Evaluation of early weight loss thresholds for identifying nonresponders to an intensive lifestyle intervention

Jessica L. Unick, Patricia E. Hogan, Rebecca H. Neiberg, Lawrence J Cheskin, Gareth R. Dutton, Gina Evans-Hudnall, Robert Jeffery, Abbas E. Kitabchi, Julie A. Nelson, F. Xavier Pi-Sunyer, Delia Smith West, Rena R. Wing

Research output: Contribution to journalArticlepeer-review


Objective Weight losses in lifestyle interventions are variable, yet prediction of long-term success is difficult. The utility of using various weight loss thresholds in the first 2 months of treatment for predicting 1-year outcomes was examined. Methods Participants included 2327 adults with type 2 diabetes (BMI:35.8 ± 6.0) randomized to the intensive lifestyle intervention (ILI) of the Look AHEAD trial. ILI included weekly behavioral sessions designed to increase physical activity and reduce caloric intake. 1-month, 2-month, and 1-year weight changes were calculated. Results Participants failing to achieve a ≥2% weight loss at Month 1 were 5.6 (95% CI:4.5, 7.0) times more likely to also not achieve a ≥10% weight loss at Year 1, compared to those losing ≥2% initially. These odds were increased to 11.6 (95% CI:8.6, 15.6) when using a 3% weight loss threshold at Month 2. Only 15.2% and 8.2% of individuals failing to achieve the ≥2% and ≥3% thresholds at Months 1 and 2, respectively, go on to achieve a ≥10% weight loss at Year 1. Conclusions Given the association between initial and 1-year weight loss, the first few months of treatment may be an opportune time to identify those who are unsuccessful and utilize rescue efforts. Trial Registration clinicaltrials.gov Identifier: NCT00017953

Original languageEnglish (US)
Pages (from-to)1608-1616
Number of pages9
Issue number7
StatePublished - 2014

ASJC Scopus subject areas

  • Endocrinology
  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Medicine(all)


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