Factors Associated with Weight Loss Maintenance among Participants

Factors Associated with Weight Loss Maintenance among Participants of a Weight Management Program at a Community Health Center in Tucson Arizona Melanie Walker B. S. , Katherine Ellingson Ph. D, Diane Haeger MBA Introduction Two-thirds of Americans are now overweight or obese 1. In America, obesity rates have risen from approximately 15% in 1980 to over 34% in 20082. Obesity is both a risk factor for many health problems, and occasionally a problem in of itself. Obesity is related to an increased risk of cardiovascular disease, diabetes, sleep apnea, osteoarthritis and certain cancers, along with mortality itself 3, 4. Obesity has also been associated with lower measures of quality of life, from physical functioning to psychological and social ramifications 5. Many clinicians encourage overweight patients to try to achieve a 10% weight loss. This amount has been shown to reduce the risks of type 2 diabetes and other obesity related comorbidities 6, 7. A 10% weight loss has also been shown to improve mood, body-image, and other psychological functioning 8. Yet many people who have lost weight struggle to maintain it. A meta-analysis of long-term weight loss studies found that over half of participants gained back the weight in two years 9. For my research, I worked with El Rio Health which is a community health center in Tucson Arizona. They have been operating their Weight Management for Optimal Health program for over five years now. I used their data collection to investigate the factors associated with weight maintenance among participants of the program. Methods For the data, participants had to have both the preprogram survey and the post-program survey entered in the data, with the assumption that if they had both they had sufficiently completed the program. The survey asked a range of health questions about current health satisfaction levels, eating and exercise behaviors, and barriers to weight loss. Among participants with both surveys, there also needed to be an initial weight and a two years post program weight entry (+/- 3 months from the two-year date). 88 participants who met the criteria were found. Patients were dichotomized into those who had maintained a 10% weight loss and those who had not. Chi-square tests were used to determine significant factors, pulled from the survey, associated with those who had maintained their weight loss versus those who had not. There is some thought that change in health behaviors have been found to be significant. Baseline levels of health behaviors such as exercise or sugary beverage consumption were subtracted from post program levels. Chisquares were then performed. Results Over 80 variables were analyzed looking for significant factors between maintainers and non-maintainers. No significant results were found at the 0. 05 alpha level. A significant number of participants reported greater health, energy and sleep satisfaction after the program than before (see table 2), but none of these factors predicated weight maintenance. Discussion While no significant factors were found, that does help focus in on a program need. Significant factors are likely not being identified or identified accurately. This highlights the need to modify the survey. The survey is long and meticulous. Many questions were left unanswered, resulting in missing data. Modifying the survey to be more clear and less cumbersome, while reducing the amount of data, might make the data more accurate. We were glad to see that so many of the people in the dataset were maintainers, 71. 9% had maintained a 10% weight loss. This might suggest that doing the program and staying in the El Rio system has some unknown positive effect. While we had a larger dataset, 88 participants, several of them had missing survey values, reducing the power. The Weight Management for Optimal Health program is not a research study. Retention rate is not high. Several participants have low health literacy rates, which contributes to inaccuracy of the self-reported survey results. Yet, as a weight management program and not a research study, we might have a better idea of how people apply weight management skills. Conclusion No significant factors were found, but we are hopeful these results can help improve the program. With the obesity epidemic growing so rapidly, finding successful measures for weight loss is highly imperative. References 1. NIH National Institute of Diabetes and Digestive and Kidney Diseases. Overweight and Obesity Statistics. WIN Weight Inf Netw. 2010. 2. Ogden CL, Carroll MD. Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults: United States, Trends 1960 -62 Through 20072008. ; 2010. 3. Shea JB, Sears S; , Wolf PA, et al. Adult Obesity Facts Overweight & Obesity CDC. ; 2008. 4. CDC. 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