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Testing a proposed mathematical model of weight loss in women enrolled on a commercial weight-loss programme: the LighterLife study

Published online by Cambridge University Press:  12 December 2024

Aoife M. Egan*
Affiliation:
Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom of Great Britain and Northern Ireland
John F. Rayman
Affiliation:
Department of Mathematics, University of Surrey, Guildford, United Kingdom of Great Britain and Northern Ireland
Adam L. Collins
Affiliation:
Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom of Great Britain and Northern Ireland
*
Corresponding author: Aoife Egan; Email: a.m.egan@surrey.ac.uk

Abstract

Weight loss results in obligatory reductions in energy expenditure (EE) due to loss of metabolically active fat-free mass (FFM). This is accompanied by adaptive reductions (i.e. adaptive thermogenesis) designed to restore energy balance while in an energy crisis. While the ‘3500-kcal rule’ is used to advise weight loss in clinical practice, the assumption that EE remains constant during energy restriction results in a large overestimation of weight loss. Thus, this work proposes a novel method of weight-loss prediction to more accurately account for the dynamic trajectory of EE. A mathematical model of weight loss was developed using ordinary differential equations relying on simple self-reported inputs of weight and energy intake to predict weight loss over a specified time. The model subdivides total daily EE into resting EE, physical activity EE, and diet-induced thermogenesis, modelling obligatory and adaptive changes in each compartment independently. The proposed model was tested and refined using commercial weight-loss data from participants enrolled on a very low-energy total-diet replacement programme (LighterLife UK, Essex). Mathematical modelling predicted post-intervention weight loss within 0.75% (1.07 kg) of that observed in females with overweight or obesity. Short-term weight loss was consistently underestimated, likely due to considerable FFM reductions reported on the onset of weight loss. The best model agreement was observed from 6 to 9 weeks where the predicted end-weight was within 0.35 kg of that observed. The proposed mathematical model simulated rapid weight loss with reasonable accuracy. Incorporated terms for energy partitioning and adaptive thermogenesis allow us to easily account for dynamic changes in EE, supporting the potential use of such a model in clinical practice.

Information

Type
Research Article
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society
Figure 0

Table 1. Post-intervention mean error of mathematical model in the LighterLife study

Figure 1

Fig. 1. Mean error of mathematical model at weekly intervals. Data presented as mean (SEM). End-weight in LighterLife participants was predicted by our mathematical model and compared to that observed. Week 1, –1.14 ± 1.68%, n = 713; week 2, –1.41 ± 2.4%, n = 656; week 3, –1.44 ± 2.5%, n = 606; week 4, –1.30 ± 2.93%, n = 599; week 5, –1.30 ± 3.64%, n = 565; week 6, –1.82 ± 4.09%, n = 578; week 7, –0.46 ± 4.4%, n = 465; week 8, –0.40 ± 4.91%, n = 388; week 9, –0.26 ± 5.27%, n = 277; week 10, 0.43 ± 6.28%, n = 190; week 11, 1.06 ± 5.96%, n = 121; week 12, 2.10 ± 6.07%, n = 59. δ, mean error ([actual-predicted end-weight/actual end-weight] × 100).

Figure 2

Table 2. Actual versus predicted weight loss at weekly intervals in females enrolled on the LighterLife study

Figure 3

Fig. 2. Bland–Altman analysis to investigate the agreement between actual and predicted weight loss. Participants followed a very low-energy total-diet replacement intervention for 6–12 weeks providing 600–800 kcal/d. Average = (actual weight loss + predicted weight loss)/2. The dotted lines represent the upper and lower limits of agreement ( ± 2 SD). The solid line represents the average difference (kg).