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Int J Behav Nutr Phys Act. 2016 Apr 1;13:43. doi: 10.1186/s12966-016-0367-9.

Can early weight loss, eating behaviors and socioeconomic factors predict successful weight loss at 12- and 24-months in adolescents with obesity and insulin resistance participating in a randomised controlled trial?

Author information

1
Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia. megan.gow@health.nsw.gov.au.
2
The Children's Hospital at Westmead Clinical School, University of Sydney, Locked Bag 4001, Westmead, NSW, 2145, Australia. megan.gow@health.nsw.gov.au.
3
The Children's Hospital at Westmead Clinical School, University of Sydney, Locked Bag 4001, Westmead, NSW, 2145, Australia.
4
Kids Research Institute, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.
5
Nutrition and Dietetics and Weight Management Services, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.
6
CSIRO Food and Nutritional Sciences, PO Box 10041, Adelaide BC, SA, 5000, Australia.
7
Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.

Abstract

BACKGROUND:

Lifestyle interventions in adolescents with obesity can result in weight loss following active intervention but individual responses vary widely. This study aimed to identify predictors of weight loss at 12- and 24-months in adolescents with obesity and clinical features of insulin resistance.

METHODS:

Adolescents (n = 111, 66 girls, aged 10-17 years) were participants in a randomised controlled trial, the RESIST study, examining the effects of two diets differing in macronutrient content on insulin sensitivity. Eighty-five completed the 12-month program and 24-month follow-up data were available for 42 adolescents. Change in weight was determined by BMI expressed as a percentage of the 95th percentile (BMI95). The study physician collected socioeconomic data at baseline. Physical activity and screen time, and psychological dimensions of eating behavior were self-reported using the validated CLASS and EPI-C questionnaires, respectively. Stepwise multiple regressions were conducted to identify models that best predicted change in BMI95 at 12- and 24-months.

RESULTS:

Mean BMI95 was reduced at 12-months compared with baseline (mean difference [MD] ± SE: -6.9 ± 1.0, P < 0.001) but adolescents had significant re-gain from 12- to 24-months (MD ± SE: 3.7 ± 1.5, P = 0.017). Participants who achieved greater 12-month weight loss had: greater 3-month weight loss, a father with a higher education, lower baseline external eating and parental pressure to eat scores and two parents living at home. Participants who achieved greater 24-month weight loss had: greater 12-month weight loss and a lower baseline emotional eating score.

CONCLUSIONS:

Early weight loss is consistently identified as a strong predictor of long-term weight loss. This could be because early weight loss identifies those more motivated and engaged individuals. Patients who have baseline factors predictive of long-term weight loss failure may benefit from additional support during the intervention. Additionally, if a patient does not achieve early weight loss, further support or transition to an alternate intervention where they may have increased success may be considered.

TRIAL REGISTRATION:

Australian New Zealand Clinical Trial Registration Number (ACTRN) 12608000416392 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=83071.

KEYWORDS:

Eating behaviors; Insulin resistance; Obesity; Pediatric; Predictors; RESIST; Socioeconomic; Weight loss

PMID:
27036113
PMCID:
PMC4818484
DOI:
10.1186/s12966-016-0367-9
[Indexed for MEDLINE]
Free PMC Article

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