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Behavior, Psychology and Sociology

The impact of early body-weight variability on long-term weight maintenance: exploratory results from the NoHoW weight-loss maintenance intervention



Weight-loss programmes often achieve short-term success though subsequent weight regain is common. The ability to identify predictive factors of regain early in the weight maintenance phase is crucial.


To investigate the associations between short-term weight variability and long-term weight outcomes in individuals engaged in a weight-loss maintenance intervention.


The study was a secondary analysis from The NoHoW trial, an 18-month weight maintenance intervention in individuals who recently lost ≥5% body weight. Eligible participants (n = 715, 64% women, BMI = 29.2 (SD 5.0) kg/m2, age = 45.8 (SD 11.5) years) provided body-weight data by smart scale (Fitbit Aria 2) over 18 months. Variability in body weight was calculated by linear and non-linear methods over the first 6, 9 and 12 weeks. These estimates were used to predict percentage weight change at 6, 12, and 18 months using both crude and adjusted multiple linear regression models.


Greater non-linear weight variability over the first 6, 9 and 12 weeks was associated with increased subsequent weight in all comparisons; as was greater linear weight variability measured over 12 weeks (up to AdjR2 = 4.7%). Following adjustment, 6-week weight variability did not predict weight change in any model, though greater 9-week weight variability by non-linear methods was associated with increased body-weight change at 12 (∆AdjR2 = 1.2%) and 18 months (∆AdjR2 = 1.3%) and by linear methods at 18 months (∆AdjR2 = 1.1%). Greater non-linear weight variability measured over 12 weeks was associated with increased weight at 12 (∆AdjR2 = 1.4%) and 18 (∆AdjR2 = 2.2%) months; and 12-week linear variability was associated with increased weight at 12 (∆AdjR2 = 2.1%) and 18 (∆AdjR2 = 3.6%) months.


Body-weight variability over the first 9 and 12 weeks of a weight-loss maintenance intervention weakly predicted increased weight at 12 and 18 months. These results suggest a potentially important role in continuously measuring body weight and estimating weight variability.

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Fig. 1: Participant flow chart.
Fig. 2: Description of the frequency of participant smart scale use throughout the trial in eligible participants (n = 715).
Fig. 3: Changes in body weight over the trial in eligible participants (n = 715).
Fig. 4: Association matrix between short-term body-weight variability (BWV) and long-term weight change shown using scatterplot with linear trendlines.

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Data availability

There are legal restrictions on sharing data that contain potentially identifying or sensitive person information. The restrictions are imposed by The Danish Data Protection Agency ( Data used in the current study will be made available upon request after application to the NoHoW data controller (The James Hutton Institute: The application procedure can be obtained from The James Hutton Institute ( or David Nutter (


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The author’s responsibilities were as follows—BLH and JS acquired funding and designed the NoHoW trial; JT designed and leds the present secondary study; JT and ML were involved in conceptualisation and hypothesis generating; JT and ROD implemented all statistical analyses; JT wrote the manuscript; JT, JS, GF, ROD, ML, ALP, SCL, and BLH were involved in editing the manuscript; all authors approved the final manuscript; JT had primary responsibility for the final content. We thank all individuals involved in the collection of data and trial maintenance at The University of Leeds (UK), The University of Lisbon (PT) and The Parker Institute (DK).


The NoHoW study received funding from the European Union’s Horizon 2020 research and innovation programme (Grant Agreement Number: 643309). Funding for the present analysis was part of a PhD studentship from the University of Leeds awarded to JT.

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Correspondence to Jake Turicchi.

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Turicchi, J., O’Driscoll, R., Lowe, M. et al. The impact of early body-weight variability on long-term weight maintenance: exploratory results from the NoHoW weight-loss maintenance intervention. Int J Obes 45, 525–534 (2021).

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