--- title: "Short-term weight trajectories and long-term weight outcomes | Sutter Health" description: "With relationship between magnitudes of short- and long-term wt change, individual wt trajectories may be useful in identifying non-responders who need alt tx." url: "https://www.sutterhealth.org/research/publications/short-term-weight-trajectories-and-long-term-weight-outcomes-1055312769" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Short-term weight trajectories and long-term weight outcomes # Short-term weight trajectories and long-term weight outcomes from a lifestyle intervention in real-world clinical practice. Romanelli RJ, Sudat S, Huang Q, Ma J, Venditti EM, Greenwood DA, Pressman AR, & Azar KMJ. _Transl Behav Med. pii: ibz118. doi: 10.1093/tbm/ibz118. \[Epub ahead of print\]_ 2019-08-01 ## Abstract Centers for Disease Control and Prevention aligned lifestyle change programs are effective in promoting weight loss among those with elevated cardiometabolic risk; yet, variability in weight outcomes among participants is high. Little is known about heterogeneity of short-term weight changes among participants in real-world clinical practice. We sought to identify short-term weight trajectory clusters among lifestyle change program participants in real-world clinical practice and to examine the relationship between cluster membership and long-term weight outcomes. We identified participants from the electronic health records (2010-2017) with weight measured ≤30 days prior to program initiation (baseline) and in four intervals (3-week segments) in the 12 weeks after baseline. Clustering analysis was performed to identify distinct trajectories in percent weight change over 12 weeks. Cluster-specific differences in weight change at 12 and 52 weeks were assessed. Among 1,148 participants, across 18 clinic sites, three clusters were identified: minimal-to-no weight loss (MWL), delayed-minimal weight loss (DWL), and steady-moderate weight loss (SWL), corresponding to mean weight changes of 0.4%, -2.3%, and -4.8% at 12 weeks follow-up, respectively. Mean weight changes were 0.4%, -1.8%, and -5.1% for MWL, DWL, and SWL clusters, respectively, at 52 weeks follow-up, which correlated in direction and magnitude with short-term weight changes. Clustering analysis reveals heterogeneous, short-term weight trajectories among lifestyle change program participants in real-world clinical practice. Given the relationship between the magnitudes of short- and long-term weight change, individual participant weight trajectories may be useful in identifying potential non-responders in need of adjunctive or alternative therapy. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/31369678) ![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 - [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) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) - [Obesity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Obesity%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Longitudinal weight outcomes from a behavioral lifestyle intervention in clinical practice.](https://www.sutterhealth.org/research/publications/weight-outcomes-from-behavioral-lifestyle-intervention-1055312674) Romanelli RJ, Huang HC, Chopra V, Ma J, Venditti EM, Sudat S, Greenwood DA, Pressman AR, Azar KMJ. Diabetes Educ. 145721719872553. doi: 10.1177/0145721719872553. \[Epub ahead of print\] 2019 Sep 03 - Publication ### [Impact of education on weight in newly diagnosed type 2 diabetes: every little bit helps.](https://www.sutterhealth.org/research/publications/education-impact-wt-diabetes-1055312810) Azar KM, Chung S, Wang EJ, Zhao B, Linde RB, Lederer J, Palaniappan LP. PLoS One. 10(6):e0129348. doi: 10.1371/journal.pone.0129348. eCollection 2015. 2015 Jun 08 - Publication ### [Comparative effectiveness of early versus delayed metformin in the treatment of type 2 diabetes.](https://www.sutterhealth.org/research/publications/early-vs-delayed-metformin-type-2-diabetes-1055312946) Romanelli RJ, Chung S, Pu J, Nimbal V, Zhao B, Palaniappan L. Diabetes Res Clin Pract. pii: S0168-8227(15)00046-7. doi: 10.1016/j.diabres.2014.12.019. \[Epub ahead of print\] 2015 Jan 21 - Publication ### [Relationship between spontaneous and iatrogenic hypoglycemia and mortality in patients hospitalized with acute myocardial infarction.](https://www.sutterhealth.org/research/publications/hypoglycemia-mortality-acute-mi-1055312950) Kosiborod M, Inzucchi SE, Goyal A, Krumholz HM, Masoudi FA, Xiao L, Spertus JA. JAMA. 301(15):1556-64. doi: 10.1001/jama.2009.496. 2009 Apr 15 - Publication ### [Nudging physicians and patients with autopend clinical decision support to improve diabetes management.](https://www.sutterhealth.org/research/publications/autopend-decision-spt-to-improve-dm-mgmt-1055312391) Panattoni L, Chan A, Yang Y, Olson C, Tai-Seale M. Am J Manag Care. 24(10):479-483. 2018 Oct 01 [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/short-term-weight-trajectories-and-long-term-weight-outcomes-1055312769#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":"Short-term weight trajectories and long-term weight outcomes"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/short-term-weight-trajectories-and-long-term-weight-outcomes-1055312769#medicalscholarlyarticle","name":"Short-term weight trajectories and long-term weight outcomes from a lifestyle intervention in real-world clinical practice.","headline":"Short-term weight trajectories and long-term weight outcomes","abstract":"Centers for Disease Control and Prevention aligned lifestyle change programs are effective in promoting weight loss among those with elevated cardiometabolic risk; yet, variability in weight outcomes among participants is high. Little is known about heterogeneity of short-term weight changes among participants in real-world clinical practice. We sought to identify short-term weight trajectory clusters among lifestyle change program participants in real-world clinical practice and to examine the relationship between cluster membership and long-term weight outcomes. We identified participants from the electronic health records (2010-2017) with weight measured ≤30 days prior to program initiation (baseline) and in four intervals (3-week segments) in the 12 weeks after baseline. Clustering analysis was performed to identify distinct trajectories in percent weight change over 12 weeks. Cluster-specific differences in weight change at 12 and 52 weeks were assessed. Among 1,148 participants, across 18 clinic sites, three clusters were identified: minimal-to-no weight loss (MWL), delayed-minimal weight loss (DWL), and steady-moderate weight loss (SWL), corresponding to mean weight changes of 0.4%, -2.3%, and -4.8% at 12 weeks follow-up, respectively. Mean weight changes were 0.4%, -1.8%, and -5.1% for MWL, DWL, and SWL clusters, respectively, at 52 weeks follow-up, which correlated in direction and magnitude with short-term weight changes. Clustering analysis reveals heterogeneous, short-term weight trajectories among lifestyle change program participants in real-world clinical practice. 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