Two-year weight trajectories following completion of a behavioral weight loss maintenance intervention

Long-term effects of behavioral weight loss maintenance interventions need to be assessed in order to understand their durability of effects. This can be evaluated with the use of weights recorded in the electronic medical record. The goal of this study was to use electronic health record (EHR)-recorded weight to examine outcomes 2 years beyond the completion of a trial in which participants were randomized to receive a weight maintenance intervention or usual care after required initial weight loss.

Weights collected in the Veteran's Affairs national EHR were obtained for 2 years following trial completion. Outliers and implausible weights were identified and removed prior to analysis. Mixed-effects models with quadratic time were fit to estimate between-arm differences in weight change.

Model-estimated weight at trial completion was 109.7 kg for usual care and 106.8 kg for intervention, estimated difference of -2.9 kg (95% confidence interval [CI]: -8.8, 3.0; p = 0.34). Two years later, estimated mean weight collected from (n = 211) participants with available EMR weights was 111.5 kg for usual care and 108.0 kg for intervention, estimated difference -3.4 kg (95% CI: -9.3, 2.4 kg; p = 0.35).

While not statistically significant, weights from the EHR suggest the possibility of a clinically meaningful difference that should be confirmed by future adequately powered studies.