The Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures Project: Rationale and Approach

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Abstract

Background

Individual variability in response to multiple modalities of obesity treatment is well documented yet our understanding of why some individuals respond while others do not is limited. The etiology of this variability is multi-factorial, but at present we lack a comprehensive evidence base to identify which factors or combination of factors influence treatment response.

Objectives

This paper provides an overview and rationale of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project, which aims to advance understanding of individual variability in response to adult obesity treatment. We provide an integrated model for how factors in the behavioral, biological, environmental, and psychosocial domains may influence obesity treatment responses and identify a core set of measures to be used consistently across adult weight loss trials. This paper provides the foundation for four companion papers that describe the core measures in detail.

Significance

The accumulation of data on factors across the four ADOPT domains can inform the design and delivery of effective, tailored obesity treatments. ADOPT provides a framework for how obesity researchers collectively can generate this evidence base and is a first step in an ongoing process that can be refined as the science advances.

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Most cited references 29

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Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Marie Ng, Tom Fleming, Margaret W. Robinson … (2015)

In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.

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The medical care costs of obesity: an instrumental variables approach.

John Cawley, Chad D Meyerhoefer (2012)

This paper is the first to use the method of instrumental variables (IV) to estimate the impact of obesity on medical costs in order to address the endogeneity of weight and to reduce the bias from reporting error in weight. Models are estimated using restricted-use data from the Medical Expenditure Panel Survey for 2000-2005. The IV model, which exploits genetic variation in weight as a natural experiment, yields estimates of the impact of obesity on medical costs that are considerably higher than the estimates reported in the previous literature. For example, obesity is associated with $656 higher annual medical care costs, but the IV results indicate that obesity raises annual medical costs by $2741 (in 2005 dollars). These results imply that the previous literature has underestimated the medical costs of obesity, resulting in underestimates of the economic rationale for government intervention to reduce obesity-related externalities. Copyright © 2011 Elsevier B.V. All rights reserved.

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Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain.

K Elfhag, S Rössner (2005)

Weight loss is difficult to achieve and maintaining the weight loss is an even greater challenge. The identification of factors associated with weight loss maintenance can enhance our understanding for the behaviours and prerequisites that are crucial in sustaining a lowered body weight. In this paper we have reviewed the literature on factors associated with weight loss maintenance and weight regain. We have used a definition of weight maintenance implying intentional weight loss that has subsequently been maintained for at least 6 months. According to our review, successful weight maintenance is associated with more initial weight loss, reaching a self-determined goal weight, having a physically active lifestyle, a regular meal rhythm including breakfast and healthier eating, control of over-eating and self-monitoring of behaviours. Weight maintenance is further associated with an internal motivation to lose weight, social support, better coping strategies and ability to handle life stress, self-efficacy, autonomy, assuming responsibility in life, and overall more psychological strength and stability. Factors that may pose a risk for weight regain include a history of weight cycling, disinhibited eating, binge eating, more hunger, eating in response to negative emotions and stress, and more passive reactions to problems.

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Author and article information

Journal

Journal ID (nlm-journal-id): 101264860

Journal ID (pubmed-jr-id): 32902

Journal ID (nlm-ta): Obesity (Silver Spring)

Journal ID (iso-abbrev): Obesity (Silver Spring)

Title: Obesity (Silver Spring, Md.)

ISSN (Print): 1930-7381

ISSN (Electronic): 1930-739X

Publication date Nihms-submitted: 18 February 2018

Publication date (Print): April 2018

Publication date PMC-release: 01 April 2019

Volume: 26

Issue: Suppl 2

Pages: S6-S15

Affiliations

[1 ]University of Colorado School of Medicine

[2 ]University of Minnesota

[3 ]National Heart, Lung, and Blood Institute

[4 ]National Cancer Institute

[5 ]University of Pittsburgh Medical Center

[6 ]Pennington Biomedical Research Center

Author notes

CORRESPONDING AUTHOR: Paul S. MacLean, PhD, Professor of Medicine and Pathology, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Anschutz Medical Campus, 12800 East 19th Avenue, RC1 North Rm 5108, Mailstop 8107, Aurora, Colorado 80045, Phone: 303-724-3030; Fax: 303-724-3031

Article

Manuscript ID: NIHMS942608

DOI: 10.1002/oby.22154

PMC ID: 5973529

PubMed ID: 29575780

SO-VID: 0ed72248-ee2b-4cd2-b2c7-ea67a114bda3

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The Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures Project: Rationale and Approach

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Abstract

Background

Objectives

Significance

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Karger: Nutrition and Dietetics

Most cited references 29

Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

The medical care costs of obesity: an instrumental variables approach.

Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain.

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