Characterizing the Pattern of Weight Loss and Regain in Adults Enrolled in a 12-Week Internet-Based Weight Management Program

OBJECTIVE: While the trajectory of weight change during/after behavioral weight management interventions is believed to include a period of weight loss followed by maintenance and later regain, the sparse data produced by existing study designs (conducting assessments at 3–6 month intervals) has limited investigation into the precise pattern. METHODS: Seventy-five adults were asked to self-weigh daily via “smart” scales during a 12 week, Internet-based weight loss program and 9 months with no further intervention. Longitudinal change-point mixed-effect models were used to characterize overall weight change patterns and identify when individuals moved from weight loss to maintenance/regain. RESULTS: Analyses suggested a 3-phase model. During the first phase, participants lost weight at a (mean±SE) rate of −0.46±.04 kg/week; after 77.66±3.96 days, they transitioned to regain (0.07±0.02 kg/week). The next transition occurred at 222.55±7.23 days, after which the rate of regain decreased slightly (0.06±.02 kg/week). Exploratory analyses identified baseline/demographic factors predicting the timing of transition points and slope of weight change within phases. CONCLUSION: In contrast to the hypothesized trajectory, results demonstrated that participants transitioned immediately from weight loss to regain (with no “maintenance” period) and later to a slower rate of regain. Future studies should investigate whether extended-care programs change or merely delay this pattern.