Weight loss success during and after a weight loss program varies.
Recently, researchers examined the factors linked to weight loss during and after a 12-month weight loss study in children and adolescents.
Here is a summary of their findings.
Children and adults respond differently to weight loss programs. Some lose weight fast, while others lose less.
Although genetics play a role in people’s ability to maintain or lose weight, socioeconomic and psychological factors also affect weight loss success.
Defining these factors, identifying their cause and knowing how to treat the underlying problems makes personalized weight loss programs possible.
Furthermore, precisely targeting the root of people’s weight problems would significantly increase long-term success.
This involves providing people with tailor-made weight loss strategies, as well as helping them deal with dysfunctional eating habits.
This study examined how early weight loss, socioeconomic factors and dysfunctional eating habits affect long-term weight loss.
Can early weight loss, eating behaviors and socioeconomic factors predict successful weight loss at 12- and 24-months in adolescents with obesity and insulin resistance participating in a randomized controlled trial?
This observational study was based on a weight loss trial known as the RESIST study, which examined how two weight loss diets affected insulin sensitivity.
The weight loss strategies included dietary support, exercise and lifestyle advice (3).
85 overweight or obese children and adolescents, aged 10–17 years, finished the 12-month weight loss program. 42 of them were followed for 12 months afterward, and all of them had pre-diabetes or insulin resistance.
The current analysis examined how early weight loss, socioeconomic factors or eating behaviors affected weight loss during and after the trial.
Change in body weight from the end of the trial (at 12 months) to the follow-up (at 24 months) was calculated using body mass index (BMI), expressed as a percentage of the 95th percentile for age groups (BMI95) (4).
The researchers looked at various factors and examined their association with weight gain or weight loss during the 12-month follow-up.
Socioeconomic data was collected using questionnaires at the start of the trial. Self-reported physical activity, screen time and eating behavior were also assessed.
Bottom Line: This study examined the association between weight loss success, socioeconomic factors, eating behavior and early weight loss.
Finding 1: Early Weight Loss Predicts Long-Term Weight Loss
Of the 85 participants who finished the trial, 79% managed to lose weight.
In comparison, only 55% of the 42 who returned for follow-up lost weight during the first year after the trial ended.
The study showed that those who lost more body weight early on were more likely to continue losing weight during the rest of the trial and after it.
Specifically, weight loss during the first 3 months of the trial was significantly associated with greater weight loss success during the whole trial.
Similarly, greater weight loss during the whole trial was significantly linked with greater weight loss during the year following the trial.
Failure to lose weight early may indicate that the weight loss program does not fit the individual and some factors necessary for success are lacking.
Often, this is simply due to lack of commitment or motivation, indicating that additional support may be necessary.
Bottom Line: The study showed that early weight loss during a weight loss program may predict further weight loss success later on.
Finding 2: High Family Income is Linked With Greater Weight Loss Success
The study found that a high family income was associated with greater weight loss during and after the trial.
It also showed that having a highly educated father increased the children’s chances of successfully losing weight.
This is supported by one previous observational study showing that children with poorly educated parents were more likely to fail at losing weight in the long-term (10).
Several factors may explain this:
- Knowledge: Educated parents may know more about healthy nutrition.
- Income: Higher education is associated with a higher family income.
- Food choice: A low income may reduce the ability or willingness to buy healthy foods, which often tend to be more expensive than junk foods (11, 12).
Bottom Line: Family income and parent education were associated with greater weight loss success during and after the weight loss program.
Finding 3: Dysfunctional Eating Habits May Prevent Weight Loss Success
At the start of the trial, the participants’ self-rated eating behavior was assessed using a questionnaire called the Eating Pattern Inventory for Children (EPI-C) (9).
The EPI-C contained 20 questions, divided into 4 categories:
- External eating: The inability to resist certain easily available foods.
- Emotional eating: The tendency to eat in response to negative emotions.
- Restrained eating: The act of limiting food intake to control body weight.
- Parental pressure to eat: Some parents pressure their children into eating.
The study found that self-rated external eating at the start of the study reduced the participants’ chance of successful weight loss.
Parental pressure to eat also reduced weight loss success. Similarly, emotional eating at the start of the study was linked with increased weight loss after the trial.
It is well known that eating disorders and dysfunctional eating habits play a role in the development of obesity in adolescents (13).
Bottom Line: External eating, emotional eating and parental pressure to eat reduced long-term weight loss success in the current study.
Finding 4: Parental Break-Up Reduces Long-Term Weight Loss Success
The study also found that individuals who had both parents living at home were more likely to continue losing weight after the trial ended.
Conflict and break-ups cause emotional stress in children, potentially increasing the risk of eating disorders and poor lifestyle habits.
One previous observational study showed that children who came from a broken family were less likely to keep weight off in the long-term (10).
Bottom Line: Coming from a broken family is a risk factor for weight gain and may reduce success during a weight loss program.
This study had several limitations. First, it was observational and could only identify associations, not true causal relationships.
Second, the researchers didn’t measure fat mass directly. Instead, they used body mass index (BMI), which is calculated from height and weight.
BMI doesn’t differentiate between fat and muscle mass, which may have affected the results. Children are also growing, which further complicates things.
However, the researchers took some of these factors into account by expressing BMI as a percentage of the 95th percentile for each gender and age group (4).
Third, most of those who initially started the trial dropped out. Only 38% of the original participants were followed for 12 months after the trial ended.
This may have caused a further bias, since only those who were the most committed or motivated may have continued participation.
Additionally, eating behaviors and socioeconomic factors were self-reported.
Finally, the study examined only 42 participants, limiting its statistical power. For an observational study, this number is rather small.
Bottom Line: This small observational study used BMI to assess weight loss. BMI doesn’t differentiate between fat and other body components.
Summary and Real-Life Application
In short, the study suggests that early weight loss during a weight loss program is a good sign, predicting further weight loss success later on.
It also indicates that low family income, dysfunctional eating habits or broken families may reduce children’s chances of being successful at losing weight in the long-term.