The Endocrine Society's 98th Annual Meeting & Expo:

Many Adults with Obesity are Cyclers—Patients who do not continually lose, gain, or maintain initial weight loss

At the Endocrine Society’s 98th Annual Meeting in Boston, Joanna Huang, PharmD presented study findings about patterns of weight loss, weight cycling and weight regain. Dr. Huang is the Senior Manager, Health Economics and Outcome Research at Novo Nordisk, Inc. in Plainsboro, New Jersey.

Obesity is an Epidemic
Overweight female measuring her waistlineIn the United States, obesity is an epidemic. Nearly one-third of American adults are obese. Concurrently, in 2010 the economic burden of obesity-related comorbidities in the US was estimated at approximately $315.8 billion.1 “Today, obesity interventions are mostly aimed at lifestyle modification which often are insufficient and difficult to maintain in the long run, thus there is a need for a patient to receive targeted and individualized treatment, and that are multidimensional, including diet, exercise, behavior modification, pharmacotherapy, and surgery,”2,3 stated Dr. Huang.

About the Study
“In order to target treatment for patients, understanding their patterns of weight loss and characteristics of the patients who successfully lost and maintained that weight loss was very important,” commented Dr. Huang. The methodology of this retrospective longitudinal study of patients with obesity (177,743; 1996-2014) used data collected from electronic medical records. The data obtained did not indicate if a patient had undergone bariatric surgery or non-prescribed interventions.

“We first defined the index date as the first observation of any patients who are having a BMI of greater than 30 kg/m2, which we defined as obesity. Then we followed that patient for 6 months to assess their initial weight change. Because we were looking for the long-term maintenance of that initial 6 months weight loss, we then followed the patient for another 2 years,” explained Dr. Huang.
Table. Weight groups based on weight change in the initial 6 monthsDr. Huang said, “Regardless of the amount of initial 6 months weight loss, after 2 years the majority of the patients become cyclers, which we defined as patients who do not continually lose, gain, or maintain that initial weight loss.” The percentage of each initial weight loss group who regained ≥50% of their weight lost during 2 years:

  • 40% in 14 months — Modest weight loss group
  • 36% in 15.2 months — Moderate weight loss group
  • 19% in 12 months — High weight loss group

Concluding Comments
“So in conclusion, despite the level of initial weight loss, weight cycling and regain were commonly observed among patients throughout the 2-year observational period. Weight loss maintenance, even in the moderate and high weight loss groups, is very difficult to achieve. Successful and sustained clinically meaningful weight loss thus requires chronic and effective weight management strategies,” said Dr. Huang.

Disclosure: Joanna Huang, PharmD is an employee of Novo Nordisk, Inc.; Novo Nordisk, Inc. supported this study in collaboration with the Analysis Group.

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