Success Breeds Success: Weight Loss Dynamics in the Presence of Short-Term and Long-Term Goals

Introduction: Although weight loss has favorable effects on intermediate outcomes, such as blood pressure and insulin resistance, few studies have examined its effects on long-term outcomes including total mortality. Methods: In the Trials of Hypertension Prevention (TOHP) individuals aged 30-54 years with high normal BP were randomized to a weight loss intervention, to one of several other lifestyle or dietary supplement interventions, or to usual care. All participants from Phase 1 (1987-90) and Phase 2 (1990-5) were followed for mortality through 2013. The association of weight change during any of the interventions with long-term mortality up to 18-24 years after the trial periods was examined among 3828 participants who fell into a high baseline weight stratum, defined as body mass index at least 26 kg/m2 in men and 24 kg/m2 in women. Results and Conclusions: There were 1477 high-weight participants in Phase 1 and 2351 in Phase 2, of whom 21% and 50%, respectively, were assigned to a weight loss intervention. Overall, mean weight change during the trial period was -1.8 lbs (-0.8% of baseline body weight) over 1.5 years in Phase 1 and 1.6 lbs (0.8%) over 3-4 years in Phase 2. A total of 556 (15%) lost > 5%, 1,101 (29%) lost <=5%, 1,567 (41%) gained less than 5%, and 604 (16%) gained > 5% in body weight. Corresponding hazard ratios (HRs) for total mortality were 0.82 (95% confidence interval (CI)=0.57-1.18), 0.94 (95% CI=0.72-1.23), 1.00 (reference), and 1.29 (95% CI=0.92-1.80) (p-trend = 0.046). There was a direct linear relationship with percent change in weight during the trial period and later mortality (HR=1.14 per 5% change, 95% CI=1.02-1.28, p=0.019). This association persisted throughout the course of mortality follow-up (Figure). In these healthy individuals taking part in lifestyle and nutrition supplement trials , short-term weight change was directly associated with mortality about two decades later. These results are consistent with a long-term beneficial effect of presumed intentional weight loss on total mortality.

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Session 23: Maintaining Motivation

Effective Weight Loss ◽

10.1093/med:psych/9780190232023.003.0024 ◽

2016 ◽

pp. 139-144

Author(s):

Evan M. Forman ◽

Meghan L. Butryn

Keyword(s):

Weight Loss ◽

Weight Control ◽

Hard Work ◽

Short Term ◽

Self Monitoring ◽

Healthy Behaviors ◽

Weight Control Behaviors ◽

Motivate Behavior ◽

Do So

This chapter (Session 23) discusses how to maintain long-term motivation for weight control by focusing on the importance of values to motivate behavior, even if short-term reward of weight control behaviors is decreasing (e.g., weight loss is slowing, self-monitoring is becoming tiresome). Clients are encouraged to view the hard work of weight control as working toward their values and to use the skill of willingness to continue to engage in healthy behaviors, even when it is difficult uncomfortable to do so.

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Weight and Glycemic Control Outcomes of Bariatric Surgery and Pharmacotherapy in Patients With Melanocortin-4 Receptor Deficiency

Frontiers in Endocrinology ◽

10.3389/fendo.2021.792354 ◽

2022 ◽

Vol 12 ◽

Author(s):

Esphie Grace Fodra Fojas ◽

Saradalekshmi Koramannil Radha ◽

Tomader Ali ◽

Evan P. Nadler ◽

Nader Lessan

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Glycemic Control ◽

Therapeutic Interventions ◽

Control Group ◽

Short Term ◽

Melanocortin 4 Receptor ◽

Significant Difference

BackgroundMelanocortin-4 receptor (MC4R) mutations are the most common of the rare monogenic forms of obesity. However, the efficacy of bariatric surgery (BS) and pharmacotherapy on weight and glycemic control in individuals with MC4R deficiency (MC4R-d) is not well-established. We investigated and compared the outcomes of BS and pharmacotherapy in patients with and without MC4R-d.MethodsPertinent details were derived from the electronic database among identified patients who had BS with MC4R-d (study group, SG) and wild-type controls (age- and sex-matched control group, CG). Short- and long-term outcomes were reported for the SG. Short-term outcomes were compared between the two groups.ResultsSeventy patients were screened for MC4R-d. The SG [six individuals (four females, two males); 18 (10–27) years old at BS; 50.3 (41.8–61.9) kg/m2 at BS, three patients with homozygous T162I mutations, two patients with heterozygous T162I mutations, and one patient with heterozygous I170V mutation] had a follow-up duration of up to 10 years. Weight loss, which varied depending on mutation type [17.99 (6.10–22.54) %] was stable for 6 months; heterogeneity of results was observed thereafter. BS was found superior to liraglutide on weight and glycemic control outcomes. At a median follow-up of 6 months, no significant difference was observed on weight loss (20.8% vs. 23.0%, p = 0.65) between the SG and the CG [eight individuals (four females, four males); 19.0 (17.8–36.8) years old at BS, 46.2 (42.0–48.3) kg/m2 at BS or phamacotherapeutic intervention]. Glycemic control in patients with MC4R-d and Type 2 diabetes improved post-BS.ConclusionOur data indicate efficacious short-term but varied long-term weight loss and glycemic control outcomes of BS on patients with MC4R-d, suggesting the importance of ongoing monitoring and complementary therapeutic interventions.

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The effects of a combination of high-protein diet and resistance training on short-term weight loss and long-term weight maintenance in overweight and obese Chinese people: a study protocol

10.21203/rs.2.13358/v1 ◽

2019 ◽

Author(s):

Xu Shaoyong ◽

Juan Zhang ◽

Yuxiang Dong ◽

Ruikun Chen ◽

Wenlei Xu ◽

...

Keyword(s):

Weight Loss ◽

Resistance Training ◽

Weight Maintenance ◽

High Protein Diet ◽

Diet Group ◽

High Protein ◽

Protein Diet ◽

Short Term ◽

Low Fat Diet

Abstract Background It is very important for clinicians and dieticians to explore reasonable weight management strategies for obese people that address both short-term weight loss and subsequent weight maintenance. We hypothesized that resistance training combined with a high-protein diet would result in similar short-term weight loss but better long-term weight maintenance than either conventional low-fat diet control or high-protein diet alone.Methods/design This is an 8-week randomized parallel controlled trial followed by a 24-week observational follow-up study. A 48-week supplementary follow-up study will be carried out if necessary. The study will be conducted between June 2019 and October 2020. The 90 overweight or obese participants will be randomly assigned to the conventional low-fat diet group, the high-protein diet group and the high-protein diet and resistance training combination group. Primary outcomes are body weight changes at week 8 and week 24 compared with the baseline level.Discussion High-quality research on the effect of a high-protein diet combined resistance training on weight loss and weight maintenance is limited in Chinese population. Our study will provide a basis for obesity management in China, and promote the development of exercise and diet-related studies.Trials registration ChiCTR1900023841, 14 June 2019

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Session 23: Maintaining Motivation

Effective Weight Loss ◽

10.1093/med:psych/9780190232009.003.0023 ◽

2016 ◽

pp. 199-204

Author(s):

Evan M. Forman ◽

Meghan L. Butryn

Keyword(s):

Weight Loss ◽

Weight Control ◽

Hard Work ◽

Short Term ◽

Self Monitoring ◽

Healthy Behaviors ◽

Weight Control Behaviors ◽

Motivate Behavior ◽

Do So

This chapter (Session 23) discusses how to maintain long-term motivation for weight control by focusing on the importance of values to motivate behavior, even if short-term reward of weight control behaviors is decreasing (e.g., weight loss is slowing, self-monitoring is becoming tiresome). Clients are encouraged to view the hard work of weight control as working toward their values and to use the skill of willingness to continue to engage in healthy behaviors, even when it is difficult uncomfortable to do so.

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Effect of short-term carbohydrate overfeeding and long-term weight loss on liver fat in overweight humans

American Journal of Clinical Nutrition ◽

10.3945/ajcn.112.038695 ◽

2012 ◽

Vol 96 (4) ◽

pp. 727-734 ◽

Cited By ~ 115

Author(s):

Ksenia Sevastianova ◽

Alexandre Santos ◽

Anna Kotronen ◽

Antti Hakkarainen ◽

Janne Makkonen ◽

...

Keyword(s):

Weight Loss ◽

Liver Fat ◽

Short Term

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Predicting successful long-term weight loss from short-term weight-loss outcomes: new insights from a dynamic energy balance model (the POUNDS Lost study)

American Journal of Clinical Nutrition ◽

10.3945/ajcn.114.091520 ◽

2014 ◽

Vol 101 (3) ◽

pp. 449-454 ◽

Cited By ~ 27

Author(s):

Diana M Thomas ◽

Andrada E Ivanescu ◽

Corby K Martin ◽

Steven B Heymsfield ◽

Kaitlyn Marshall ◽

...

Keyword(s):

Weight Loss ◽

Energy Balance ◽

Energy Balance Model ◽

Balance Model ◽

Short Term ◽

Weight Loss Outcomes

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Short-, medium-, and long-term weight changes and all-cause mortality in old age: Findings from the National Survey of the Japanese Elderly

The Journals of Gerontology Series A ◽

10.1093/gerona/glab052 ◽

2021 ◽

Author(s):

Hiroshi Murayama ◽

Jersey Liang ◽

Benjamin A Shaw ◽

Anda Botoseneanu ◽

Erika Kobayashi ◽

...

Keyword(s):

Weight Loss ◽

Old Age ◽

Mortality Risk ◽

Weight Change ◽

Medium Term ◽

Short Term ◽

Asian Populations ◽

All Cause Mortality ◽

Japanese Elderly

Abstract Background Recent studies, predominantly in Western populations, suggest that both weight loss and weight gain are associated with an increased mortality risk in old age. However, evidence of this association in older Asian populations remains sparse. This study aimed to examine the association between weight change and all-cause mortality in a nationally representative sample of community-dwelling older Japanese people. Methods Data were obtained from the National Survey of the Japanese Elderly, which included 4,869 adults aged ≥60 years. Participants were followed for up to 30 years. We considered three indicators of weight change according to the follow-up interval: short-term (3 years), medium-term (6–7 years), and long-term (12–13 years). Weight change was classified as loss ≥5%, loss 2.5–4.9%, stable (±2.4%), gain 2.5–4.9%, and gain ≥5%. Cox proportional hazards models were used to calculate the relative mortality risk of each weight change category. Results Weight loss ≥5% for all intervals was associated with higher mortality than stable weight and the effects were largely similar across all three intervals (hazard ratio [95% confidence interval]: 1.36 [1.22–1.51] for short-term, 1.36 [1.22–1.51] for medium-term, and 1.31 [1.11–1.54] for long-term). A similar pattern of results was observed among the young-old and old-old, and among men and women. The effect of weight loss on higher mortality was greater among those with a lower body mass index at baseline. Conclusions These findings could inform clinical and public health approaches to body-weight management aimed at improving the health and survival of older adults, particularly in Asian populations.

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Leptin administration to overweight and obese subjects for 6 months increases free leptin concentrations but does not alter circulating hormones of the thyroid and IGF axes during weight loss induced by a mild hypocaloric diet

Acta Endocrinologica ◽

10.1530/eje-11-0252 ◽

2011 ◽

Vol 165 (2) ◽

pp. 249-254 ◽

Cited By ~ 33

Author(s):

Greeshma K Shetty ◽

Giuseppe Matarese ◽

Faidon Magkos ◽

Hyun-Seuk Moon ◽

Xiaowen Liu ◽

...

Keyword(s):

Weight Loss ◽

Hypocaloric Diet ◽

Short Term ◽

Obese Adults ◽

Neuroendocrine Function ◽

Term Energy ◽

Obese Subjects ◽

Energy Deprivation ◽

To Receive

ObjectiveShort-term energy deprivation reduces leptin concentrations and alters the levels of circulating hormones of the hypothalamic–pituitary–peripheral axis in lean subjects. Whether the reduction in leptin concentration during long-term weight loss in obese individuals is linked to the same neuroendocrine changes seen in lean, leptin-sensitive subjects remains to be fully clarified.MethodsIn this study, 24 overweight and obese adults (16 women and eight men; body mass index (BMI): 27.5–38.0 kg/m2) were prescribed a hypocaloric diet (−500 kcal/day) and were randomized to receive recombinant methionyl leptin (n=18, metreleptin, 10 mg/day self-injected s.c.) or placebo (n=6, same volume and time as metreleptin) for 6 months.ResultsMetreleptin administration did not affect weight loss beyond that induced by hypocaloric diet alone (P for interaction=0.341) but increased the serum concentrations of total leptin by six- to eight-fold (P<0.001) and led to the generation of anti-leptin antibodies. Despite free leptin concentration (P for interaction=0.041) increasing from 9±1 ng/ml at baseline to 43±15 and 36±12 ng/ml at 3 and 6 months, respectively, changes in circulating hormones of the thyroid and IGF axes at 3 and 6 months were not significantly different in the placebo- and metreleptin-treated groups.ConclusionsLeptin does not likely mediate changes in neuroendocrine function in response to weight loss induced by a mild hypocaloric diet in overweight and obese subjects.

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