BACKGROUND: Clinically significant weight loss (CWL) of ≥ 7% is often attainable initially, yet nearly eighty percent of adults that lose weight tend to return to baseline levels, if not above. During initial weight loss, cardiometabolic risk factors tend to recede, however, upon regaining weight, disease and metabolic profiles often return to high-risk stratifications. Few data are available for predictors of weight loss in response to exercise and an OPTIFAST diet, thus, the purpose of this analysis, was to evaluate predictors of weight loss in adults with overweight and obesity in response to a 10-week lifestyle intervention. METHODS: Thirty-six sedentary adults with overweight and obesity (Age: 46.5 ± 10.5 yrs; BMI: 34.2 ± 3.4 kg/m2) completed a 10-week lifestyle intervention involving a hypocaloric diet, weekly behavioral education, and exercise to achieve CWL (≥7%). Concurrent, supervised aerobic exercise began at 300 MET-min/week and increased weekly until 700 MET-min/week was reached. Percent weight loss was used as the dependent variable in the stepwise linear regression models. Predictors used in the regression models included body composition variables, behavioral class attendance, and exercise variables. RESULTS: Participants decreased average bodyweight (-8.3%) and waist circumference (cm) (-8.4), and improved relative fitness (ml/kg/min) (2.4) during the intervention (ps<0.001). Linear regression analysis revealed that the strongest predictors (R2=0.65) of weight loss in response to the intervention were changes in waist circumference (cm) (β=0.61, p=0.002), initial weight loss (β=0.37, p<0.001) and behavioral class attendance (%) (β=-0.36, p=0.002). CONCLUSIONS: Weight loss was at least in part predicted by initial weight loss, body composition changes, and intervention adherence following a 10-week lifestyle intervention in adults with overweight and obesity. These results indicate that greater adherence to a short-term lifestyle intervention during an active weight loss phase can predict adults reaching clinically significant weight loss.

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