Obesity Science & Practice最新文献

{"title":"Effects of the HEARTY exercise randomized controlled trial on eating behaviors in adolescents with obesity.","authors":"Angela S Alberga,&nbsp;Iyoma Y Edache,&nbsp;Ronald J Sigal,&nbsp;Kristin M von Ranson,&nbsp;Shelly Russell-Mayhew,&nbsp;Glen P Kenny,&nbsp;Steve Doucette,&nbsp;Denis Prud'homme,&nbsp;Stasia Hadjiyannakis,&nbsp;Jameason D Cameron,&nbsp;Gary S Goldfield","doi":"10.1002/osp4.620","DOIUrl":"https://doi.org/10.1002/osp4.620","url":null,"abstract":"<p><strong>Background: </strong>There are well-recognized benefits of behavioral interventions that include exercise for children and adolescents with obesity. However, such behavioral weight management programs may precipitate unintended consequences. It is unclear if different exercise modalities impact eating behaviors differently in youth with obesity.</p><p><strong>Objectives: </strong>The purpose of this study was to examine the effects of aerobic, resistance, and combined aerobic and resistance exercise training on eating attitudes and behaviors (uncontrolled eating, restrained eating, emotional eating, external eating and food craving) among adolescents with overweight and obesity.</p><p><strong>Methods: </strong><i>N</i> = 304 (70% female) adolescents with overweight and obesity participated in the 6-month Healthy Eating Aerobic and Resistance Training in Youth (HEARTY) randomized controlled trial. All participants were inactive post-pubertal adolescents (15.6 ± 1.4 years) with a mean BMI = 34.6 ± 4.5 kg/m². The Food Craving Inventory (food cravings), Dutch Eating Behavior Questionnaire (restrained eating, emotional eating, external eating), and the Three-Factor Eating Questionnaire (uncontrolled eating) were used to assess eating attitudes and behaviors.</p><p><strong>Results: </strong>All exercise groups showed within-group decreases in external eating and food cravings. Participants randomized to the Combined training group and were more adherent showed the greatest improvements in eating behaviors and cravings.</p><p><strong>Conclusions: </strong>A 6-month exercise intervention produced improvements in disordered eating behaviors and food cravings, but effects may be gender and modality-specific. Findings highlight the need to tailor exercise intervention to participant characteristics for the promotion of healthier eating and weight management outcomes in youth with obesity.</p><p><p>Clinical Trial Registration # and Date: ClinicalTrials.Gov NCT00195858, September 12, 2005.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/04/OSP4-9-158.PMC10073823.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9627496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived intrinsic, social, and environmental barriers for weight management in older Hispanic/Latino adults with obesity.","authors":"Maria Carlota Dao,&nbsp;Zihan Yu,&nbsp;Ana Maafs-Rodríguez,&nbsp;Brandy Moser,&nbsp;Adolfo G Cuevas,&nbsp;Christina D Economos,&nbsp;Susan B Roberts","doi":"10.1002/osp4.631","DOIUrl":"https://doi.org/10.1002/osp4.631","url":null,"abstract":"<p><strong>Background: </strong>The burden of obesity and chronic disease is increasing in the older US Hispanic/Latino adult population. There is limited evidence on successful weight management strategies as perceived by this population. Assessing barriers and opportunities for weight management using mixed methods is a robust approach to collect in-depth information that can be applied to the development of well-tailored weight management interventions for this population.</p><p><strong>Objective: </strong>The objective of this study was to assess perceived individual, interpersonal, and environmental factors that influence weight management in older Hispanic/Latino adults.</p><p><strong>Methods: </strong>This community-based cross-sectional study included 23 Hispanic/Latino older (>50y) adults with obesity (BMI >30 kg/m²). Perceived barriers and opportunities for weight management were assessed through validated questionnaires and focus groups. Prospectively registered on ClinicalTrials.gov (NCT03978416) on 7 June 2019.</p><p><strong>Results: </strong>In this demographically heterogeneous population, language acculturation was generally low, and the frequency of poor dietary behaviors was high. Participants linked financial strain to lower diet quality, as well as anxiety to uncontrolled eating and food cravings. Social support and trust in healthcare professionals were perceived as priorities for healthy eating. Structural and environmental barriers such as affordability and availability of culturally preferred foods were also identified as influences on food choices and eating behavior.</p><p><strong>Conclusions: </strong>This study revealed opportunities for culturally tailored weight management interventions in older Hispanic/Latino adults with obesity.</p><p><strong>Clinical trial registry number: </strong>NCT03978416 (ClinicalTrials.gov).</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/4b/OSP4-9-145.PMC10073816.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9627497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the behavior change techniques used in obesity interventions: An example from the EARLY trials.","authors":"Leslie A Lytle,&nbsp;Heather M Wasser,&nbsp;Job Godino,&nbsp;Pao-Hwa Lin,&nbsp;Deborah F Tate","doi":"10.1002/osp4.633","DOIUrl":"https://doi.org/10.1002/osp4.633","url":null,"abstract":"<p><strong>Objective: </strong>The dissemination of effective obesity interventions requires the documentation of key elements of the intervention. But outcome papers and other published manuscripts often lack detail that allow the replication of the intervention. The Behavior Change Technique (BCT) Taxonomy (BCTTv1) is a widely used approach to identify key elements of an intervention study. This study compares the extent to which BCTs and domains identified in studies' intervention protocol are concordant with detail from corresponding intervention design and study outcome papers.</p><p><strong>Methods: </strong>Data come from four obesity interventions with complete intervention protocols as well as published intervention design and outcome papers. The number of domains and BCTs was calculated for each treatment arm and stratified by coding source. Emphasis of domains and BCTs was determined using an Analytical Hierarchy Process (AHP).</p><p><strong>Results: </strong>A review of each study's intervention protocol showed the mean number of domains and BCTs used in treatment arms as 11.8 and 26.7, respectively. Primary outcome papers had a mean loss of 34% of the reported domains and 43% of BCTS as compared with intervention protocl. Design papers showed a loss of 11% and 21% of domains and BCTs, respectively.</p><p><strong>Conclusions: </strong>The results confirm the limitations of using the BCTTv1 coding of outcome papers to describe obesity-related interventions. The results also highlight the need for mechanisms that allow for a full description of intervention content such as inclusion in a supplemental section of an online journal or the use of intervention-focused consort guidelines.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/71/OSP4-9-179.PMC10073819.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9627494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of patient risk factors associated with post-bariatric surgery leak.","authors":"Calista Spiro,&nbsp;Simon Bennet,&nbsp;Kiron Bhatia","doi":"10.1002/osp4.628","DOIUrl":"https://doi.org/10.1002/osp4.628","url":null,"abstract":"<p><strong>Objective: </strong>Modifiable risk factors such as diabetes, hyperlipidemia, hypertension, obstructive sleep apnea (OSA), chronic kidney disease (CKD), chronic steroid use and smoking, have been shown in observational studies to negatively affect surgical outcomes. The purpose of this study is to identify and determine the effect of modifiable risk factors on post-operative bariatric surgery leak, as pre-operative risk modification has been shown to reduce the impact on complications.</p><p><strong>Methods: </strong>Electronic literature searches of MEDLINE, PUBMED, OVID and Cochrane Library databases were performed, including a manual reference check, over the period of 2010 and 2020. 620 articles were screened according to the PRISMA protocol.</p><p><strong>Results: </strong>Twenty articles were included in the meta-analysis of risk factors. Significant risk factors and the associated effect sizes include: 1. Smoking with an overall OR of 1.31 [1.06, 1.61] and an OR of 1.72 [1.44, 2.05] in Sleeve gastrectomy (SG) patient cohorts; 2. Diabetes with an overall OR of 1.23 [1.08, 1.39] and an OR of 1.33 [1.02, 1.73] in Roux-en-Y patient cohorts; 3. Chronic kidney disease with an overall OR of 2.41 [1.62, 3.59] and 4. Steroid use with an overall OR of 1.57 [1.22, 2.02]. Non-significant risk factors include hypertension with an OR of 0.85, 1.83, OSA with an OR of 1.08 [0.83, 1.39] and hyperlipidemia with an OR of 0.80 [0.61, 1.04]. Combined SG and Roux-en-Y patient cohorts with hyperlipidemia have shown a protective effect of 0.78 [0.65, 0.94].</p><p><strong>Conclusions: </strong>Significant risk factors for leak post bariatric surgery are smoking in all patients and particularly SG patients, diabetes for all patients and particularly Roux-en-Y patients, and CKD and chronic steroid for all patients. Hyperlipidemia in two combined patient cohorts (SG and Roux-en-Y) appears to have a weak protective effect.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a2/df/OSP4-9-112.PMC10073826.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9627498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunohistochemical analysis of caspase expression in the brains of individuals with obesity or overweight.","authors":"Erick Gómez-Apo,&nbsp;Juan Silva-Pereyra,&nbsp;Virgilia Soto-Abraham,&nbsp;Alejandra Mondragón-Maya,&nbsp;Javier Sanchez-Lopez","doi":"10.1002/osp4.632","DOIUrl":"https://doi.org/10.1002/osp4.632","url":null,"abstract":"<p><p>Mechanisms underlying the negative effects of obesity on the brain are still unknown. Obesity is associated with oxidative stress in the brain and neuroinflammation that promotes neurodegenerative diseases. Chronic low-grade neuroinflammation in obesity could be associated with lower volumes of gray matter and lower neuronal density. If neuroinflammation mediated by the expression of cytokines and chemokines leads to apoptosis, this can be assessed by examining caspase expression. The aim of this study was to compare the expression of caspases in the 16 brains of donors with obesity/overweight (<i>n</i> = 8; Body Mass Index [BMI] = 31.6 ± 4.35 kg/m²; 2 females; Age = 52.9 ± 4.76 years) and normal weight (<i>n</i> = 8; BMI = 21.8 ± 1.5 kg/m²; 3 females; Age = 37.8 ± 19.2 years). Sixteen human brain samples were processed. Serial paraffin sections were examined by anti-caspase immunochemistry (caspase-3, caspase-4, caspase-6, caspase-1, caspase-8, and caspase-9 antibodies). Postmortem samples of cerebral cortex tissue were captured as photomicrographs and the images obtained were analyzed using ImageJ software to obtain the percentage of positive caspase expression. Nonparametric Mann-Whitney <i>U</i> tests were performed to compare caspase expression between samples from donors with obesity/overweight and normal weight. Taking into consideration the immunohistochemistry results, the Search Tool for the Retrieval of Interacting Genes was used to model molecular interactions. Results showed that brain samples from individuals with obesity/overweight exhibited significantly greater values of positive expression for Caspase-1 (<i>U</i> = 16.5, <i>p</i> = 0.05, Cohen <i>d</i> = 0.89) and -8 (<i>U</i> = 15, <i>p</i> = 0.03, Cohen <i>d</i> = 0.99) than those from donors with normal weight. This study contributes to the knowledge about the inflammatory effects of obesity/overweight on brain, suggesting the activation of the alternative inflammasome pathway in which interact caspase-1 and -8.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/11/86/OSP4-9-137.PMC10073824.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9642105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity prevention across the US: A review of state-level policies from 2009 to 2019.","authors":"Lauren P Cleveland,&nbsp;Anna H Grummon,&nbsp;Elsa Konieczynski,&nbsp;Sally Mancini,&nbsp;Anjali Rao,&nbsp;Denise Simon,&nbsp;Jason P Block","doi":"10.1002/osp4.621","DOIUrl":"https://doi.org/10.1002/osp4.621","url":null,"abstract":"<p><strong>Objective: </strong>Uniquely, state legislators may enact obesity prevention policies tailored to each state's needs and take diverse policy approaches to address obesity prevalence. The objective of this study was to identify and describe state-level obesity-related policies between 2009 and 2019.</p><p><strong>Methods: </strong>Using a database of legislation covering 2009-2019, researchers categorized obesity-related legislation by status (proposed/enacted), topic, and environment impacted. Researchers determined the number of policies proposed; enacted, by political party control; obesity prevalence, by states over time.</p><p><strong>Results: </strong>3256 obesity-related policies were proposed among 50 states and Washington DC between 2009 and 2019. Collectively, 18% (593) of policies were enacted; California (96), New and Jersey (57) enacted the most. Across environment and topics, the most enacted policies categorized in school environment (226) and school nutrition (150) topic area. Most policies were proposed (496) and enacted (77) in 2011. On average, Democrat-controlled states had higher enactment rates than Republican-controlled states, as did states with lower (vs. higher) obesity prevalence.</p><p><strong>Conclusions: </strong>States have actively pursued obesity-related legislation across multiple topics and environments from 2009 to 2019, with mixed enactment rates. Evaluating the impact of these policies, alone and in combination, will be important to determine whether these state-level efforts reduce obesity.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/47/OSP4-9-95.PMC10073818.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9642103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparable quality performance between telemedicine and office-based care for abnormal BMI screening and management.","authors":"Derek Baughman,&nbsp;Kathryn Baughman,&nbsp;Yalda Jabbarpour,&nbsp;Abdul Waheed","doi":"10.1002/osp4.625","DOIUrl":"https://doi.org/10.1002/osp4.625","url":null,"abstract":"<p><strong>Background: </strong>Despite widespread adoption during COVID-19, there is limited evidence supporting the quality of telemedicine care in managing patients with abnormal BMI.</p><p><strong>Objective: </strong>To evaluate the comparability of telemedicine and in-person (office) quality performance for abnormal body mass index (BMI kg/m2) screening and management in primary care.</p><p><strong>Methods: </strong>This retrospective cohort study measured Healthcare Effectiveness Data and Information Set (HEDIS) quality performance for abnormal BMI screening (patients with BMIs <18.5 or >25 kg/m2 and a qualifying documented follow up plan) across an 8-hospital integrated health system seen via primary care from 4/1/20 - 9/30/21. Encounters were divided into three exposure groups: office (excluding telemedicine), telemedicine (excluding office), and blended telemedicine (office + telemedicine). Demographic stratification compared group composition. Chi squared tests determined statistical differences in quality performance (<i>p</i> = <0.05).</p><p><strong>Results: </strong>Demographics of sub-groups for the 287,387 patients (office: 222,333; telemedicine: 1,556; blended-telemedicine: 63,489) revealed a modest female predominance, majority ages 26-70, mostly White non-Hispanics of low health risk, and the majority BMI representation was overweight, followed closely by class 1 obesity. In both HEDIS specified and HEDIS modified performance, blended-telemedicine performed better than office (12.56%, 95% CI 12.29%-13.01%; 11.16%, 95% CI: 10.85%-11.48%; <i>p</i> < 0.0001); office performed better than telemedicine (4.29%, 95% CI 2.84%-5.54%; 4.79%, 95% CI 3.99%-5.35%; <i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>Quality performance was highest for blended-telemedicine, followed by office-only, then telemedicine-only. Given the known cost savings, adding telemedicine as a care venue might promote value within health systems without negatively impacting HEDIS performance.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/50/OSP4-9-87.PMC10073821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9642106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Information","authors":"","doi":"10.1002/osp4.610","DOIUrl":"https://doi.org/10.1002/osp4.610","url":null,"abstract":"No abstract is available for this article.","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49602269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of self-weighing to avoid post-cessation weight gain: A secondary analysis of the fit and quit randomized trial.","authors":"Mackenzi Oswald, Kathryn M Ross, Ning Sun, Wupeng Yin, Stephanie J Garcia, Zoran Bursac, Rebecca A Krukowski","doi":"10.1002/osp4.668","DOIUrl":"10.1002/osp4.668","url":null,"abstract":"<p><strong>Background: </strong>Smoking cessation is associated with weight gain, and the risk of weight gain is a common deterrent to quitting smoking. Thus, the identification of strategies for reducing post-smoking cessation weight gain is critical.</p><p><strong>Objective: </strong>Conduct secondary analysis of data from the Fit & Quit trial to determine if greater frequency of self-weighing is associated with less weight gain in the context of smoking cessation.</p><p><strong>Methods: </strong>Participants (<i>N</i> = 305) were randomized to one of three 2-month weight interventions (i.e., Stability, Loss, Bibliotherapy), followed by a smoking cessation intervention. Stability and Loss conditions received different types of self-weighing feedback. All participants received e-scales at baseline, to capture daily self-weighing data over 12 months. General linear models were applied to test the main objective.</p><p><strong>Results: </strong>Frequency of self-weighing was (mean ± SD) 2.67 ± 1.84 days/week. The Stability condition had significantly higher self-weighing frequency (3.18 ± 1.72 days/week) compared to the Loss (2.51 ± 1.99 days/week) and the Bibliotherapy conditions (2.22 ± 1.63 days/week). Adjusting for baseline weight and treatment condition, self-weighing 3-4 days/week was associated with weight stability (-0.77 kg, 95% CI: -2.2946, 0.7474, <i>p</i> = 0.3175), and self-weighing 5 or more days/week was associated with 2.26 kg weight loss (95% CI: -3.9249, -0.5953, <i>p</i> = 0.0080).</p><p><strong>Conclusions: </strong>Self-weighing may serve as a useful tool for weight gain prevention after smoking cessation. Feedback received about self-weighing behaviors and weight trajectory (similar to the feedback Stability participants received) might enhance adherence.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/76/OSP4-9-416.PMC10399538.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9952840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight loss and modeled cost savings in a digital diabetes prevention program.","authors":"OraLee H Branch, Mohit Rikhy, Lisa A Auster-Gussman, Kimberly G Lockwood, Sarah A Graham","doi":"10.1002/osp4.665","DOIUrl":"10.1002/osp4.665","url":null,"abstract":"<p><strong>Background: </strong>Participation in the National Diabetes Prevention Program (DPP) can improve individual health through reduced risk of type 2 diabetes and save the healthcare system substantial medical costs associated with a diagnosis of type 2 diabetes and its associated complications. There is less evidence of outcomes and cost savings associated with a fully digital delivery of the DPP.</p><p><strong>Methods: </strong>This study assessed 13,593 members who provided an initial digital weight and subsequently achieved various weight loss and engagement outcomes during their participation in a digital DPP. Analyzed data included both complete observations and missing observations imputed using maximum likelihood estimation. Findings include members' behavioral correlates of weight loss and a literature-based cost-savings estimate associated with achieving three mutually exclusive weight loss or engagement benchmarks: ≥5% weight loss, >2% but <5% weight loss, and completion of ≥4 educational lessons.</p><p><strong>Results: </strong>11,976 members (88%) provided a weight after 2 months of participation, enabling calculation of their weight nadir. Considering complete data, 97% of members maintained or lost weight. Using the imputed data for these calculations, 32.0% of members achieved ≥5%, 32.4% achieved >2% but <5%, 32.0% maintained ±2%, and 3.6% gained weight. Members who lost the most weight achieved their weight nadir furthest into the program (mean day = 189, SE = 1.4) and had the longest active engagement (mean days = 268, SE = 1.4), particularly compared to members who gained weight (mean nadir day = 119, SE = 3.7; active engagement mean days = 199, SE = 4.9) (both <i>p</i> ≤ 0.0001). Modeled 1-year cost-savings estimates ranged from $11,229,160 to $12,960,875.</p><p><strong>Conclusions: </strong>Members of a fully digital DPP achieved clinical and engagement outcomes during their participation in the program that confer important health benefits and cost savings.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10399528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9955308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}