Early results matter: Your first 3 fitness classes can predict future weight loss

STOCKHOLM, Sweden — Losing weight is a tough task for many people, but it can be particularly difficult for those living with type 2 diabetes (T2D). Interesting new research, however, finds that early weight loss success among diabetics attending weight management programs can stronger predict their future results.

More specifically, the study finds people with T2D who fail to lose at least 0.5 percent of their body weight after the first three sessions of a fitness program are unlikely to find success in the long run with that approach to slimming down.

Study authors explain that following this simple “rule of thumb” can help those struggling with weight loss recognize early on that what they’re doing isn’t working and it’s time to explore a different weight loss strategy. This study was led by researcher Lulwa Al-Abdullah from the University of Glasgow and Professor Jennifer Logue from Lancaster University.

What do weight loss plans try to achieve?

Behavioral weight loss programs aim to help participants change their eating, physical activity, and behavioral habits. These programs are often put together by commercial groups such as WW (formerly Weight Watchers) and Slimming World, and usually hope to see participants lose around at least five percent of their body weight over the course of roughly 12 weeks. Weight maintenance advice is also common.

“Such programs help some, but not all, people living with obesity – around 40% do not achieve significant weight loss,” says Al-Abdullah in a media release. “If we knew early on which participants were unlikely to succeed, we could switch them to other interventions, including pharmacological options, when they are still highly motivated.”

The research team conducted an analysis of the electronic health records pertaining to adults living with both T2D and obesity who had been referred to the NHS Greater Glasgow and Clyde Weight Management Service between 2004 and 2014. They looked specifically for any demographic and clinical factors which may have predicted future successful weight loss outcomes.

In all, 1,658 participants (60% female) took part in the study, all of whom had been diagnosed with T2D for an average of 5.3 years. The group also had a median BMI of 40.2 kg/m2 and an average age of 57.8.

Study authors defined a successful short-term outcome as a person attending seven out of nine weight management sessions held over a 16-week period and losing over five percent of their body weight. Also, those who successfully lost weight early on and were able to maintain a weight loss of more than five percent three years later were classified as having a successful medium-term outcome.

Weight loss is the biggest indicator of success

A total of 333 participants (20%) had a successful short-term outcome. Notably, the only demographic or clinical factor associated with successful short-term outcomes was early weight loss: 90.4 percent of those who lost 0.5 percent of their weight after the initial three sessions (held over four weeks) had a successful short-term outcome. No other factors (age, sex, socioeconomic status, ethnicity, diabetes medication, average blood sugar level) appeared to correlate with short-term success.

Study authors had access to three-year data pertaining to a total of 1,152 participants, and 12.1 percent (139) of this group enjoyed a successful medium-term outcome. However, just like before, early weight loss was identified as the only factor associated with success. An astounding 89.9 percent of those who lost 0.5 percent of their weight after just three sessions also showed a successful medium-term outcome at three years.

The research team explains that the threshold of failing to achieve 0.5 percent body weight loss within three sessions turned out to be 95 percent accurate at picking out the people who wouldn’t succeed in the long-run.

Breaking the ‘one-size-fits-all’ weight loss model

In conclusion, study authors say early weight loss is strongly associated with short and medium-term success, thus making it a simple way to identify participants more likely to struggle with weight loss as early as possible.

“Currently, people are referred to weight management programs in a ‘one-size-fits-all’ model and, if they are struggling, they have no alternative other than to drop out. This can have a wider health impact, as it may worsen self-stigma and feelings of failure and result in reluctance to visit healthcare professionals in future,” explains study leader Professor Jennifer Logue.

“By identifying those individuals for whom a program is not working early in the process, you can provide support and possibly alternative therapies before the person disengages from treatment. Early review is standard practice in our treatment of other conditions such as diabetes and high blood pressure and our findings will allow it to become standard in the treatment of obesity.”

“It is likely the first few weeks are so important because this is the time when people are having to adapt their shopping, eating, cooking and physical activity behavior to follow whatever the program recommends. They will also need to understand the program, have support from family and friends and be able to afford the food the diet plan suggests,” Al-Abdullah concludes. “This is a large behavioral change and also assumes that there are not underlying differences in appetite control and psychological conditions that will affect their ability to make these changes.”

The team is presenting their findings at the annual meeting of the European Association for the Study of Diabetes (EASD).

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