How effective is rejoining a long-term weight loss program? The 5- and 10-year MRI-assessed Follow Interventions
Hadar Klein1, Dafna Pachter1, Dana Tamar Goldberg Toren1
1Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, School of Public Health, The Health and Nutrition Innovative International Research Center, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, 8410501, Israel.
BMC Medicine
|January 29, 2026
Summary
Reengaging in lifestyle weight loss interventions offers long-term benefits. Despite initial reduced effectiveness, repeated participation leads to sustainable metabolic improvements and less weight regain over time.
Area of Science:
- Obesity research
- Metabolic health
- Lifestyle interventions
Background:
- Long-term effectiveness of repeated lifestyle weight loss interventions remains unclear.
- Previous trials CENTRAL (NCT01530724) and DIRECT-PLUS (NCT03020186) provide data for re-evaluation.
- Understanding sustained impact is crucial for public health strategies.
Purpose of the Study:
- To assess the long-term efficacy of reengaging in lifestyle weight loss programs.
- To compare outcomes of participants in one versus multiple intervention trials.
- To evaluate sustained effects on weight, body composition, and metabolic markers.
Main Methods:
- Analysis of 572 trial observations from 480 participants across two weight-loss trials (CENTRAL and DIRECT-PLUS).
- Follow-up assessment five years after the second trial, including weight, metabolic biomarkers, and MRI-measured fat depots.
- Comparison of outcomes between first-time participants and those rejoining interventions (T1+T2 rejoiners).
Main Results:
- Rejoiners showed similar initial weight loss but presented improved metabolic profiles at the second trial's baseline.
- Subsequent interventions yielded attenuated improvements in weight and fat depots for rejoiners compared to their first intervention and first-time participants.
- Despite attenuated response, rejoiners experienced significantly less weight and fat regain 5 years post-intervention compared to first-time participants.
Conclusions:
- Repeated engagement in structured lifestyle interventions provides significant long-term benefits.
- Sustainable metabolic improvements are achievable even with an attenuated weight-loss response upon re-intervention.
- This suggests value in offering repeated lifestyle interventions for sustained health outcomes.
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