TOPLINE:

A 24-month intensive lifestyle intervention in primary care improved quality-of-life (QOL) domains compared with usual care in patients with obesity, with greater weight loss associated with greater gains.

METHODOLOGY:

• The PROPEL trial previously showed that a high-intensity lifestyle intervention produced significantly greater weight loss than usual care in patients with obesity; however, its effect on health-related QOL was unknown.
• Researchers analyzed PROPEL trial data from patients with obesity enrolled across primary care clinics in Louisiana (2016-2019) to evaluate the intervention’s impact on both weight-related and generic health-related QOL.
• The intensive lifestyle intervention group received coach‑led sessions over 24 months — weekly for the first 6 months and at least monthly thereafter — targeting ≥ 10% weight loss and maintenance through personalized goals, portion control/meal replacements, increased activity, self‑monitoring, structured eating, healthy snacking, and stress management; the usual care group received standard primary care and periodic newsletters.
• QOL outcomes were assessed at 6, 12, and 24 months using validated questionnaires, with weight‑related QOL scores measured across five domains and generic health‑related QOL scores across seven domains.

TAKEAWAY:

• The analysis included 803 patients (age, 20-75 years; 84.4% female; 67% Black), with 451 randomized to the intensive lifestyle intervention and 352 to usual care.
• At 24 months, the intervention group showed significantly greater improvements than usual care in total weight‑related QOL, four weight‑related domains (physical function, self‑esteem, sexual life, and work), and two generic domains (fatigue and social functioning).
• Improvements in both weight-related and generic QOL were comparable between women and men in the intervention group; however, Black patients had smaller gains in total weight-related QOL scores than patients of other races (P for interaction = .02).
• Weight-related QOL improvements showed a graded association with weight loss over 24 months: 7.6 points for < 5% weight loss, 15.1 points for 5% to < 10% loss, and 19.1 points for ≥ 10% loss (P for trend < .001 for all).
• Greater weight loss was also associated with larger improvements in most generic QOL domains at all timepoints (P for trend < .05), including physical function, fatigue, pain interference, and social functioning.

IN PRACTICE:

“Greater weight loss was associated with greater weight-related and generic [health-related QOL], with the greatest improvements experienced by those who lost at least 10% of their initial body weight,” the authors wrote.

SOURCE:

This study was led by Kara D. Denstel, Pennington Biomedical Research Center, Baton Rouge, Louisiana. It was published online in Obesity.

LIMITATIONS:

This study was a secondary analysis of the PROPEL trial, which was not designed to evaluate the association between weight loss and QOL, limiting causal inference. The predominantly female population limited generalizability. QOL measures may not have captured all aspects relevant to patients with obesity.

DISCLOSURES:

This study was funded by the Patient-Centered Outcomes Research Institute, the National Institute of General Medical Sciences, and other sources. In-kind support was provided by Health and Nutrition Technology and Nutrisystem. Some authors disclosed serving on data safety and monitoring boards; having research contracts; and receiving research grants, royalties, and speaking honoraria from various institutions and industry.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.