{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T02:00:45Z","timestamp":1785117645373,"version":"3.55.0"},"reference-count":33,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Sustained weight loss remains one of the greatest challenges in obesity management, as many individuals experience weight regain after initial treatment success. Although early weight loss has consistently been associated with greater overall weight reduction, its relationship with subsequent weight regain in routine clinical practice remains insufficiently characterized. This study examined the association between early weight loss and clinically significant weight regain among adults participating in a lifestyle-based obesity management program. Materials and Methods: We conducted a retrospective cohort study of adults receiving structured lifestyle-based obesity treatment at a tertiary care obesity clinic. Early weight loss was defined as the percentage reduction in body weight from baseline to the routinely scheduled third-month follow-up measurement. Clinically significant weight regain at one year was defined as regaining at least 50% of the maximum weight lost from baseline to nadir weight, expressed as the weight regain ratio (WRR \u2265 0.50). Logistic regression was used to examine the association between early weight loss and subsequent weight regain after adjustment for age, baseline body mass index, and baseline body weight. Sensitivity analyses included a female-only model, an alternative weight regain definition (WRR \u2265 0.25), and Firth-penalized logistic regression. Results: Among 79 participants with complete follow-up data, 9 (11.4%) experienced clinically significant weight regain at one year. Conclusions: Greater early weight loss was independently associated with lower odds of clinically significant weight regain (adjusted odds ratio 0.784, 95% confidence interval 0.646\u20130.950; p = 0.013). The association remained consistent in the female-only analysis and in the Firth-penalized logistic regression. When clinically significant weight regain was alternatively defined as WRR \u2265 0.25, the association remained in the same direction but did not reach statistical significance. Age, baseline body mass index, and baseline body weight were not significantly associated with the outcome.<\/jats:p>","DOI":"10.3390\/medicina62081450","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:26:23Z","timestamp":1785115583000},"page":"1450","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Early Weight Loss and One-Year Weight Regain After Lifestyle-Based Obesity Treatment: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"62","author":[{"given":"\u0130brahim","family":"Do\u011fan","sequence":"first","affiliation":[{"name":"Department of General Surgery, Van Training & Research Hospital, University of Health Sciences, 65170 Van, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serpil","family":"Sevimli Deniz","sequence":"additional","affiliation":[{"name":"Department of Statistics, Institute of Science, Van Yuzuncu Yil University, 65080 Van, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0648-861X","authenticated-orcid":false,"given":"Mehmet Kadir","family":"Bart\u0131n","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Van Training & Research Hospital, University of Health Sciences, 65170 Van, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezgi","family":"S\u00f6nmez","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Van Training & Research Hospital, University of Health Sciences, 65170 Van, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meltem","family":"Ceylan Delice","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Resuscitation, Van Training & Research Hospital, University of Health Sciences, 65170 Van, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar","family":"\u00c7oban","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Van Training & Research Hospital, University of Health Sciences, 65170 Van, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebahattin","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Van Training & Research Hospital, University of Health Sciences, 65170 Van, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E875","DOI":"10.1503\/cmaj.191707","article-title":"Obesity in adults: A clinical practice guideline","volume":"192","author":"Wharton","year":"2020","journal-title":"Can. Med. Assoc. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1007\/s11695-023-06913-8","article-title":"IFSO consensus on definitions and clinical practice guidelines for obesity management\u2014An international Delphi study","volume":"34","author":"Salminen","year":"2024","journal-title":"Obes. Surg."},{"key":"ref_3","unstructured":"World Health Organization (2024). Obesity and Overweight, World Health Organization. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2025). Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of Care in Diabetes\u20142025. Diabetes Care, 48, S167\u2013S180.","DOI":"10.2337\/dc25-S008"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1038\/s41591-020-0803-x","article-title":"Joint international consensus statement for ending stigma of obesity","volume":"26","author":"Rubino","year":"2020","journal-title":"Nat. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S102","DOI":"10.1161\/01.cir.0000437739.71477.ee","article-title":"2013 AHA\/ACC\/TOS guideline for the management of overweight and obesity in adults","volume":"129","author":"Jensen","year":"2014","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4158\/EP161365.GL","article-title":"American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity","volume":"22","author":"Garvey","year":"2016","journal-title":"Endocr. Pract."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1038\/ijo.2014.216","article-title":"The role of higher protein diets in weight control and obesity-related comorbidities","volume":"39","author":"Astrup","year":"2015","journal-title":"Int. J. Obes."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"g2646","DOI":"10.1136\/bmj.g2646","article-title":"Long-term maintenance of weight loss with non-surgical interventions in obese adults: Systematic review and meta-analyses of randomised controlled trials","volume":"348","author":"Dombrowski","year":"2014","journal-title":"BMJ"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.mcna.2017.08.012","article-title":"Maintenance of lost weight and long-term management of obesity","volume":"102","author":"Hall","year":"2018","journal-title":"Med. Clin. N. Am."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"989","DOI":"10.3945\/ajcn.112.036350","article-title":"Energy balance and its components: Implications for body weight regulation","volume":"95","author":"Hall","year":"2012","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1042\/CS20120223","article-title":"The defence of body weight: A physiological basis for weight regain after weight loss","volume":"124","author":"Sumithran","year":"2013","journal-title":"Clin. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1056\/NEJMoa1105816","article-title":"Long-term persistence of hormonal adaptations to weight loss","volume":"365","author":"Sumithran","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Look AHEAD Research Group (2014). Eight-year weight losses with an intensive lifestyle intervention: The Look AHEAD Study. Obesity, 22, 5\u201313.","DOI":"10.1002\/oby.20662"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1038\/oby.2011.230","article-title":"Four-year weight losses in the Look AHEAD study: Factors associated with long-term success","volume":"19","author":"Wadden","year":"2011","journal-title":"Obesity"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"222S","DOI":"10.1093\/ajcn\/82.1.222S","article-title":"Long-term weight loss maintenance","volume":"82","author":"Wing","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1037\/0278-6133.19.Suppl1.5","article-title":"Long-term maintenance of weight loss: Current status","volume":"19","author":"Jeffery","year":"2000","journal-title":"Health Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s11695-019-04210-x","article-title":"Definitions of long-term weight regain and their associations with clinical outcomes","volume":"30","author":"Voorwinde","year":"2020","journal-title":"Obes. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"101261","DOI":"10.1016\/j.lanepe.2025.101261","article-title":"Health outcomes and their association with weight regain after substantial weight loss in Sweden: A prospective cohort study","volume":"52","author":"Carlsson","year":"2025","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"R581","DOI":"10.1152\/ajpregu.00755.2010","article-title":"Biology\u2019s response to dieting: The impetus for weight regain","volume":"301","author":"MacLean","year":"2011","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1002\/oby.21538","article-title":"Persistent metabolic adaptation 6 years after \u201cThe Biggest Loser\u201d competition","volume":"24","author":"Fothergill","year":"2016","journal-title":"Obesity"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/j.1467-789X.2012.01041.x","article-title":"Adaptive thermogenesis in human body weight regulation: More of a concept than a measurable entity?","volume":"13","author":"Dulloo","year":"2012","journal-title":"Obes. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/obr.12257","article-title":"Appetite control and energy balance: Impact of exercise","volume":"16","author":"Blundell","year":"2015","journal-title":"Obes. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s13679-017-0262-y","article-title":"Weight loss and improvement in comorbidity: Differences at 5%, 10%, 15%, and over","volume":"6","author":"Ryan","year":"2017","journal-title":"Curr. Obes. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1002\/oby.20777","article-title":"Evaluation of early weight loss thresholds for identifying nonresponders to an intensive lifestyle intervention","volume":"22","author":"Unick","year":"2014","journal-title":"Obesity"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s12529-010-9092-y","article-title":"The association between rate of initial weight loss and long-term success in obesity treatment","volume":"17","author":"Nackers","year":"2010","journal-title":"Int. J. Behav. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/j.soard.2020.03.034","article-title":"Weight regain after bariatric surgery: A systematic literature review and comparison across studies using a large reference sample","volume":"16","author":"King","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1111\/j.1467-789X.2012.01012.x","article-title":"Why do individuals not lose more weight from an exercise intervention at a defined dose? An energy balance analysis","volume":"13","author":"Thomas","year":"2012","journal-title":"Obes. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"Altman","year":"2007","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/S0895-4356(96)00236-3","article-title":"A simulation study of the number of events per variable in logistic regression analysis","volume":"49","author":"Peduzzi","year":"1996","journal-title":"J. Clin. Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2409","DOI":"10.1002\/sim.1047","article-title":"A solution to the problem of separation in logistic regression","volume":"21","author":"Heinze","year":"2002","journal-title":"Stat. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1056\/NEJMoa2032183","article-title":"Once-weekly semaglutide in adults with overweight or obesity","volume":"384","author":"Wilding","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1056\/NEJMoa2206038","article-title":"Tirzepatide once weekly for the treatment of obesity","volume":"387","author":"Jastreboff","year":"2022","journal-title":"N. Engl. J. Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/8\/1450\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:50:39Z","timestamp":1785117039000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/8\/1450"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,26]]},"references-count":33,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["medicina62081450"],"URL":"https:\/\/doi.org\/10.3390\/medicina62081450","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,26]]}}}