Maintenance of weight loss or stability in subjects with obesity: a retrospective longitudinal analysis of a real-world population

Abstract

Objectives: Characterize patterns of weight change among subjects with obesity.

Methods: A retrospective observational longitudinal study of subjects with obesity was conducted using the General Electric Centricity electronic medical record database. Subjects who were ≥18 years old with BMI ≥30 kg/m² (first defining index BMI), had no medical conditions associated with unintentional weight loss, and had ≥4 BMI measurements/year for ≥2.5 years were included and categorized into groups (stable weight: within <5% of index BMI; modest weight loss: ≥5 to <10% of index BMI lost; moderate weight loss: ≥10 to <15% of index BMI lost; and high weight loss: ≥15% of index BMI lost) based on weight change during 6 months following index. No interventions were considered. Patterns of weight change were then assessed for 2 years.

Results: A total of 177,743 subjects were included: 85.1% of subjects were in the stable weight, 9.3% in the modest, 2.3% in the moderate, and 3.3% in the high weight loss groups. The proportion of subjects who maintained or continued to lose weight decreased over the 2 year observation period; 11% of those with high weight loss continued to lose weight and 19% maintained their weight loss. This group had the lowest percentage of subjects who regained ≥50% of lost weight and the lowest proportion of subjects with weight cycling (defined as not continuously losing, gaining, or maintaining weight throughout the 2 year observation period relative to its beginning). This trend persisted in subgroups with class II–III obesity, pre-diabetes, and type 2 diabetes.

Conclusion: Weight cycling and regain were commonly observed. Subjects losing the most weight during the initial period were more likely to continue losing weight.

Keywords:

• BMI
• Obesity
• Weight loss
• Weight maintenance

Transparency

Declaration of funding

This study was supported by Novo Nordisk Inc, Plainsboro, NJ, USA.

Author contributions: All authors have made substantial contributions to the conception and design of the study and defined the intellectual content. J.H., S.B., B.G.S., J.B., and R.G. assisted with acquisition of the data; M.D., R.H.B., F.V., and M.S.D. assisted with statistical analysis of the data; all authors contributed to the interpretation of data; M.D., R.H.B., J.H., and S.B. drafted the manuscript; F.V., B.G.S., J.B., R.G., and M.S.D. critically reviewed and revised the intellectual content of the manuscript; all authors provided final approval of the submitted manuscript.

Declaration of financial/other relationships

J.B., B.G.S. and R.G. have disclosed that they are employees of Novo Nordisk Inc. (NNI) and receive a salary from NNI and report ownership of stock options. J.H. has disclosed that she was an employee of NNI while this research was conducted, and received a salary and stock options. S.B. has disclosed that she was an employee of NNI while this research was conducted and received a salary. M.D., R.H.B., F.V., and M.S.D. have disclosed that they are employees of Analysis Group Inc. which receives research funds from NNI.

CMRO peer reviewers on this manuscript have received an honorarium from CMRO for their review work, but have no relevant financial or other relationships to disclose.

Acknowledgments

No assistance in the preparation of this article is to be declared.

Previous presentation: This study was previously presented as an oral presentation at ENDO 2016 and a poster presentation at ISPOR 2016.