• GibbsBethany BaroneBB0000-0002-0732-6148University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA, USA. bbarone@pitt.edu., Dana Tudorascu, Cindy L Bryce, Diane Comer, Gary S Fischer, Rachel Hess, Kimberl... more y A Huber, Kathleen M McTigue, Laurey R Simkin-Silverman, and Molly B Conroy. less
• University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA, USA. bbarone@pitt.edu.
• J Gen Intern Med. 2020 Nov 1; 35 (11): 3227-3233.

BackgroundThough long-term weight loss maintenance is the treatment goal for obesity, weight regain is typical and few studies have evaluated lifestyle habits associated with weight regain.ObjectiveTo identify dietary and physical activity habits associated with 6- and 24-month weight regain among participants in a weight loss maintenance clinical trial.DesignSecondary analysis of randomized clinical trial data.ParticipantsAdult primary care patients with recent, intentional weight loss of at least 5%.Main MeasuresLifestyle habits included consumption of low-fat foods, fish, desserts, sugary beverages, fruits, and vegetables and eating at restaurants from the Connor Diet Habit Survey; moderate-vigorous physical activity by self-report; steps recorded by a pedometer; and sedentary behavior by self-report. The outcome variable was weight change at 6 and 24 months. Linear regression models estimated adjusted associations between changes in weight and changes in dietary and physical activity habits.Key ResultsOverall, participants (mean (SD): 53.4 (12.2) years old; 26% male; 88% white) maintained weight loss at 6 months (n = 178, mean (SD): - 0.02 (5.70)% change) but began to regain weight by 24 months (n = 157, mean (SD): 4.22 (9.15)% increase). When considered all together, more eating at restaurants, reduced fish consumption, and less physical activity were most consistently associated with weight regain in fully adjusted models at both 6 and 24 months of follow-up. In addition, more sedentary behavior was associated with weight regain at 6 months while reduced consumption of low-fat foods, and more desserts and sugary beverages were associated with weight regain at 24 months.ConclusionsConsuming less fish, fewer steps per day, and more frequent restaurant eating were most consistently associated with weight regain in primary care patients. Primary care providers may consider addressing specific lifestyle behaviors when counseling patients after successful weight loss.Trial RegistrationClinicalTrials.gov Identifier: NCT01946191.

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