Predictors of weight loss outcomes in obesity care: results of the national ACTION study

BACKGROUND: A key objective of this study was to examine obesity care attitudes and behaviors of people with obesity (PwO) and determine independent factors associated with a self-reported sustained weight loss success outcome. METHODS: An online survey was conducted in 2015 among 3008 U.S. adult PwO (BMI > 30 through self-reported height and weight). Multivariate logistic models explained variation in weight loss success, defined as ≥ 10% weight loss in previous 3 years and maintained for > 1 year. RESULTS: Controlling for weight changes over time, we found significant associations between self-reported weight history and weight loss success. PwO who had personal motivation to lose weight, were willing to talk to a diabetes educator about their weight, who had their weight loss attempts recognized by a healthcare provider, and were diagnosed with “obesity” or “overweight” were more likely to report having success losing weight. CONCLUSIONS: This study does not determine causality, but suggests motivation and engagement with PwO may impact weight loss, and presents a basis for assessing the mechanism involved. Determining such mechanisms may identify important targets to improve obesity treatment outcomes. TRIAL REGISTRATION: This study is registered with ClinicalTrials.gov, number NCT03223493, https://clinicaltrials.gov/ct2/show/NCT03223493. Registered July 17, 2017 (retrospectively registered).