Weight Loss for Patients With Obesity

An Analysis of Long-Term Electronic Health Record Data

Bibliographic Data

ID9099217
AuthorsNatalie Liu (0000-0001-8273-7708, Surgery, University of Wisconsin School of Medicine and Public Health, corresponding author), Jen Birstler (Biostatistics and Medical Informatics, University of Wisconsin), Manasa Venkatesh (0000-0002-6451-5252, Surgery, University of Wisconsin School of Medicine and Public Health, corresponding author), Lawrence P Hanrahan (0000-0001-8491-8537, Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health), Guanhua Chen (0000-0001-5015-0902, Biostatistics and Medical Informatics, University of Wisconsin), Luke M Funk (0000-0003-4475-304X, Surgery, University of Wisconsin School of Medicine and Public Health, corresponding author)
Year2020
Volume58
Issue3
Pages265-272
Publication date2020-03-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001277
PMID31876663
OpenAlexW2997590473
LanguageEN
References cited35

BACKGROUND: Numerous studies have reported that losing as little as 5% of one's total body weight (TBW) can improve health, but no studies have used electronic health record data to examine long-term changes in weight, particularly for adults with severe obesity [body mass index (BMI) ≥35 kg/m]. OBJECTIVE: To measure long-term weight changes and examine their predictors for adults in a large academic health care system. RESEARCH DESIGN: Observational study. SUBJECTS: We included 59,816 patients aged 18-70 years who had at least 2 BMI measurements 5 years apart. Patients who were underweight, pregnant, diagnosed with cancer, or had undergone bariatric surgery were excluded. MEASURES: Over a 5-year period: (1) ≥5% TBW loss; (2) weight loss into a nonobese BMI category (BMI <30 kg/m); and (3) predictors of %TBW change via quantile regression. RESULTS: Of those with class 2 or 3 obesity, 24.2% and 27.8%, respectively, lost at least 5% TBW. Only 3.2% and 0.2% of patients with class 2 and 3 obesity, respectively, lost enough weight to attain a BMI <30 kg/m. In quantile regression, the median weight change for the population was a net gain of 2.5% TBW. CONCLUSIONS: Although adults with severe obesity were more likely to lose at least 5% TBW compared with overweight patients and patients with class 1 obesity, sufficient weight loss to attain a nonobese weight class was very uncommon. The pattern of ongoing weight gain found in our study population requires solutions at societal and health systems levels

Body mass index · Body weight · Environmental health · Obesity · Overweight · Population · Underweight · Weight change · Weight gain · Weight loss · Bariatric Surgery and Outcomes · Cancer Risks and Factors · Demography · Internal Medicine · Medicine · Nutrition and Health in Aging · Gerontology · Pediatrics

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