Effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization.

<h4>Objective</h4>Determine the impact of long-term non-surgical weight loss maintenance on clinical relevance for osteoarthritis, cancer, opioid use, and depression/anxiety and healthcare resource utilization.<h4>Methods</h4>A cohort of adults receiving primary care within G...

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Autores principales:	G Craig Wood, Lisa Bailey-Davis, Peter Benotti, Adam Cook, James Dove, Jacob Mowery, Abhilasha Ramasamy, Neeraj Iyer, B Gabriel Smolarz, Neela Kumar, Christopher D Still
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d54654e69ae646ab8cb3262d591ff8dd
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spelling	oai:doaj.org-article:d54654e69ae646ab8cb3262d591ff8dd2021-12-02T20:04:30ZEffects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization.1932-620310.1371/journal.pone.0258545https://doaj.org/article/d54654e69ae646ab8cb3262d591ff8dd2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258545https://doaj.org/toc/1932-6203<h4>Objective</h4>Determine the impact of long-term non-surgical weight loss maintenance on clinical relevance for osteoarthritis, cancer, opioid use, and depression/anxiety and healthcare resource utilization.<h4>Methods</h4>A cohort of adults receiving primary care within Geisinger Health System between 2001-2017 was retrospectively studied. Patients with ≥3 weight measurements in the two-year index period and obesity at baseline (BMI ≥30 kg/m2) were categorized: Obesity Maintainers (reference group) maintained weight within +/-3%; Weight Loss Rebounders lost ≥5% body weight in year one, regaining ≥20% of weight loss in year two; Weight Loss Maintainers lost ≥5% body weight in year one, maintaining ≥80% of weight loss. Association with development of osteoarthritis, cancer, opioid use, and depression/anxiety, was assessed; healthcare resource utilization was quantified. Magnitude of weight loss among maintainers was evaluated for impact on health outcomes.<h4>Results</h4>In total, 63,567 patients were analyzed including 67% Obesity Maintainers, 19% Weight Loss Rebounders, and 14% Weight Loss Maintainers; median follow-up was 9.7 years. Time until osteoarthritis onset was delayed for Weight Loss Maintainers compared to Obesity Maintainers (Logrank test p <0.0001). Female Weight Loss Maintainers had a 19% and 24% lower risk of developing any cancer (p = 0.0022) or obesity-related cancer (p = 0.0021), respectively. No significant trends were observed for opioid use. Weight loss Rebounders and Maintainers had increased risk (14% and 25%) of future treatment for anxiety/depression (both <0.0001). Weight loss maintenance of >15% weight loss was associated with the greatest decrease in incident osteoarthritis. Healthcare resource utilization was significantly higher for Weight Loss Rebounders and Maintainers compared to Obesity Maintainers. Increased weight loss among Weight Loss Maintainers trended with lower overall healthcare resource utilization, except for hospitalizations.<h4>Conclusions</h4>In people with obesity, sustained weight loss was associated with greater clinical benefits than regained short-term weight loss and obesity maintenance. Higher weight loss magnitudes were associated with delayed onset of osteoarthritis and led to decreased healthcare utilization.G Craig WoodLisa Bailey-DavisPeter BenottiAdam CookJames DoveJacob MoweryAbhilasha RamasamyNeeraj IyerB Gabriel SmolarzNeela KumarChristopher D StillPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0258545 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q G Craig Wood Lisa Bailey-Davis Peter Benotti Adam Cook James Dove Jacob Mowery Abhilasha Ramasamy Neeraj Iyer B Gabriel Smolarz Neela Kumar Christopher D Still Effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization.
description	<h4>Objective</h4>Determine the impact of long-term non-surgical weight loss maintenance on clinical relevance for osteoarthritis, cancer, opioid use, and depression/anxiety and healthcare resource utilization.<h4>Methods</h4>A cohort of adults receiving primary care within Geisinger Health System between 2001-2017 was retrospectively studied. Patients with ≥3 weight measurements in the two-year index period and obesity at baseline (BMI ≥30 kg/m2) were categorized: Obesity Maintainers (reference group) maintained weight within +/-3%; Weight Loss Rebounders lost ≥5% body weight in year one, regaining ≥20% of weight loss in year two; Weight Loss Maintainers lost ≥5% body weight in year one, maintaining ≥80% of weight loss. Association with development of osteoarthritis, cancer, opioid use, and depression/anxiety, was assessed; healthcare resource utilization was quantified. Magnitude of weight loss among maintainers was evaluated for impact on health outcomes.<h4>Results</h4>In total, 63,567 patients were analyzed including 67% Obesity Maintainers, 19% Weight Loss Rebounders, and 14% Weight Loss Maintainers; median follow-up was 9.7 years. Time until osteoarthritis onset was delayed for Weight Loss Maintainers compared to Obesity Maintainers (Logrank test p <0.0001). Female Weight Loss Maintainers had a 19% and 24% lower risk of developing any cancer (p = 0.0022) or obesity-related cancer (p = 0.0021), respectively. No significant trends were observed for opioid use. Weight loss Rebounders and Maintainers had increased risk (14% and 25%) of future treatment for anxiety/depression (both <0.0001). Weight loss maintenance of >15% weight loss was associated with the greatest decrease in incident osteoarthritis. Healthcare resource utilization was significantly higher for Weight Loss Rebounders and Maintainers compared to Obesity Maintainers. Increased weight loss among Weight Loss Maintainers trended with lower overall healthcare resource utilization, except for hospitalizations.<h4>Conclusions</h4>In people with obesity, sustained weight loss was associated with greater clinical benefits than regained short-term weight loss and obesity maintenance. Higher weight loss magnitudes were associated with delayed onset of osteoarthritis and led to decreased healthcare utilization.
format	article
author	G Craig Wood Lisa Bailey-Davis Peter Benotti Adam Cook James Dove Jacob Mowery Abhilasha Ramasamy Neeraj Iyer B Gabriel Smolarz Neela Kumar Christopher D Still
author_facet	G Craig Wood Lisa Bailey-Davis Peter Benotti Adam Cook James Dove Jacob Mowery Abhilasha Ramasamy Neeraj Iyer B Gabriel Smolarz Neela Kumar Christopher D Still
author_sort	G Craig Wood
title	Effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization.
title_short	Effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization.
title_full	Effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization.
title_fullStr	Effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization.
title_full_unstemmed	Effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization.
title_sort	effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/d54654e69ae646ab8cb3262d591ff8dd
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Effects of sustained weight loss on outcomes associated with obesity comorbidities and healthcare resource utilization.

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