or comparator tool arm. Patients with obesity and a scheduled appointment with a randomized PCP were assigned to complete the mobilization or comparator tool prior to their appointment. The online mobilization tool asks patients to answer questions about a variety of weight-related topics and then provides automated, tailored feedback that addresses psychosocial determinants of weight loss treatment initiation. The comparator tool provided a nontailored description of treatments. All participants were offered free enrollment in behavioral weight loss treatments. Six PCPs were randomized. Sixty patients (57% female; 66% white; aged 55 ± 13 years) participated in this study of 296 contacted for eligibility evaluation (20.2%). Six-month follow-up assessments were completed by 65% (22/34) of the mobilization and 73% (19/26) of comparator tool participants. Participants completing the acceptability survey reported that the mobilization tool was usable, enjoyable, informative, and useful. Weight loss treatment was initiated by 59% (n = 19) of mobilization and 33% (n = 8) of comparator tool participants. The mobilization tool shows promise for increasing treatment initiation among primary care patients, which may increase population weight loss. Trial Registration: Clinicaltrials.gov identifier: NCT02708121.

A telehealth intervention to promote weight loss and physical activity in overweight primary care patients

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 100509
Author(s):  
Ian Hurst ◽  
Paul J. Bixenstine ◽  
Carlos Casillas ◽  
Anna Rasmussen ◽  
Sondra Grossman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Weight Loss ◽  
Promote Weight Loss ◽  
Telehealth Intervention ◽  
Primary Care Patients

scholarly journals Weight Cycling in Women: Adaptation or Risk?

2020 ◽  
Author(s):  
Katelyn J. Carey ◽  
Wendy Vitek
Keyword(s):  
Weight Loss ◽  
Body Composition ◽  
Weight Gain ◽  
Pregnancy Complications ◽  
Weight Regain ◽  
Reproductive Age ◽  
Cardiometabolic Health ◽  
Surrogate Markers ◽  
Weight Cycling ◽  
Gut Peptides

AbstractObesity, dieting, and weight cycling are common among reproductive-age women. Weight cycling refers to intentional weight loss followed by unintentional weight regain. Weight loss is accompanied by changes in gut peptides, adipose hormones, and energy expenditure that promote weight regain to a tightly regulated set point. While weight loss can improve body composition and surrogate markers of cardiometabolic health, it is hypothesized that the weight regain can result in an overshoot effect, resulting in excess weight gain, altered body composition, and negative effects on surrogate markers of cardiometabolic health. Numerous observational studies have examined the association of weight cycling and health outcomes. There appears to be modest association between weight cycling with type 2 diabetes mellitus and dyslipidemia in women, but no association with hypertension, cardiovascular events, and overall cancer risk. Interestingly, mild weight cycling may be associated with a decreased risk of overall and cardiovascular mortality. Little is known about the effects of weight cycling in the preconception period. Although obesity and weight gain are associated with pregnancy complications, preconception weight loss does not appear to mitigate the risk of most pregnancy complications related to obesity. Research on preconception weight cycling may provide insight into this paradox.

scholarly journals Dietary and Lifestyle Factors Serve as Predictors of Successful Weight Loss Maintenance Postbariatric Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Afshan Masood ◽  
Lujain Alsheddi ◽  
Loura Alfayadh ◽  
Bushra Bukhari ◽  
Ruba Elawad ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Dietary Habits ◽  
Weight Maintenance ◽  
Dietary Counseling ◽  
Beneficial Effects ◽  
Predicting Factors ◽  
Lifestyle Practices ◽  
Fiber Consumption

Bariatric surgery is considered to be an effective treatment for the resolution of severe obesity; however, in more than half of the bariatric surgery patients, weight reacquisition occurs as early as 18 months postsurgery, compromising the surgery’s beneficial effects. Maintaining weight loss after surgery poses a great challenge, necessitating the identification of predicting factors. In the present study, we explored the association between weight regain and dietary habits and behavioral lifestyle practices in patients following bariatric surgery. Fifty patients who underwent bariatric surgery with ≥18-month postoperative period of follow-up were included. They were classified into two groups: weight maintainers (n = 29) were patients who regained <15% of their weight, and weight regainers (n = 21) were patients who regained ≥15% of their weight compared to their lowest postoperative weight. The mean age of the study participants was 41.4 ± 8.9 years, and twenty-eight patients (56%) of the total, were females. A detailed analysis of dietary and lifestyle habits was performed by questionnaire-based interviews. Significant weight regain was noted in the regainers compared to the maintainers (19.6 ± 8.4 kg vs. 4.5 ± 3.5 kg, respectively, P≤0.001), which was attributed to their following of unhealthy dietary habits and behavioral lifestyle practices. The dietary and behavioral lifestyle practices adopted by the maintainers were higher fiber consumption and water intake, monitored pace of eating, evasion of emotional binge, and distracted eating and following of self-assessment behaviors. Additionally, regular nutritional follow-ups and compliance with postoperative dietary counseling significantly helped to improve weight maintenance. In conclusion, the effectiveness of weight loss postbariatric surgery was compromised by weight regain due to unhealthy dietary and behavioral lifestyle practices stemming from a lack of nutritional guidance and knowledge. The implementation of comprehensive nutritional counseling and advice on behavioral changes before and after surgery will help achieve optimal weight results.

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