Longitudinal Weight Outcomes From a Behavioral Lifestyle Intervention in Clinical Practice
2019
Romanelli, Robert J. | Huang, Xiaojing | Chopra, Vidita | Ma, Jun | Venditti, Elizabeth M. | Sudat, Sylvia | Greenwood, Deborah A. | Pressman, Alice R. | Azar, Kristen M. J.
The purpose of this electronic health record (EHR)–based retrospective cohort study was to characterize a population of patients participating in a 12-month, lifestyle change program in a community-based health system and to examine longitudinal weight outcomes. Program participants were identified in the EHRs of a health care delivery system across 18 sites between 2010 and 2017. Outcomes were mean weight change and proportion of patients with ≥5% weight loss through 24 months from program initiation. Among 4463 program participants, 3156 met study eligibility criteria, with a mean ± SD age of 53.5 ± 13.1 years; 77.7% were women. Mean baseline weight ± SD was 101.3 ± 23.8 kg. Three main cardiometabolic risk groups were identified: prediabetes/high risk for diabetes (47.3%), overweight/obese in the absence of elevated diabetes risk (27.2%), and existing diabetes (23.9%). Maximal mean weight loss was 3.9% at 6 months from baseline. At 12 and 24 months from baseline, mean weight loss was 3.2% and 2.3%, respectively, with 31% and 29% of participants attaining ≥5% weight loss. Long-term weight outcomes were similar across risk groups. A lifestyle change program in a clinical practice setting is associated with modest weight loss, sustained through 24 months, among participants with a range of cardiometabolic risk factors. More than one-quarter of participants achieve ≥5% weight loss, regardless of cardiometabolic risk.
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