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Uncovering key factors in weight loss effectiveness through machine learning.

作者信息

Yang Hui-Wen, De la Peña-Armada Rocío, Sun Haoqi, Peng Yu-Qi, Lo Men-Tzung, Scheer Frank A J L, Hu Kun, Garaulet Marta

机构信息

Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.

Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.

出版信息

Int J Obes (Lond). 2025 May 6. doi: 10.1038/s41366-025-01766-w.


DOI:10.1038/s41366-025-01766-w
PMID:40328924
Abstract

BACKGROUND/OBJECTIVES: One of the main challenges in weight loss is the dramatic interindividual variability in response to treatment. We aim to systematically identify factors relevant to weight loss effectiveness using machine learning (ML). SUBJECTS/METHODS: We studied 1810 participants in the ONTIME program, which is based on cognitive-behavioral therapy for obesity (CBT-OB). We assessed 138 variables representing participants' characteristics, clinical history, metabolic status, dietary intake, physical activity, sleep habits, chronotype, emotional eating, and social and environmental barriers to losing weight. We used XGBoost (extreme gradient boosting) to predict treatment response and SHAP (SHapley Additive exPlanations) to identify the most relevant factors for weight loss effectiveness. RESULTS: The total weight loss was 8.45% of the initial weight, the rate of weight loss was 543 g/wk., and attrition was 33%. Treatment duration (mean ± SD: 14.33 ± 8.61 weeks) and initial BMI (28.9 ± 3.33) were crucial factors for all three outcomes. The lack of motivation emerged as the most significant barrier to total weight loss and also influenced the rate of weight loss and attrition. Participants who maintained their motivation lost 1.4% more of their initial body weight than those who lost motivation during treatment (P < 0.0001). The second and third critical factors for decreased total weight loss were lower "self-monitoring" and "eating habits during treatment" (particularly higher snacking). Higher physical activity was a key variable for the greater rate of weight loss. CONCLUSIONS: Machine learning analysis revealed key modifiable lifestyle factors during treatment, highlighting avenues for targeted interventions in future weight loss programs. Specifically, interventions should prioritize strategies to sustain motivation, address snacking behaviors, and enhance self-monitoring techniques. Further research is warranted to evaluate the efficacy of these strategies in improving weight loss outcomes. TRIAL REGISTRATION: clinicaltrials.gov: NCT02829619.

摘要

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本文引用的文献

[1]
Impact of polygenic score for BMI on weight loss effectiveness and genome-wide association analysis.

Int J Obes (Lond). 2024-5

[2]
Behavioral and Psychological Factors Affecting Weight Loss Success.

Curr Obes Rep. 2023-9

[3]
Effectiveness and cost-effectiveness of text messages with or without endowment incentives for weight management in men with obesity (Game of Stones): study protocol for a randomised controlled trial.

Trials. 2022-7-22

[4]
The Effectiveness of Combining Nonmobile Interventions With the Use of Smartphone Apps With Various Features for Weight Loss: Systematic Review and Meta-analysis.

JMIR Mhealth Uhealth. 2022-4-8

[5]
Machine learning traditional regression models predicting treatment outcomes for binge-eating disorder from a randomized controlled trial.

Psychol Med. 2023-5

[6]
Daily Rhythm of Fractal Cardiac Dynamics Links to Weight Loss Resistance: Interaction with 3111T/C Genetic Variant.

Nutrients. 2021-7-19

[7]
Grazing's frequency and associations with obesity, psychopathology, and loss of control eating in clinical and community contexts: A systematic review.

Appetite. 2021-12-1

[8]
Machine Learning Analysis to Identify Digital Behavioral Phenotypes for Engagement and Health Outcome Efficacy of an mHealth Intervention for Obesity: Randomized Controlled Trial.

J Med Internet Res. 2021-6-24

[9]
Low-carbohydrate ketogenic diets in body weight control: A recurrent plaguing issue of fad diets?

Obes Rev. 2021-3

[10]
Older age does not influence the success of weight loss through the implementation of lifestyle modification.

Clin Endocrinol (Oxf). 2021-2

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