Weight loss among underserved patients improves weight-related quality of life: Results from the PROPEL pragmatic trial.

Purpose. Over 40% of adults in the United States have obesity. Obesity is associated with leading causes of preventable death, including heart disease, and psychological challenges, including lower quality of life (QOL). Weight loss of 5-10% of body weight significantly improves health and quality of life, though these findings are primarily derived from studies conducted in centers of excellence. It is unclear if similar improvements in quality of life are achieved during pragmatic trials that treat underserved patients. The present analysis tested the hypothesis that, compared to a usual care (UC) control group, quality of life would significantly improve among underserved patients who received an intensive lifestyle intervention (ILI) for weight loss. Methods. Data from 24-month pragmatic cluster-randomized trial were evaluated. Of 18 clinics enrolled, 9 were randomly assigned to provide patients with UC and 9 to deliver an ILI for weight loss (N=803). Assessments occurred at baseline and months 6, 12, and 24. Weight-related QOL was assessed with the Impact of Weight on Quality of Life – Lite (IWQOL) and health-related QOL was assessed with PROMIS-29. Using an intent-to-treat approach, change on the outcome variables was examined with a linear mixed effects multi-level model, with intervention group, clinic, assessment time, and their interactions included in the model. Results. The sample was predominantly Black (67.3%) and female (84.4%). Mean±SD age and body mass index were 49.4±13.1 years and 37.2±4.7 kg/m2, respectively. Weight loss at month 24 was significantly greater in the ILI (-4.99%) vs. the UC (-0.48%) group. Compared to UC, the ILI group experienced significant improvements in weight-related QOL, measured with the IWQOL’s Total score and Physical Function scale, at months 6, 12, and 24. Self-esteem, measured with the IWQOL, increased significantly in the ILI vs. UC group at months 6 and 12. With one exception at month 6 (Social Functioning), change in PROMIS scores did not differ by group. Conclusions. Weight loss induced by an ILI improved weight-related QOL among underserved patients in a pragmatic trial, extending findings from previous clinical trials. Improvements in health-related QOL were modest, possibly due to poor sensitivity of the PROMIS.      «

Purpose. Over 40% of adults in the United States have obesity. Obesity is associated with leading causes of preventable death, including heart disease, and psychological challenges, including lower quality of life (QOL). Weight loss of 5-10% of body weight significantly improves health and quality of life, though these findings are primarily derived from studies conducted in centers of excellence. It is unclear if similar improvements in quality of life are achieved during pragmatic trials that...     »