Repeated lifestyle interventions lead to progressive weight loss: A retrospective review chart study

Aims: This study aimed to investigate whether repeated lifestyle interventions lead to progressive weight loss or to weight cycling. Methods: A retrospective review chart study with follow-up on 2120 participants (mean +/- SD age 36 +/- 15 years; body weight 116 +/- 28 kg; fat 43 +/- 6%). All had participated in one to four 11-12 week lifestyle interventions (residential weight loss programme, mixed activities). Weight loss was promoted through a hypocaloric diet (-500 to -700 kcal/day) and daily physical activity (1-3 hours/day). Primary outcomes were weight loss and change in body composition (bioimpedance measurements) after the intervention periods and at follow-up. Results: A total of 2120, 526, 139 and 47 people participated in one to four interventions with mean +/- SEM times from start to follow-up of 1.3 +/- 0.1, 2.9 +/- 0.2, 4.2 +/- 0.3 and 5.2 +/- 0.4 years respectively. Overall 50, 41, 18 and 11% of the participants were lost to follow-up after one to four interventions, respectively. The cumulated weight loss at follow-up increased with the number of interventions from one to four: 12.2 +/- 0.1, 15.9 +/- 0.7, 16.1 +/- 1.2 and 18.5 +/- 2.0 kg (p<0.001). The ratios between cumulated loss of fat and fat free mass after one to four interventions decreased with the number of interventions (2.4, 2.2, 2.1 and 1.4). Rates of weight loss during the interventions ranged from 0.70 +/- 0.06 to 1.06 +/- 0.01 kg/week and the maximum weight regain during the follow-up periods was 0.039 +/- 0.007 kg/week. Conclusions: Repeated relatively short lifestyle interventions in a selected and motivated group can be an efficient method for weight loss maintenance with only limited body weight cycling in the interim periods. However, the relationship between loss of fat and fat free mass might change in an unfavourable direction.