Effects of a 2‐Year Primary Care Weight Loss Intervention on Quality of Life in Patients With Obesity

ABSTRACT Objective This study examined (1) the association between weight loss and changes in health‐related quality of life (HRQoL) and (2) treatment response heterogeneity among patients in a weight loss intervention. Methods Eighteen primary care clinics were randomized to a 24‐month intensive lifestyle intervention or usual care. Generic HRQoL and weight‐related QoL were assessed at baseline and months 6, 12, and 24. Associations were analyzed using repeated‐measures linear multilevel models. Results The sample included 803 patients with obesity. Changes in generic HRQoL did not differ by race or sex, and weight‐related QoL did not differ by sex. However, Black patients experienced less improvement in weight‐related QoL compared to other races. There was a graded association between improvements in weight‐related QoL and greater weight loss between baseline and 24 months: 7.4 (95% CI: 5.1, 9.7) for those who lost < 5% of their initial body weight, 15.0 (11.4, 18.5) for 5% to < 10% weight loss, and 18.9 (15.4, 22.4) for ≥ 10% weight loss. Greater weight loss was also related to greater improvements in most generic HRQoL domains. Conclusions Weight loss was associated with improvements in HRQoL, and race differences were identified in changes in weight‐related QoL, highlighting the need for precision medicine approaches to weight loss. Trial Registration ClinicalTrials.gov identifier NCT02561221