Is drop-out from obesity treatment a predictable and preventable event?

Nutrition Journal

Anna Tagliabue¹  Simona Villani²  Piergiuseppe Vinai³  Claudia Trentani¹  Cinzia Ferraris¹  Virginia Valeria Ferretti²  Ottavia Colombo¹ 

[1] Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensics Medicine, University of Pavia, via A. Bassi, 21, I-27100 Pavia, Italy;Biostatistics and Epidemiology Unit, Department of Public Health, Experimental and Forensics Medicine, University of Pavia, via Forlanini, 2, I-27100 Pavia, Italy;“GNOSIS” Research and Psychotherapy Group V, Mondovì, Italy

关键词: Early weight loss;    Predictors;    Attrition rate;    Drop-out;    Obesity treatment;   

Others  :  801803
DOI  :  10.1186/1475-2891-13-13

 received in 2013-10-18, accepted in 2014-01-28,  发布年份 2014

【 摘 要 】

Background

Attrition is an important but understudied issue that plays a vital role in the successful treatment of obesity. To date, most studies focusing on attrition rates and/or its predictors have been based on pretreatment data routinely collected for other purposes. Our study specifically aims at identifying the predictors of drop-out focusing on empirically or theoretically-based factors.

Methods

We conducted a retrospective observational study in an academic outpatient clinical nutrition service in Pavia, Italy. We examined a total of 98 adult obese patients (36 males, 62 females) who underwent a 6-month dietary behavioral weight-loss treatment at our Center. Pre-treatment and treatment-related variables were collected or calculated from clinical charts in order to discriminate those subjects who completed treatment from those who abandoned it before its completion. Multivariable regression analysis was used to identify the independent predictors of drop-out.

Results

The drop-out rates were 21% at 1 month and 57% at 6 months. Compared with completers, noncompleters were significantly younger in terms of age at first dieting attempt (24.0 ± 10.7 vs. 31.3 ± 11.2 years, P = 0.005), had lower diastolic blood pressure (87.8 ± 9.7 vs. 92.7 ± 11.4 mmHg, P = 0.022), had a lower baseline body fat percentage (38.5 ± 6.4 vs. 41.2 ± 4.4% weight, P = 0.015), and had a lower percentage of early weight loss (-1.8 ± 1.8% vs. -3.1 ± 2.1%, P = 0.035). Moreover, noncompleters significantly differed from completers with regard to type of referral (34.1% vs. 53.3% sent by a physician, P = 0.036) and SCL-90 anger-hostility subscale (0.83 ± 0.72 vs. 0.53 ± 0.51, P = 0.022). A multivariable logistic regression analysis including pre-treatment variables showed that body fat percentage (P = 0.030) and SCL-90 anger-hostility subscale (P = 0.021) were independently associated with attrition. In a multivariable model considering both pre-treatment and treatment-related factors, attrition was found to be independently related to the age at first dieting attempt (P = 0.016) and the achievement of early weight loss (P = 0.029).

Conclusions

Our data confirm that psychopathological tracts, early dieting attempts, and a poor initial treatment response are key independent predictors of drop-out from obesity treatment.

【 授权许可】

   
2014 Colombo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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