Primary care weight loss maintenance with behavioral nutrition: An observational study

Abstract

Objective To evaluate the rate of weight loss maintenance, defined as a 10% loss of initial weight maintained beyond 1 year, among patients with BMI > 25 kg/m2 who had been managed by primary care physicians practicing behavioral nutrition (moderately high-protein diet, carbohydrate restriction, and behavioral therapy). Methods Restrospective analysis of anthropometric characteristics, weight loss, and its determinants was conducted in 14,256 patients. Results 26.7% of subjects met the success criterion (successful maintenance group; SM), 25.7% did not maintain their weight loss (unsuccessful maintenance group; UM), and 47.6% did not lose 10% of their initial weight (failure group; F). At inclusion, patients in the SM group had a greater BMI and fat mass percentage (40.5% in SM, 38.5% in UM, and 37.0% in F). These patients lost more weight (-14.1% vs. -4.59%) and fat mass (-24.7% vs. -8.21%) than patients in the UM group, and contribution of adiposity to their weight loss was 75.1%. Follow-up of patients in the SM group was characterized by a greater frequency of consultations. Conclusions Management by primary care providers with behavioral nutrition facilitates weight loss maintenance in patients with overweight and obesity. The determinants of success are frequency of consultations, initial BMI, and initial weight loss.