scholarly journals Two‐year treatment programme showed that younger age and initial weight loss predicted better results in overweight and obese children aged 2‐16 years

2020 ◽  
Vol 109 (8) ◽  
pp. 1649-1655
Author(s):  
Sina Dalby ◽  
Signe Vahlkvist ◽  
Inge Østergaard ◽  
Joan Park Jørgensen ◽  
Claus Bogh Juhl
Keyword(s):  
Weight Loss ◽  
Treatment Programme ◽  
Obese Children ◽  
Initial Weight ◽  
Initial Weight Loss ◽  
Younger Age

Abstract MP003: Development and Validation of a Prediction Model of Weight Loss Maintenance or Regain at 4 Years in the Look AHEAD Trial

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Samantha E Berger ◽  
Gordon S Huggins ◽  
Jeanne M McCaffery ◽  
Alice H Lichtenstein
Keyword(s):  
Machine Learning ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Logistic Regression ◽  
Prediction Model ◽  
Weight Regain ◽  
Initial Weight ◽  
Initial Weight Loss ◽  
Look Ahead

Introduction: The development of type 2 diabetes is strongly associated with excess weight gain and can often be partially ameliorated or reversed by weight loss. While many lifestyle interventions have resulted in successful weight loss, strategies to maintain the weight loss have been considerably less successful. Prior studies have identified multiple predictors of weight regain, but none have synthesized them into one analytic stream. Methods: We developed a prediction model of 4-year weight regain after a one-year lifestyle-induced weight loss intervention followed by a 3 year maintenance intervention in 1791 overweight or obese adults with type 2 diabetes from the Action for Health in Diabetes (Look AHEAD) trial who lost ≥3% of initial weight by the end of year 1. Weight regain was defined as regaining <50% of the weight lost during the intervention by year 4. Using machine learning we integrated factors from several domains, including demographics, psychosocial metrics, health status and behaviors (e.g. physical activity, self-monitoring, medication use and intervention adherence). We used classification trees and stochastic gradient boosting with 10-fold cross validation to develop and internally validate the prediction model. Results: At the end of four years, 928 individuals maintained ≥50% of their initial weight lost (maintainers), whereas 863 did not met that criterion (regainers). We identified an interaction between age and several variables in the model, as well as percent initial weight loss. Several factors were significant predictors of weight regain based on variable importance plots, regardless of age or initial weight loss, such as insurance status, physical function score, baseline BMI, meal replacement use and minutes of exercise recorded during year 1. We also identified several factors that were significant predictors depending on age group (45-55y/ 56-65y/66-76y) and initial weight loss (lost 3-9% vs. ≥10% of initial weight). When the variables identified from machine learning were added to a logistic regression model stratified by age and initial weight loss groups, the models showed good prediction (3-9% initial weight loss, ages 45-55y (n=293): ROC AUC=0.78; ≥10% initial weight loss, ages 45-55y (n=242): ROC AUC=0.78; (3-9% initial weight loss, ages 56-65y (n=484): ROC AUC=0.70; ≥10% initial weight loss, ages 56-65y (n=455): ROC AUC = 0.74; 3-9% initial weight loss, ages 66-76y (n=150): ROC AUC=0.84; ≥10% initial weight loss, ages 66-76y (n=167): ROC AUC=0.86). Conclusion: The combination of machine learning methodology and logistic regression generates a prediction model that can consider numerous factors simultaneously, can be used to predict weight regain in other populations and can assist in the development of better strategies to prevent post-loss regain.

scholarly journals MON-LB101 5-Year Data of an Aggressive Pharmacological Approach to Moderate and Morbid Obesity: Is Prevention of Bariatric Surgery Feasible in the Long Run?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Flavio Cadegiani
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Body Weight ◽  
Weight Regain ◽  
Morbidly Obese ◽  
Biochemical Profile ◽  
Initial Weight ◽  
Initial Weight Loss

Abstract Background: Maintenance of weight loss in patients that undergo weight loss interventions is highly challenging, irrespective of the type of approach to obesity (whether surgical, pharmacological, or non-pharmacological). We proposed a protocol of an aggressive clinical treatment for obesity aiming to prevent the need of bariatric surgery, in patients unwilling to undergo this procedure, by proposing a protocol that included the combination of different anti-obesity medications and non-pharmacological modalities, for longer duration, and with an active approach to prevent weight regain. Our initial 2-year data showed that 93% (40 of 43 patients) with moderate and morbid obesity were able to avoid the need of bariatric surgery, with concomitant improvements of the biochemical profile. However, whether these patients would maintain their successful rates after five years was uncertain. Our objective is to describe the efficacy and safety of a long term (5-year data) pharmacological and multi-modal treatment for moderate and severe obesity. Methods: The 40 patients that were successful in the two-year approach in our obesity center (Corpometria Institute, Brasilia, DF, Brazil) were enrolled. A long-term anti-obesity protocol was employed, with continuous or intermittent use of anti-obesity drugs, trimestral body composition analysis, psychotherapy, visit to a nutritionist every four months, and both resistance and endurance exercises at least four times a week. Body weight (BW), total weight excess (TWE), body fat, markers of lipid and glucose metabolism, liver function, and inflammation were analyzed. Subjects that dropped out were considered as weight regain. Therapeutic success for the 5-year follow-up included as the maintenance of &gt;20% loss of the initial BW loss, and no weight regain (or &lt; 20% of the initial weight loss). Results: A total of 27 patients (67.5%) were able to maintain the body weight, seven dropped out, and six regained more than 20% of the initial weight loss. Of these, 21 (77.8%) had significant further increase of muscle mass and decrease of fat loss, while 17 (63.0%) had further weight loss (p &lt; 0.05), compared to the 2-year data. Improvements on the biochemical profile persisted in all 27 patients, and had significant further improvements in 24 (88.9%) of these patients. Conclusion: The risk of weight regain five years after a weight loss treatment for obesity was significantly lower compared to previous literature, and comparable to the long-term outcomes of bariatric procedures. An aggressive, structured, and long-term clinical weight loss approach has been shown to be feasible, even for morbidly obese patients.

scholarly journals Initial Weight Loss after Restrictive Bariatric Procedures May Predict Mid-Term Weight Maintenance: Results From a 12-Month Pilot Trial

2015 ◽  
Vol 10 (2) ◽  
pp. 68-73 ◽  
Author(s):  
Marko Nikolić ◽  
Ivan Kruljac ◽  
Lora Kirigin ◽  
Gorana Mirošević ◽  
Neven Ljubičić ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Maintenance ◽  
Pilot Trial ◽  
Initial Weight ◽  
Initial Weight Loss

Predictors of initial weight loss after gastric bypass surgery in twelve veterans affairs medical centers

2013 ◽  
Vol 7 (5) ◽  
pp. e367-e376 ◽  
Author(s):  
David Arterburn ◽  
Edward H. Livingston ◽  
Maren K. Olsen ◽  
Valerie A. Smith ◽  
Andrew L. Kavee ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Veterans Affairs ◽  
Initial Weight ◽  
Initial Weight Loss ◽  
Medical Centers ◽  
Veterans Affairs Medical Centers

Weight Changes after Vertical Banded Gastroplication

2005 ◽  
Vol 50 (2) ◽  
pp. 58-60
Author(s):  
J J Lara ◽  
L Murray ◽  
R Carter ◽  
R Stuart ◽  
M E J Lean
Keyword(s):  
Weight Loss ◽  
Surgical Treatment ◽  
Weight Change ◽  
Weight Regain ◽  
Liquid Diet ◽  
Weight Changes ◽  
Initial Weight ◽  
Initial Weight Loss

Aims: This study assessed the patterns of weight change in response to surgical treatment for obesity. Methods: Vertical Banded Gastroplication (VBG) was performed during the period 1994–2000. Patients were required to follow a liquid diet (8oo kcals) for 12 weeks before surgery. The same diet plus a multivitamin capsule (Forceval) was followed for 12 weeks postoperatively, after which normal foods were introduced. Data from 23 patients, 16 women and 7 men, aged 33–63 years (mean, SD; 42±8yrs), with BMI from 38 to 69 kg/m2 (52.5 ± 8.1 kg/m2) at the time of the surgery were available for analysis. Follow up was 3 to 7 years (mean 4 years). Results: An initial weight loss of 44.4 ± 24.3 kg (min 11.5, max 110.5 kg) was reached during the first two years (mean BMI decrease 15.8 kg/m2). However a regain in weight (36% of the initial weight loss = 5.6 kg/m2) up to 3 to 7 years after surgery was usual. Average annual regain was 13.6 kg (n=17), 9.45 kg (n=11) and 0.8 kg (n=8) during the 3rd, 4th and 5th year after surgery). Five participants reached a BMI below 30 but only one, BMI<25, has maintained all the weight loss after 5 years. Conclusions: Weight loss following VBG ceased after two years with a subsequent substantial weight regain. Auxiliary therapies to counteract weight regain are necessary after VBG.

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