title: Predictors of attrition and weight loss success: Results from a randomized controlled trial.
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., >or=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 <or= 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.
authors.affiliation: University of Pennsylvania School of Medicine, 3535 Market Street, Ste. 3108, Philadelphia, PA 19104-3309, United States. fabricat@mail.med.upenn.edu
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Fabricatore
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wadden
authors.forename: Reneé H
authors.initials: RH
authors.lastname: Moore
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Butryn
authors.forename: Steven B
authors.initials: SB
authors.lastname: Heymsfield
authors.forename: Allison Martin
authors.initials: AM
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000367:Age Factors; D001067:Appetite Depressants / Q000627:therapeutic use; D001835:Body Weight; D003131:Combined Modality Therapy / Q000379:methods / Q000523:psychology; D003503:Cyclobutanes / Q000627:therapeutic use*; D003863:Depression / Q000150:complications / Q000523:psychology*; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D001067:Appetite Depressants; D003503:Cyclobutanes; C058254:sibutramine