Impact of weight loss and regain - Obesity

Nutrition Research Newsletter, Nov, 2003 by Scott G. Engel

The prevalence of obesity is increasing, with an estimated prevalence of 250 million people worldwide, which is equivalent to 7% of the adult population. There have been numerous reports in the literature, from both population and weight loss studies, suggesting that obesity is associated with impaired health-related quality of life (HRQOL). In addition, weight loss, in those who are overweight or obese, has been associated with improvements in HRQOL.

However, there is a lack of research on the effects of weight gain on HRQOL. Since it is unknown how weight regain affects HRQOL, a recent study in Obesity Research examines this relationship. Specifically, three questions were addressed.

1. Does the loss of weight result in improved HRQOL to the same extent that the regaining of weight results in decreased HRQOL?

2. Is the relationship between HRQOL and weight change a linear or curvilinear path?

3. Does initial severity of baseline HRQOL impact the manner in which HRQOL changes with respect to weight loss and regain?

The subjects in this study included 122 overweight and obese men and women in a weight reduction program (phenterminefenfluramine and dietary counseling) who had initially lost at least 5% of their total body weight and then regained at least 5% of their weight during the follow-up period. Follow-up periods ranged from ten to 41 months. All subjects completed the Impact of Weight on Quality of Life-Lite, an obesity-specific health-related quality of life (HRQOL) measured at three month intervals.

Mean BMI at baseline was 40.9 kg/[m.sup.2]. The average weight loss from baseline to low weight was 18.8% and the average weight regain was 10.1%. Neither differed by gender. The effects of weight regain on HRQOL mirrored the effects of weight loss--rates of HRQOL change were similar in magnitude but different in direction for comparable weight loss and regain. These changes in HRQOL occurred in a linear fashion across the entire weight change continuum from weight loss to weight regain. Those patients who initially reported the greatest impairment in HRQOL also reported greatest improvement in HRQOL per unit of weight loss and greatest deterioration of HRQOL per unit of weight regained.

The results suggest strong empirical support of the importance of weight loss maintenance. The data suggest a linear relationship for HRQOL change across both weight loss and regain. Therefore, patients who have lost weight do not seem to continue to reap the benefits of their successful weight loss once they begin to regain weight.

Scott G. Engel, Ross D. Crosby, Ronette L. Kolotkin, et al., Impact of Weight Loss and Regain on Quality of Life: Mirror Image or Differential Effect, Obesity Research 11(10): 1207-1213 (October 2003) [Address correspondence to: Scott G. Engel, Neuropsychiatric Research Institute, 700 First Avenue South, Fargo, ND 58107. E-mail: scott.engel@ndsu.nodak3.edu]