Group-based trajectory analysis of physical activity change in a US weight loss intervention

BACKGROUND: The obesity epidemic is a global concern. Standard behavioral treatment including increased physical activity, reduced energy intake, and behavioral change counseling is an effective lifestyle intervention for weight loss.

PURPOSE: To identify distinct step count patterns among weight loss intervention participants, examine weight loss differences by trajectory group, and examine baseline factors associated with trajectory group membership.

METHODS: Both groups received group-based standard behavioral treatment while the experimental group received up to 30 additional, one-on-one self-efficacy enhancement sessions. Data were analyzed using group-based trajectory modeling, analysis of variance, chi-square tests, and multinomial logistic regression.

RESULTS: Participants (N = 120) were mostly female (81.8%) and white (73.6%) with a mean (SD) body mass index of 33.2 (3.8) kg/m 2. Four step count trajectory groups were identified: active (>10,000 steps/day; 11.7%), somewhat active (7500-10,000 steps/day; 28.3%), low active (5000-7500 steps/day; 27.5%), and sedentary (<5000 steps/day; 32.5%). Percent weight loss at 12 months increased incrementally by trajectory group (5.1% [5.7%], 7.8% [6.9%], 8.0% [7.4%], and 13.63% [7.0%], respectively; P = .001). At baseline, lower body mass index and higher perceived health predicted membership in the better performing trajectory groups.

CONCLUSIONS: Within a larger group of adults in a weight loss intervention, 4 distinct trajectory groups were identified and group membership was associated with differential weight loss.