Continuous Engagement in a Weight-Loss Program Promotes Sustained Significant Weight Loss.

BACKGROUND: Significant weight loss improves health but regain is common. OBJECTIVE: The objective of the study was to determine if 2,346 members of Take Off Pounds Sensibly-a national, low-cost, peer-led weight-loss program-achieved and maintained significant weight loss with 7 consecutive annual renewals. METHODS: This study was a retrospective cohort design. For each renewal, the cumulative change from baseline weight was calculated. Weight change was placed into 1 of 3 categories: significant weight loss, loss ≥ 5%; weight stable, loss of 0 to < 5%; or weight gain, any amount above baseline weight. RESULTS: The cohort included 2,346 individuals. Fifty-one percent (n=740) of participants were in the significant weight-loss category all 7 years; 256 (18%) were in the significant weight-loss category at year 1 but moved into at least 1 other category during years 2 through 6; 359 (25%) were in the weight stable category at year 1; and 98 (7%) were in the weight gain category at year 1. CONCLUSIONS: Over 60% of the population achieved significant weight loss by year 7. Since continuous, long-term engagement in a weight-loss program can lead to significant weight loss, even if significant weight loss is not initially achieved, participation should be encouraged.

The Impact of Timing of Exercise Initiation on Weight Loss: An 18-Month Randomized Clinical Trial.

OBJECTIVE: This study aimed to evaluate the impact of timing of exercise initiation on weight loss within a behavioral weight loss program. METHODS: Adults with overweight or obesity (N = 170; age 18-55 years; BMI 25-42 kg/m2 ; 83.5% women) were enrolled in an 18-month behavioral weight loss program consisting of a reduced-calorie diet, exercise, and group-based support. The standard group (STD) received a supervised exercise program (progressing to 300 min/wk of moderate-intensity aerobic exercise) during months 0 to 6. The sequential group (SEQ) was asked to refrain from changing exercise during months 0 to 6 and received the supervised exercise program during months 7 to 12. On completion of supervised exercise, both groups were instructed to continue 300 min/wk of moderate-intensity exercise for the study duration. RESULTS: At 6 months, the STD group exhibited greater reductions in body weight (-8.7 ± 0.7 kg) compared with the SEQ group (-6.9 ± 0.6 kg; P = 0.047). Between 6 and 18 months, the STD group regained more weight (2.5 ± 0.8 kg vs. 0.0 ± 0.8 kg; P = 0.02). At 18 months, there were no between-group differences in changes in weight (STD: -6.9 ± 1.2 kg; SEQ: -7.9 ± 1.2 kg), fat mass, lean mass, physical activity, or attrition. CONCLUSIONS: Both immediate and delayed exercise initiation within a behavioral weight loss program resulted in clinically meaningful weight loss at 18 months. Thus, timing of exercise initiation can be personalized based on patient preference.