Predictors of attrition and weight loss success: Results from a randomized controlled trial |
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| Authors: | Anthony N. Fabricatore Thomas A. Wadden Reneé H. Moore Meghan L. Butryn Steven B. Heymsfield Allison Martin Nguyen |
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| Affiliation: | 1. University of Pittsburgh School of Social Work, Pittsburgh, PA, USA;2. University of Pittsburgh School of Nursing, Pittsburgh, PA, USA;3. University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA;4. Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA;5. Centers for Disease Control and Prevention, Atlanta, GA, USA;6. Boston College School of Nursing, Chestnut Hill, MA, USA;1. Department of Sports and Exercise Medicine, Oulu Deaconess Institute, P.O. BOX 365, FI-90101 Oulu, Finland;2. Institute of Health Sciences, University of Oulu, P.O. BOX 5000, FI-90014 University of Oulu, Finland;3. MRC Oulu, University Hospital of Oulu and University of Oulu, P.O. BOX 5000, FI-90014 OYS, Finland;4. Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. BOX 1627, FI-70211 Kuopio, Finland;5. Clinical Nutrition and Obesity Centre, Department of Medicine, Kuopio University Hospital, P.O. BOX 100, FI-70029 KYS, Finland;6. Clinical Research Center and Medical Research Center, University Hospital of Oulu, P.O. BOX 5000, FI-90014 OYS, Finland |
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| Abstract: | Attrition is a common problem in weight loss trials. The present analysis examined several baseline and early-treatment process variables, as predictors of attrition and outcome in a clinical trial that combined pharmacotherapy and behavior therapy for weight loss. Participants were 224 obese adults who were treated with sibutramine alone, lifestyle modification alone, combined therapy, or sibutramine plus brief lifestyle modification. Predictors included baseline characteristics (e.g., demographic, weight-related, psychological, and consumption-related variables), plus attendance, adherence, and weight loss in the early weeks of treatment. Outcomes were attrition and weight loss success (i.e., ≥5% reduction in body weight) at 1 year. Multivariable models, adjusting for other relevant variables, found that younger age and greater baseline depressive symptoms were related to increased odds of attrition (ps ≤ 0.003). Greater early weight loss marginally reduced the odds of attrition (p = 0.06). Predictors of weight loss success at 1 year were Caucasian ethnicity (p = 0.04), lower baseline depressive symptoms (p = 0.04), and weight loss during the first 3 weeks of treatment (p < 0.001). Thus, depressive symptoms at baseline were a significant predictor of both attrition and weight loss success. As a process variable, early weight loss appears to have more predictive value than early attendance at treatment sessions or early adherence. |
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