The Role of Early and Later Response on Overall Outcomes in School-Based Obesity Intervention

Katherine R. Arlinghaus, Daniel P. O’Connor, Tracey A. Ledoux, Sheryl O. Hughes, Craig A. Johnston

Research output: Contribution to journalArticlepeer-review


Objective: Early response to obesity intervention consistently predicts long-term BMI reductions. However, little is known about how changes in weight at other times in an intervention may impact long-term outcomes. This study examined the relationship between weight-related changes that occurred early and later during an intervention and the association between these changes with overall outcomes. Methods: A secondary analysis of a school-based obesity intervention with replicated efficacy among Hispanic middle school students was conducted (n = 174). Linear regression models were developed in which first and second semester changes in BMI represented as a percentage of the 95th BMI percentile (%BMIp95) were separately used to predict overall %BMIp95 outcomes. First semester changes in %BMIp95 were used to predict subsequent %BMIp95 change (i.e., second semester). Results: Changes in %BMIp95 during both the first and second semesters were independently associated with overall changes from baseline (e.g., at 24 months: first semester, β = 0.59, P < 0.01; second semester, β = 1.02, P < 0.001). First semester %BMIp95 change was not associated with second semester change (β = −0.07, P = 0.32). Conclusions: Change at any point during the intervention was predictive of overall weight outcomes. Additional research is needed to understand patterns of weight changes throughout interventions to better understand long-term outcomes.

Original languageEnglish (US)
Pages (from-to)177-183
Number of pages7
Issue number1
StatePublished - Jan 2021
Externally publishedYes

Bibliographical note

Funding Information:
Financial support was provided by the United States Department of Agriculture (grant nos. ARS 2533759358 and ARS 6250-51000).

Publisher Copyright:
© 2020 The Obesity Society

PubMed: MeSH publication types

  • Journal Article
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.


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