Behavioral transitions and weight change patterns within the PREMIER trial.

Area of Science:

• Obesity research
• Behavioral medicine
• Public health

Background:

• Transitioning from short-term weight loss to sustained weight maintenance presents significant challenges.
• Understanding the behavioral factors influencing long-term weight management is crucial for effective intervention design.

Purpose of the Study:

• To examine the association between intervention behavioral targets and short-term (6-month) and long-term (18-month) weight loss.
• To identify patterns of weight change and their relationship with adherence to self-monitoring behaviors.

Main Methods:

• Analysis of overweight/obese participants (n=507) from the PREMIER trial, a 18-month lifestyle intervention.
• Logistic regression used to assess associations between behaviors (attendance, physical activity, food records) and achieving ≥5% weight loss.
• ANOVA used to compare adherence to behaviors across five weight change categories (weight gained, stable, relapse, late loss, maintenance).

Main Results:

• Higher adherence to attendance, food records, and physical activity monitoring was linked to greater odds of achieving 5% weight loss.
• The weight loss and maintenance group showed significantly smaller declines in self-monitoring behaviors compared to other groups.
• While all groups reduced behavior frequency, the maintenance group sustained higher levels of engagement.

Conclusions:

• Behaviors promoting short-term weight loss remain relevant for long-term weight maintenance.
• Sustaining engagement with self-monitoring behaviors, even at reduced frequencies, is critical for long-term weight loss success.
• Interventions should focus on strategies to minimize the decline in behavioral adherence over time to support sustained weight management.