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Weight loss in nonalcoholic fatty liver disease patients in an ambulatory care setting is largely unsuccessful but correlates with frequency of clinic visits

Dudekula, A and Rachakonda, V and Shaik, B and Behari, J (2014) Weight loss in nonalcoholic fatty liver disease patients in an ambulatory care setting is largely unsuccessful but correlates with frequency of clinic visits. PLoS ONE, 9 (11).

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Abstract

© 2014 Dudekula et al. Background and Aims: Nonalcoholic fatty liver disease (NALFD) is a leading cause of liver disease. Weight loss improves clinical features of NAFLD; however, maintenance of weight loss outside of investigational protocols is poor. The goals of this study were to characterize patterns and clinical predictors of long-term weight loss in ambulatory patients with NAFLD.Methods: We retrospectively reviewed 924 non-cirrhotic patients with NAFLD presenting to a liver clinic from May 1st 2007 to April 30th 2013. Overweight and obese patients were counseled on lifestyle modifications for weight loss as per USPSTF guidelines. The primary outcome was percent weight change between the first and last recorded visits: % weight change = weight initial-weight final weight initial. Baseline BMI and percent BMI change were secondary measures. Predictors of weight loss were determined using logistic regression.Results: The mean baseline BMI was 33.3±6.6 kg/m2 and the mean follow-up duration was 17.3±17.6 months. Most patients with NAFLD were in either overweight (26.1%) or class I obesity (30.5%) categories at baseline, while the prevalence of underweight and class III obesity was lower (0.2% and 15.4%, respectively). Overall, there was no change in mean weight or BMI during the follow-up period, and only 183 patients (19.8%) lost at least 5% body weight during the follow up period. Independent predictors of weight loss included number of clinic visits and baseline BMI, and patients with higher baseline BMI required more clinic visits to lose weight.Conclusions: Weight loss is largely unsuccessful in NAFLD patients in the ambulatory care setting. Frequent clinical encounters are associated with weight reduction, especially among individuals with high baseline BMI. Future studies are required to define effective weight loss strategies in NAFLD patients.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Dudekula, A
Rachakonda, V
Shaik, B
Behari, Jjab31@pitt.eduJAB31
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
EditorSookoian, Silvia CUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 6 November 2014
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 9
Number: 11
DOI or Unique Handle: 10.1371/journal.pone.0111808
Schools and Programs: School of Medicine > Medicine
Refereed: Yes
Other ID: NLM PMC4222918
PubMed Central ID: PMC4222918
PubMed ID: 25375228
Date Deposited: 12 May 2015 18:51
Last Modified: 02 Feb 2019 16:58
URI: http://d-scholarship.pitt.edu/id/eprint/24040

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