Vimal Bodiwala, MD1, Catherine Gardiner, MD1, Sonia Pothraj, BA1, Timothy Marshall, PhD, MS, ACSM/ACS-CET2, Shannon Clifford, PT, PhD, MPT2, Mark Schwartz, MD3, Rameck Hunt, MD3
1Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; 2Kean University, Union, NJ; 3Penn Medicine Princeton Medical Center, Princeton, NJ
Introduction: Identifying predictors of weight loss are of paramount importance for patients and clinicians involved in obesity management. The aim of this study was to identify predictors of weight loss for patients enrolled in an intensive medical weight management program (IMWMP).
Methods: Our IMWMP involved visits every two to four weeks with medical providers, a recommended low carbohydrate diet with the goal carbohydrates individualized and often fewer than 100 g per day, encouraging physical activity, pharmacotherapy for some patients and surveillance every three months with bioimpedance plethysmography analysis (BIA). A binomial logistic regression was performed to ascertain the effects of gender, number of visits, number of daily steps, waist circumference, starting weight, starting fat mass measured by BIA, body mass index, HgbA1C, carbohydrate intake and pharmacologic medications to identify predictors of 10% weight loss from the time of enrollment to most recent office visit over a three year period.
Results: 160 consecutive patients enrolled in our IMWMP who had at least three or more follow-up visits were analyzed. The mean weight at the time of joining IMWMP and most recent office visit were 238.8 lbs and 214.6 lbs, respectively, for a mean weight loss of 24.2 lbs (-10.1%; p=0.01). Ten or more visits to our IMWMP was identified a predictor of 10% weight loss (p=.012; eB: 9.6 [CI (1.63-55.5)]; see Table 1). Female gender (p=.139; eB: 3.1 [CI (.69-14.0)]) and starting fat mass less than the mean of 106 kg on BIA (p=.054; eB: 6.37 [CI (0.97-41.7)]) showed trends towards significance. Interestingly, a starting weight under the mean of 242 pounds was associated with a reduction in the likelihood of losing 10% body weight (p=.113; eB: 0.213[CI (0.031-1.45)]. Other predictors of 10% weight loss that had a positive estimate of odds ratio (eB) but did not achieve or show trends towards significance included starting waist circumference below mean of 45 inches, daily carbohydrate intake less than 65 grams, daily steps greater than 5000 and use of pharmacologic therapy intended for weight loss.
Discussion: 10 or more visits to our IMWMP are identified as a predictor of 10% weight loss. These results provide insights into predictors of weight loss in obesity management. Further studies are needed to establish the current trends and to identify additional modifiable factors.
Citation: Vimal Bodiwala, MD; Catherine Gardiner, MD; Sonia Pothraj, BA; Timothy Marshall, PhD, MS, ACSM/ACS-CET; Shannon Clifford, PT, PhD, MPT; Mark Schwartz, MD; Rameck Hunt, MD. P0765 - IDENTIFYING PREDICTORS OF WEIGHT LOSS FOR PATIENTS ENROLLED IN AN INTENSIVE MEDICAL WEIGHT MANAGEMENT PROGRAM. Program No. P0765. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.