Table 2.
Predictors of weight loss response to lifestyle and behavioral interventions.
| Author | Inclusion criteria | n | Study design | Predictors of response |
|---|---|---|---|---|
| Aller and colleagues52 | Adults, BMI ⩾30 kg/m2, participating in a lifestyle modification program | 587 | Prospective cohort study assessing the association between genotype and 3- and 12-month weight loss among patients enrolled in a weight loss program | G/G genotype of PLIN1 (rs2289487) and PLIN1 (rs2304795); T/T genotype of PLIN1 (rs1052700), and C/C genotype of MMP2 predicted ⩾5% weight loss at 3 months. C/G-G/G genotype of PPARγ (rs1801282) and T/C genotype of TIMP4 (rs3755724) predicted ⩾5% weight loss at 12 months. Those with combination of PPARγ (rs1801282) C/G-G/G and TIMP4 (rs3755724) T/C had even greater weight loss |
| Apolzan and colleagues43 | Adults, BMI ⩾24 kg/m2 (⩾22 kg/m2 in Asian descent), FPG 95–125, FPG 140–199 mg/dl after 2 h oral glucose load | 3234 | Retrospective analysis of data from the Diabetes Prevention Program (compared weight loss with metformin, intensive lifestyle intervention, and placebo) to identify predictors of long-term (15 year) weight loss | Greater weight loss in first year, older age, and continued metformin use in the metformin group; older age and absence of either DM or family history of DM in the intensive lifestyle group; and higher baseline FPG levels in the placebo group independently predicted greater long-term weight loss |
| Bachar and colleagues44 | Adults, BMI ⩾25 kg/m2, attending outpatient clinics | 11,482 | Retrospective analysis of electronic health records examining factors associated with 5% weight loss at 6 months and weight maintenance at 1 year | Higher BMI, younger age, increased visits with a dietician, and not treated with insulin associated with greater odds of ⩾5% weight loss at 6 months. In those with ⩾5% weight loss at 6 months, more frequent weighing associated with improved weight maintenance at 1 year |
| Balantekin and colleagues51 | Children (7–11 years), BMI ⩾85th percentile, participating in family-based behavioral weight loss treatment | 241 | Retrospective study assessing if children with distinct eating disorder patterns differed in eating disorder pathology and BMI-for-age z-score (zBMI) change | Children with highest eating disorder pathology did not achieve clinically significant weight loss (defined as zBMI ⩾ 0.25 unit loss) |
| Braet39 | Children (7–17 years), BMI >95th percentile | 122 | Cross-sectional study examining predictors of treatment outcomes 2 years after completion of 10-month inpatient treatment program | Higher baseline weight, age, and weight loss during inpatient treatment predicted greater weight loss; higher eating disorder characteristics predicted lower weight loss |
| Chan and Raffa42 | Adults in MOVE! Weight Management Program | 237,577 | Retrospective study assessing association between participation in lifestyle intervention program and weight loss | Increased participation with MOVE! Program increased odds of ⩾5% weight loss |
| Chen and colleagues53 | Adults females with obesity | 34 | Prospective study assessing neural activation to palatable food receipt and genetics; compared those receiving 12-week BWL intervention with those not receiving intervention | Among BWL participants, baseline to 12-week reduction in frontostriatal activation to milkshake predicted greater weight loss at 12, 36, and 60 weeks; possessing A/A or T/A genotype of FTO variant rs9939609 predicted greater weight loss at 12 and 36 weeks |
| Danielsson and colleagues54 | Children (6–16 years), followed in weight management program | 643 | Retrospective analysis assessing if degree of obesity and age predict efficacy of long-term behavioral treatment | 6–9 year olds with severe pediatric obesity (BMI-SD ⩾3.5) more likely to achieve ⩾0.5 unit BMI-SD reduction than adolescents with severe pediatric obesity |
| Di Stefano and colleagues55 | Children (8–15 years), BMI >95th percentile | 418 | Prospective 2-year cohort study assessing association between baseline serum leptin and response to educational based weight loss program | Odds ratio of weight loss response significantly increased by greater quintile of serum leptin concentration |
| Funk and colleagues45 | Adult veterans, BMI ⩾40 kg/m2 or ⩾35 kg/m2 with ⩾1 obesity-related comorbidities | 206 | Retrospective analysis of participants in a 4-month weight loss program examining predictors of weight loss | Greater social support and older age associated with greater weight loss |
| Grave and colleagues47 | Adults, BMI ⩾30 kg/m2 | 500 | Prospective 12-month cohort study of participants entering weight loss programs, assessing psychological predictors of weight loss | Increased baseline dietary restraint and decreased disinhibition predicted increased likelihood of achieving ⩾5% weight loss at 12 months |
| Gross and colleagues40 | Children (4–18 years), followed in weight management programs | 687 | Retrospective analysis of the Pediatric Obesity Weight Evaluation Registry (POWER) | ⩾3% BMI reduction at 1 month associated with increased BMI reduction at 6 and 12 months |
| Hainer and colleagues56 | Adult females with obesity exhibiting stable weight on a 1 week normocaloric diet | 67 | Prospective 4-week inpatient weight reduction program assessing psycho-behavioral and hormonal factors as predictors of weight loss | Baseline free T3, c-peptide, GH, PP associated with higher reduction in weight; baseline IGF-1, cortisol, adiponectin, NPY correlated with lower reduction in weight |
| Horth and colleagues57 | Adults, BMI 30–40 kg/m2 | 307 | Retrospective analysis of a clinical trial in which patients with obesity randomized to ad libitum low-carbohydrate or low-fat diet for 2 years | Pre-DM (FPG 100–125 mg/dl) and high fasting insulin levels associated with greater weight loss to low-fat versus low-carbohydrate diet at 2 years. Pre-DM and low fasting insulin levels associated with greater weight loss to low-carbohydrate versus low-fat diet at 2 years. |
| Kong and colleagues37 | Adults, BMI ⩾27 kg/m2 with pre-DM or metabolic syndrome | 51 | Retrospective analysis of lifestyle modification weight loss trial, assessing predictors of retention after 1 year of intervention with ⩾5% weight loss | Lower response rate to question “I am capable of doing more physical activity” and weight loss <0.5% at 6 weeks after intervention initiation predicted lower retention and <5% weight loss at 1 year |
| Kong and colleagues58 | Adults, BMI 25–38 kg/m2 | 50 | Prospective 3-month cohort study assessing predictors of weight loss through 6 weeks of energy restriction followed by 6 weeks of weight maintenance | Participants with lower weight loss and rapid weight had highest baseline plasma insulin, IL-6, and adipose tissue inflammation (HAM56+ cells); plasma insulin, IL-6, leukocyte number, and adipose tissue (HAM56) together predicted weight trajectory |
| Madsen and colleagues59 | Children (8–19 years), followed in a weight management clinic | 214 | Retrospective cohort study of children undergoing clinic-based lifestyle modification program, assessing efficacy and predictors of weight loss | Higher baseline BMI z-score predicted poor response at first (mean 4.1 months) and ultimate (mean 12.1 months) follow-ups; fasting insulin explained 6% response variance at first follow up; baseline BMI z-score plus change in BMI z-score at first visit explained up to 50% of response at ultimate visit |
| Moens and colleagues50 | Children with obesity followed in a weight management program | 90 | Prospective 8-year cohort study assessing child and familial variables associated with long-term weight regulation | Age, degree of overweight at baseline, global self-worth positively predicted, and psychopathology in mother negative predicted weight loss after 8 years |
| Rotella and colleagues49 | Adults with obesity referred to weight management clinic | 270 | Prospective 6-month cohort study assessing psychological/psychopathological features associated with better treatment response to a lifestyle modification program | In women, higher psychopathology associated with worse outcomes. In men, higher motivation was associated with increased likelihood achieving ⩾5% weight loss |
| Samblas and colleagues60 | Adults, WC >94 cm (males) and >80 cm (females) with metabolic syndrome | 47 | Case-control study assessing transcriptomic and epigenomic patterns; compared high weight loss responders (>8% body weight) with low responders (<8% body weight) following 6-month dietary modification program | CD44 showed higher expression and lower DNA methylation levels in low responders versus high responders |
| Stotland and Larocque41 | Adults, BMI ⩾ 25 kg/m2 | 344 | Prospective 9-month cohort study assessing if early treatment response and change in eating behavior predicted ongoing weight loss to low/very low-calorie diets | Very low-calorie diet, BMI change, number of weigh-ins, and change in uncontrolled eating in first 5 weeks predicted ongoing weight loss at 9 months |
| Teixeira and colleagues46 | Adults, BMI 25–38 kg/m2 | 158 | Prospective 16-month cohort study comparing behavioral/psychosocial differences between those with ⩾5% weight loss and those with <5% weight loss 1 year after a 6-week weight management program | Higher accepting dream weight, lower level of previous dieting, higher exercise self-efficacy, and smaller waist-to-hip ratio predicted increased likelihood of achieving ⩾5% weight loss at 16 months |
| Teixeira and colleagues48 | Adults, female BMI 25–40 kg/m2 | 225 | Retrospective 2-year cohort study assessing mediators of weight loss and weight loss maintenance during/after 1-year weight loss intervention | Lower emotional eating, increased flexible cognitive restraint, and fewer exercise barriers mediated 1-year weight loss; flexible restraint and exercise self-efficacy mediated 2-year weight loss |
| Yank and colleagues38 | Adults, BMI ⩾25 kg/m2 with pre-DM or metabolic syndrome | 72 | Retrospective 15-month cohort study assessing weight loss patterns and predictors of response to primary care-based lifestyle intervention | Participants with moderate and steady, and substantial and early, weight loss achieved ⩾5% short-term weight loss and maintained this at 15 months |
BMI, body mass index; BWL, behavioral weight loss; DM, diabetes mellitus; FPG, fasting plasma glucose; FTO, fat mass and obesity-associated protein; GH, growth hormone; IGF-1, insulin-like growth factor-1; IL-6, interleukin-6; NPY, neuropeptide Y; PP, pancreatic polypeptide; PPARγ, peroxisome proliferator-activated receptor gamma; RCT, randomized controlled trial; SD, standard deviation; WC, waist circumference.