--- title: "Early wt loss and tx response in lifestyle change program. | Sutter Health" description: "Percentage weight change at 12 weeks from baseline can serve as a single indicator of nonresponse at the completion of the 12-month lifestyle change program." url: "https://www.sutterhealth.org/research/publications/early-wt-loss-and-tx-response-in-lifestyle-change-program-1055312721" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Early wt loss and tx response in lifestyle change program. # Early weight loss and treatment response: data from a lifestyle change program in clinical practice. Romanelli RJ, Sudat S, Huang Q, Pressman AR, & Azar K. _Am J Prev Med. pii: S0749-3797(19)30421-0. doi: 10.1016/j.amepre.2019.09.014. \[Epub ahead of print\]_ 2019-12-20 ## Abstract INTRODUCTION: The purpose of this study was to develop and validate a predictive model for the early identification of nonresponders to a 12-month lifestyle change program in clinical practice. METHODS: Investigators identified lifestyle change program participants in the electronic health records of a large healthcare delivery system between 2010 and 2017. Nonresponse was defined as weight gain or no weight loss at 12 months from the program initiation (baseline). Logistic regression with percentage weight change at 2-12 weeks from baseline was used as an independent predictor of nonresponse. Baseline demographics and clinical characteristics were also tested as potential predictors. The authors performed ten-fold cross-validation for model assessment and examined model performance with the area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values. The analyses were conducted in 2019. RESULTS: Among 947 program participants, 30% were classified as nonresponders at 12 months. The model with the best discrimination of responders from nonresponders included weight change at 12 weeks from baseline as the sole predictor (area under the receiver operating characteristic curve, 0.789). Sensitivity and positive predictive value were maximized at 0.56 (specificity and negative predictive value, 0.81 each). CONCLUSIONS: In a cohort of lifestyle change program participants from clinical practice, percentage weight change at 12 weeks from baseline can serve as a single indicator of nonresponse at the completion of the 12-month program. Clinicians can easily apply this algorithm to identify and assess participants in potential need of adjunctive or alternative therapy to maximize treatment outcomes. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/31870590) ![Kristen M J Azar, RN, MSN, MPH](https://dyn.mktgcdn.com/p/rFmyR1kiX8JzE5-XNwup0gVC1GRaVTlH7oSDlG0Tr5A/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Kristen M J Azar, RN, MSN, MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985) ![Sylvia Sudat, Ph.D.](https://dyn.mktgcdn.com/p/2AHRaDJwevdbwzC2ecrwY3nYIxbiqxd9NbpxBlI8Kpk/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Sylvia Sudat, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/sylvia-sudat-phd-1049681027) ## Research topics - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Diabetes Type 2](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Diabetes+Type+2%5C%22%22) - [Diabetes, Insulin Resistance and Metabolic Syndrome](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Diabetes%2C+Insulin+Resistance+and+Metabolic+Syndrome%5C%22%22) - [Food and Nutrition](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Food+and+Nutrition%5C%22%22) - [Obesity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Obesity%5C%22%22) - [Prevention and Health Maintenance](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Prevention+and+Health+Maintenance%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [A Latino Patient-Centered, Evidence-Based Approach to Diabetes Prevention.](https://www.sutterhealth.org/research/publications/latino-pt-centered-evidence-based-approach-to-dm-prevention-1055312326) Rosas LG, Lv N, Lewis MA, Venditti EM, Zavella P, Luna V, Ma J. J Am Board Fam Med. 31(3):364-374. doi: 10.3122/jabfm.2018.03.170280. 2018 May 01 - Publication ### [Examining paradoxical session attendance and weight loss relationships in a clinic based lifestyle modification intervention](https://www.sutterhealth.org/research/publications/paradoxical-session-attendance-weight-loss-relationships-1055312915) Kristen M. J. Azar, Sylvia Sudat, Qiwen Huang, Alice P. Pressman, Nina K. Szwerinski, Catherine Nasrallah, Elizabeth M. Venditti, Robert J. Romanelli Examining paradoxical session attendance and weight loss relationships in a clinic-based lifestyle modification intervention.Obes Sci Pract. 2023; 2023 Jul 04 - Publication ### [Diabetes prevention and weight loss with a fully automated behavioral intervention by email, web, and mobile phone: a randomized controlled trial among persons with prediabetes.](https://www.sutterhealth.org/research/publications/diabetes-prev-wt-loss-automated-beh-intervention-1055312953) Block G, Azar KM, Romanelli RJ, Block TJ, Hopkins D, Carpenter HA, Dolginsky MS, Hudes ML, Palaniappan LP, Block CH. J Med Internet Res. 17(10):e240. doi: 10.2196/jmir.4897. 2015 Oct 23 - Publication ### [Behavioral lifestyle interventions for moderate and severe obesity: a systematic review.](https://www.sutterhealth.org/research/publications/beh-lifestyle-interventions-mod-severe-obesity-1055312350) Lv N, Azar KMJ, Rosas LG, Wulfovich S, Xiao L, Ma J. Prev Med. pii: S0091-7435(17)30142-1. doi: 10.1016/j.ypmed.2017.04.022. \[Epub ahead of print\] 2017 Apr 24 - Publication ### [Evaluation of a culturally-adapted lifestyle intervention to treat elevated cardiometabolic risk of Latino adults in primary care (Vida Sana): a randomized controlled trial.](https://www.sutterhealth.org/research/publications/eval-outpt-diabetes-prev-prog-latino-adults-1055312475) Rosas LG, Lv N, Xiao L, Lewis M, Zavella P, Kramer MK, Luna V, Ma J. Contemp Clin Trials. pii: S1551-7144(16)30029-5. doi: 10.1016/j.cct.2016.03.003. \[Epub ahead of print\] 2016 Mar 16 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/early-wt-loss-and-tx-response-in-lifestyle-change-program-1055312721#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Early wt loss and tx response in lifestyle change program."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/early-wt-loss-and-tx-response-in-lifestyle-change-program-1055312721#medicalscholarlyarticle","name":"Early weight loss and treatment response: data from a lifestyle change program in clinical practice.","headline":"Early wt loss and tx response in lifestyle change program.","abstract":"INTRODUCTION: The purpose of this study was to develop and validate a predictive model for the early identification of nonresponders to a 12-month lifestyle change program in clinical practice. METHODS: Investigators identified lifestyle change program participants in the electronic health records of a large healthcare delivery system between 2010 and 2017. Nonresponse was defined as weight gain or no weight loss at 12 months from the program initiation (baseline). Logistic regression with percentage weight change at 2-12 weeks from baseline was used as an independent predictor of nonresponse. Baseline demographics and clinical characteristics were also tested as potential predictors. The authors performed ten-fold cross-validation for model assessment and examined model performance with the area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values. The analyses were conducted in 2019. RESULTS: Among 947 program participants, 30% were classified as nonresponders at 12 months. The model with the best discrimination of responders from nonresponders included weight change at 12 weeks from baseline as the sole predictor (area under the receiver operating characteristic curve, 0.789). Sensitivity and positive predictive value were maximized at 0.56 (specificity and negative predictive value, 0.81 each). CONCLUSIONS: In a cohort of lifestyle change program participants from clinical practice, percentage weight change at 12 weeks from baseline can serve as a single indicator of nonresponse at the completion of the 12-month program. Clinicians can easily apply this algorithm to identify and assess participants in potential need of adjunctive or alternative therapy to maximize treatment outcomes.","description":"Percentage weight change at 12 weeks from baseline can serve as a single indicator of nonresponse at the completion of the 12-month lifestyle change program.","keywords":["Cardiovascular Diseases","Diabetes Type 2","Diabetes, Insulin Resistance and Metabolic Syndrome","Food and Nutrition","Obesity","Prevention and Health Maintenance"],"datePublished":"2019-12-20","url":"https://www.sutterhealth.org/research/publications/early-wt-loss-and-tx-response-in-lifestyle-change-program-1055312721","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"31870590"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1016/j.amepre.2019.09.014"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/31870590/","https://doi.org/10.1016/j.amepre.2019.09.014"],"isPartOf":{"@type":"Periodical","name":"Am J Prev Med"},"author":[{"@type":"Person","name":"Romanelli RJ"},{"@type":"Person","@id":"https://www.sutterhealth.org/research/investigators/sylvia-sudat-phd-1049681027","name":"Sudat S","url":"https://www.sutterhealth.org/research/investigators/sylvia-sudat-phd-1049681027"},{"@type":"Person","name":"Huang Q"},{"@type":"Person","name":"Pressman AR"},{"@type":"Person","@id":"https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985","name":"Azar K","url":"https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Cardiovascular Diseases","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Cardiovascular+Diseases%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Diabetes Type 2","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Diabetes+Type+2%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Diabetes, Insulin Resistance and Metabolic Syndrome","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Diabetes%2C+Insulin+Resistance+and+Metabolic+Syndrome%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Food and Nutrition","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Food+and+Nutrition%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Obesity","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Obesity%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Prevention and Health Maintenance","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Prevention+and+Health+Maintenance%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/early-wt-loss-and-tx-response-in-lifestyle-change-program-1055312721","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/early-wt-loss-and-tx-response-in-lifestyle-change-program-1055312721#breadcrumblist"}}} ```