Dataset Information

Importance of self-weighing to avoid post-cessation weight gain: A secondary analysis of the fit and quit randomized trial.

ABSTRACT:

Background

Smoking cessation is associated with weight gain, and the risk of weight gain is a common deterrent to quitting smoking. Thus, the identification of strategies for reducing post-smoking cessation weight gain is critical.

Objective

Conduct secondary analysis of data from the Fit & Quit trial to determine if greater frequency of self-weighing is associated with less weight gain in the context of smoking cessation.

Methods

Participants (N = 305) were randomized to one of three 2-month weight interventions (i.e., Stability, Loss, Bibliotherapy), followed by a smoking cessation intervention. Stability and Loss conditions received different types of self-weighing feedback. All participants received e-scales at baseline, to capture daily self-weighing data over 12 months. General linear models were applied to test the main objective.

Results

Frequency of self-weighing was (mean ± SD) 2.67 ± 1.84 days/week. The Stability condition had significantly higher self-weighing frequency (3.18 ± 1.72 days/week) compared to the Loss (2.51 ± 1.99 days/week) and the Bibliotherapy conditions (2.22 ± 1.63 days/week). Adjusting for baseline weight and treatment condition, self-weighing 3-4 days/week was associated with weight stability (-0.77 kg, 95% CI: -2.2946, 0.7474, p = 0.3175), and self-weighing 5 or more days/week was associated with 2.26 kg weight loss (95% CI: -3.9249, -0.5953, p = 0.0080).

Conclusions

Self-weighing may serve as a useful tool for weight gain prevention after smoking cessation. Feedback received about self-weighing behaviors and weight trajectory (similar to the feedback Stability participants received) might enhance adherence.

SUBMITTER: Oswald M

PROVIDER: S-EPMC10399538 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Importance of self-weighing to avoid post-cessation weight gain: A secondary analysis of the fit and quit randomized trial.

Oswald Mackenzi M Ross Kathryn M KM Sun Ning N Yin Wupeng W Garcia Stephanie J SJ Bursac Zoran Z Krukowski Rebecca A RA

Obesity science & practice 20230317 4

<h4>Background</h4>Smoking cessation is associated with weight gain, and the risk of weight gain is a common deterrent to quitting smoking. Thus, the identification of strategies for reducing post-smoking cessation weight gain is critical.<h4>Objective</h4>Conduct secondary analysis of data from the Fit & Quit trial to determine if greater frequency of self-weighing is associated with less weight gain in the context of smoking cessation.<h4>Methods</h4>Participants (<i>N</i> = 305) were randomiz ...[more]

PMID: 37546280

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Project description:Background/objectivesWeight gain is a barrier to smoking cessation. Previous interventions targeting weight gain while quitting smoking have largely been unsuccessful. The current study aimed to assess the efficacy of weight stability and weight loss interventions compared to a low-intensity, self-guided bibliotherapy weight management group.Subjects/methodsA randomized controlled trial with 12-month follow-up from 2018 to 2022 was conducted with participants (N = 305) who reported smoking at least five cigarettes per day for the last year and interest in quitting initially recruited from the Memphis, TN, USA area. Recruitment was expanded nationally with the onset of the COVID-19 pandemic. Subsequently, 276 completed 12-month follow-up.Interventions/methodsThe Bibliotherapy group was provided a weight management book. Both the Stability and Loss groups met via telephone for eight weeks to learn strategies for maintaining/losing weight, respectively. All three groups then received the same six-week smoking cessation intervention, with six months of varenicline provided.ResultsIndividuals in the Loss group lost more weight (-2.01 kg, SE = 1.58) than individuals in the Bibliotherapy group (+1.08 kg, SE = 1.49, p = 0.0004), while the Stability group (-0.30 kg, SE = 1.56) was not significantly different from the Bibliotherapy group (p = 0.17). Those in the Stability group did not gain a significant amount of weight. Participants in the Loss group did not gain back all weight lost after smoking cessation and ended the study approximately 2.01 kg lower than baseline. The Bibliotherapy group did not gain the amount of weight expected after cessation. There were no significant differences between groups related to self-reported smoking cessation at each time point except at eight-month follow-up (p = 0.005).Conclusions and relevanceResults indicated the Stability and the Loss interventions were effective for preventing post-smoking cessation weight gain, with the Loss group having the benefit of sustained weight loss. These interventions may be helpful to implement to combat weight gain and potentially facilitate smoking cessation.Trial registrationThe trial is registered on clinicaltrials.gov (NCT03156660).

Project description:IntroductionApproved pharmacological treatments for smoking cessation are modestly effective, underscoring the need for improved pharmacotherapies. Glucagon-like peptide-1 receptor (GLP-1R) agonists attenuate the rewarding effects of nicotine in preclinical studies. We examined the efficacy of extended-release exenatide, a GLP-1R agonist, combined with nicotine replacement therapy (NRT, patch) for smoking cessation, craving, and withdrawal symptoms, with post-cessation body weight as a secondary outcome.MethodsEighty-four prediabetic and/or overweight smokers were randomized (1 : 1) to once-weekly placebo or exenatide, 2 mg, subcutaneously. All participants received NRT (21 mg) and brief smoking cessation counseling. Seven-day point prevalence abstinence (expired CO level ≤5 ppm), craving, withdrawal, and post-cessation body weight were assessed following 6 weeks of treatment. A Bayesian approach for analyzing generalized linear models yielded posterior probabilities (PP) to quantify the evidence favoring hypothesized effects of treatment on the study outcomes.ResultsExenatide increased the risk for smoking abstinence compared to placebo (46.3% and 26.8%, respectively), (risk ratio [RR] = 1.70; 95% credible interval = [0.96, 3.27]; PP = 96.5%). Exenatide reduced end-of-treatment craving in the overall sample and withdrawal among abstainers. Post-cessation body weight was 5.6 pounds lower in the exenatide group compared to placebo (PP = 97.4%). Adverse events were reported in 9.5% and 2.3% of participants in the exenatide and placebo groups, respectively.ConclusionsExenatide, in combination with the NRT improved smoking abstinence, reduced craving and withdrawal symptoms, and decreased weight gain among abstainers. Findings suggest that the GLP-1R agonist strategy is worthy of further research in larger, longer duration studies.ImplicationsDespite considerable progress in tobacco control, cigarette smoking remains the leading cause of preventable disease, disability, and death. In this pilot study, we showed that extended-release exenatide, a glucagon-like peptide-1 receptor agonist, added to the nicotine patch, improved abstinence and mitigated post-cessation body weight gain compared to patch alone. Further research is needed to confirm these initial positive results.

Dataset Information

Importance of self-weighing to avoid post-cessation weight gain: A secondary analysis of the fit and quit randomized trial.

Background

Objective

Methods

Results

Conclusions

Publications

Importance of self-weighing to avoid post-cessation weight gain: A secondary analysis of the fit and quit randomized trial.

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