Predictors of early attrition and successful weight loss in patients attending an obesity management program
Tóm tắt
Our objective was to identify factors that are independently associated with early attrition and successful weight loss (WL) in an obesity-management program. Participants were 9,498 patients enrolled in treatment at the Wharton Weight Management Clinic for at least 6 months. Predictors of early attrition (<6 months) and successful WL (≥5 %) were analyzed using relative risk (RR) in men and women separately. Pearson’s correlation was used to determine the relationship between WL and treatment time Weight loss and attrition analysis was restricted to patients who had more than two visits (n = 5415). Older individuals had lower early attrition (RR Range:0.74–0.92, P < 0.05) and greater WL success (RR Range:1.40–1.65, P < 0.05) than younger individuals. Males with hypertension and females with depression had greater early attrition (RR Range:1.09–1.20, P < 0.05) and lower WL success (RR Range:0.48–0.57, P < 0.05) than those without these health conditions. Males with lower education had greater early attrition (RR = 1.11[1.03–1.19]) than males with higher education, but did not differ in WL. Females who smoked had greater early attrition (RR = 1.06[1.01–1.11]) than females who did not smoke, but did not differ in WL. Ethnicity was not related to early attrition, however, females of Black and Other ethnicities had lower WL success compared to White females (RR Range:0.58–0.74, P < 0.05). After adjusting for treatment time, all above associations were no longer significant and treatment time remained as the only independent predictor of WL success (P < 0.0001). As WL is positively and independently related with treatment time, individuals at risk for early attrition may need alternative treatment options, in order to improve patient retention and improve WL success.
Tài liệu tham khảo
Moroshko I, Brennan L, O’Brien P. Predictors of dropout in weight loss interventions: a systematic review of the literature. Obes Rev. 2011;12:912–34.
Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Metcalfe LL, Blew RM, Sardinha LB, Lohman TG. Pretreatment predictors of attrition and successful weight management in women. Int J Obes Relat Metab Disord. 2004;28:1124–33.
Yackobovitch-Gavan M, Steinberg DM, Endevelt R, Benyamini Y. Factors associated with dropout in a group weight-loss programme: a longitudinal investigation. J Hum Nutr Diet. 2014;28:33–40.
Michelini I, Falchi AG, Muggia C, Grecchi I, Montagna E, De Silvestri A, Tinelli C. Early dropout predictive factors in obesity treatment. Nutr Res Pract. 2014;8:94–102.
Vinkers CDW, Adriaanse MA, de Ridder DTD. In it for the long haul: characteristics of early and late drop out in a self-management intervention for weight control. J Behav Med. 2013;36:520–30.
Honas JJ, Early JL, Frederickson DD, O’Brien MS. Predictors of attrition in a large clinic-based weight-loss program. Obes Res. 2003;11:888–94.
Graffagnino CL, Falko JM, La Londe M, Schaumburg J, Hyek MF, Shaffer LET, Snow R, Caulin-glaser T, Cheryl L, Londe MLA. Effect of a Community-Based Weight Management Program on Weight Loss and Cardiovascular Disease Risk Factors. Obesity. 2006;14:280–8.
Kong W, Langlois M-F, Kamga-Ngandé C, Gagnon C, Brown C, Baillargeon J-P. Predictors of success to weight-loss intervention program in individuals at high risk for type 2 diabetes. Diabetes Res Clin Pract. 2010;90:147–53.
Gill RS, Karmali S, Hadi G, Al-Adra DP, Shi X, Birch DW. Predictors of attrition in a multidisciplinary adult weight management clinic. Can J Surg. 2012;55:239–43.
Inelmen EM, Toffanello ED, Enzi G, Gasparini G, Miotto F, Sergi G, Busetto L. Predictors of drop-out in overweight and obese outpatients. Int J Obes. 2005;29:122–8.
Davis MJ, Addis ME. Predictors of Attrition from Behavioral Medicine Treatments. Ann Behav Med. 1999;21(4):339–49.
Douketis JD, Morrison KM, Hramiak IM, Sharma AM. Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2006;2007(176):S1–S13.
Jeffery RW, Drewnowski A, Epstein LH, Stunkard AJ, Wilson GT, Wing RR, Hill DR. Long-term maintenance of weight loss: current status. Heal Psychol. 2000;19:5–16.
Perri MG, Nezu A, Patti ET, McCann K. Effect of Length of Treatment on Weight Loss. J Consult Clin Psychol. 1989;57(3):450–2.
Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr. 2005;82(1 Suppl):222S–5S.
Huisman S, Maes S, De Gucht VJ, Chatrou M, Haak HR. Low goal ownership predicts drop-out from a weight intervention study in overweight patients with type 2 diabetes. Int J Behav Med. 2010;17:176–81.
Grossi E, Dalle Grave R, Mannucci E, Molinari E, Compare A, Cuzzolaro M, Marchesini G. Complexity of attrition in the treatment of obesity: clues from a structured telephone interview. Int J Obes (Lond). 2006;30:1132–7.
Greenberg I, Stampfer MJ, Schwarzfuchs D, Shai I. Adherence and success in long-term weight loss diets: the dietary intervention randomized controlled trial (DIRECT). J Am Coll Nutr. 2009;28:159–68.
Fabricatore AN, Wadden TA, Moore RH, Butryn ML, Heymsfield SB, Nguyen AM. Predictors of attrition and weight loss success: Results from a randomized controlled trial. Behav Res Ther. 2009;47:685–91.
Packianathan I, Sheikh M, Boniface D, Finer N. Predictors of programme adherence and weight loss in women in an obesity programme using meal replacements. Diabetes Obes Metab. 2005;7:439–47.
Bradshaw AJ, Horwath CC, Katzer L, Gray A. Non-dieting group interventions for overweight and obese women: what predicts non-completion and does completion improve outcomes? Public Health Nutr. 2010;13:1622–8.
Chang M-W, Brown R, Nitzke S. Participant recruitment and retention in a pilot program to prevent weight gain in low-income overweight and obese mothers. BMC Public Health. 2009;9:424.
Busetto L, Mazza M, Salvalaio S, De Stefano F, Marangon M, Calò E, Sampietro S, Enzi G. Obesity treatment in elderly outpatients : Predictors of efficacy and drop-out. Eat Weight Disord. 2009;14(September):e56–65.
Grave RD, Suppini A, Calugi S, Marchesini G. Factors Associated with Attrition in Weight Loss Programs. Int J Behav Consult Ther. 2006;2:341–53.
Chang M, Niaura R, King T, Pera V. Depression, smoking, activity level, and health status: pretreatment predictors of attrition in obesity treatment. Addict Behav. 1996;21:509–13.
Marcus MD, Wing RR, Hopkins J. Obese Binge Eaters: Affect, Cognitions, and Response to Behavioral Weight Control. J Consult Clin Psychol. 1988;56:433–9.
Bacon S, Sherwood A, Hinderliter A, Blumenthal J. Effects of Exercise, Diet and Weight Loss on High Blood Pressure. Sport Med. 2004;34:307–16.
Allison DB, Mentore JL, Heo M, Chandler LP, Cappelleri JC, Infante MC, Weiden PJ. Antipsychotic-induced weight gain: A comprehensive research synthesis. Am J Psychiatry. 1999;156:1686–96.
Elfhag K, Rössner S. Initial weight loss is the best predictor for success in obesity treatment and sociodemographic liabilities increase risk for drop-out. Patient Educ Couns. 2010;79:361–6.
Spring B, Sohn M-W, Locatelli SM, Hadi S, Kahwati L, Weaver FM. Individual, facility, and program factors affecting retention in a national weight management program. BMC Public Health. 2014;14:363.
Chiolero A, Faeh D, Paccaud F, Cornuz J. Consequences of smoking for body weight, body fat distribution, and insulin resistance. Am J Clin Nutr. 2008;87:801–9.
Admiraal WM, Bouter K, Celik F, Gerdes VEA, Klaassen RA, van Dielen FMH, van Ramshorst B, van Wagensveld BA, Hoekstra JBL, Holleman F. Ethnicity Influences Weight Loss 1 Year After Bariatric Surgery: a study in Turkish, Moroccan, South Asian, African and Ethnic Dutch Patients. Obes Surg. 2013;23:1497–500.
Abildso CG, Schmid O, Byrd M, Zizzi S, Quartiroli A, Fitzpatrick SJ. Predictors of weight loss maintenance following an insurance-sponsored weight management program. J Obes. 2014;2014:1–12.
