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

Ottavia Colombo, Virginia Valeria Ferretti, Cinzia Ferraris, Claudia Trentani, Piergiuseppe Vinai, Simona Villani, Anna Tagliabue

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Abstract. 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.

Original languageEnglish
Article number13
JournalNutrition Journal
Volume13
Issue number1
DOIs
Publication statusPublished - Feb 3 2014

Fingerprint

Obesity
Therapeutics
Weight Loss
Hostility
Anger
Adipose Tissue
Regression Analysis
Blood Pressure
Italy
Observational Studies
Outpatients
Referral and Consultation
Retrospective Studies
Logistic Models
Physicians
Weights and Measures

Keywords

  • Attrition rate
  • Drop-out
  • Early weight loss
  • Obesity treatment
  • Predictors

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Medicine(all)

Cite this

Colombo, O., Ferretti, V. V., Ferraris, C., Trentani, C., Vinai, P., Villani, S., & Tagliabue, A. (2014). Is drop-out from obesity treatment a predictable and preventable event? Nutrition Journal, 13(1), [13]. https://doi.org/10.1186/1475-2891-13-13

Is drop-out from obesity treatment a predictable and preventable event? / Colombo, Ottavia; Ferretti, Virginia Valeria; Ferraris, Cinzia; Trentani, Claudia; Vinai, Piergiuseppe; Villani, Simona; Tagliabue, Anna.

In: Nutrition Journal, Vol. 13, No. 1, 13, 03.02.2014.

Research output: Contribution to journalArticle

Colombo, O, Ferretti, VV, Ferraris, C, Trentani, C, Vinai, P, Villani, S & Tagliabue, A 2014, 'Is drop-out from obesity treatment a predictable and preventable event?', Nutrition Journal, vol. 13, no. 1, 13. https://doi.org/10.1186/1475-2891-13-13
Colombo, Ottavia ; Ferretti, Virginia Valeria ; Ferraris, Cinzia ; Trentani, Claudia ; Vinai, Piergiuseppe ; Villani, Simona ; Tagliabue, Anna. / Is drop-out from obesity treatment a predictable and preventable event?. In: Nutrition Journal. 2014 ; Vol. 13, No. 1.
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abstract = "Abstract. 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.",
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AU - Ferretti, Virginia Valeria

AU - Ferraris, Cinzia

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AU - Vinai, Piergiuseppe

AU - Villani, Simona

AU - Tagliabue, Anna

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N2 - Abstract. 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.

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KW - Attrition rate

KW - Drop-out

KW - Early weight loss

KW - Obesity treatment

KW - Predictors

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