Maintenance of weight loss or stability in subjects with obesity: a retrospective longitudinal analysis of a real-world population

Objectives: Characterize patterns of weight change among subjects with obesity. Methods: A retrospective observational longitudinal study of subjects with obesity was conducted using the General Electric Centricity electronic medical record database. Subjects who were >= 18 years old with BMI >= 30 kg/m(2) (first defining index BMI), had no medical conditions associated with unintentional weight loss, and had >= 4 BMI measurements/year for >= 2.5 years were included and categorized into groups (stable weight: within <5% of index BMI; modest weight loss: >= 5 to <10% of index BMI lost; moderate weight loss: >= 10 to <15%of index BMI lost; and high weight loss: >= 15% of index BMI lost) based on weight change during 6 months following index. No interventions were considered. Patterns of weight change were then assessed for 2 years. Results: A total of 177,743 subjects were included: 85.1% of subjects were in the stable weight, 9.3% in the modest, 2.3% in the moderate, and 3.3% in the high weight loss groups. The proportion of subjects who maintained or continued to lose weight decreased over the 2 year observation period; 11% of those with high weight loss continued to lose weight and 19% maintained their weight loss. This group had the lowest percentage of subjects who regained >= 50% of lost weight and the lowest proportion of subjects with weight cycling (defined as not continuously losing, gaining, or maintaining weight throughout the 2 year observation period relative to its beginning). This trend persisted in subgroups with class II-III obesity, pre-diabetes, and type 2 diabetes. Conclusion: Weight cycling and regain were commonly observed. Subjects losing the most weight during the initial period were more likely to continue losing weight.