title: Predictors of attrition in a multidisciplinary adult weight management clinic.
abstract: BACKGROUND
  Worldwide, more than 1.7 billion individuals may be classified as overweight and are in need of appropriate medical and surgical treatments. The primary goal of a comprehensive weight management program is to produce sustainable weight loss. However, for such a program to be effective, the patient must complete it. We analyzed attrition rates and predictors of attrition within a publicly funded, multidisciplinary adult weight management program.
  
  
  METHODS
  We retrospectively reviewed charts from an urban multidisciplinary adult weight management clinic program database. Patients received medical or surgical treatment with appropriate follow-up. We collected information on demographics and comorbidities. Patients in the surgical clinics received either laparoscopic gastric band insertion or gastric bypass. We conducted univariate analysis and multivariate analyses on predictors of attrition.
  
  
  RESULTS
  A total of 1205 patients were treated in the weight management program: 887 in the medical clinic and 318 with surgery and follow-up in a surgical clinic. Overall, 516 patients left the program or were lost to follow-up (attrition rate 42.8%). The attrition rate was 53.9% in the medical clinic and 11.9% in the surgical clinic. Multivariate analyses identified participation in the medical clinic, younger patient age and lower body mass index as predictors of attrition.
  
  
  CONCLUSIONS
  We found lower attrition rates among surgically than medically treated patients in a multidisciplinary weight management clinic. Further research is needed to understand those variables that lead to improved attrition rates.
authors.affiliation: The Department of Surgery, University of Alberta, 10240 Kingsway Avenue, Edmonton, AB.
authors.forename: Richdeep S
authors.initials: RS
authors.lastname: Gill
authors.forename: Shahzeer
authors.initials: S
authors.lastname: Karmali
authors.forename: Ghassan
authors.initials: G
authors.lastname: Hadi
authors.forename: David P
authors.initials: DP
authors.lastname: Al-Adra
authors.forename: Xinzhe
authors.initials: X
authors.lastname: Shi
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Birch
mesh_terms: D000328:Adult; D000416:Alberta; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D000704:Analysis of Variance; D050110:Bariatric Surgery / Q000706:statistics & numerical data; D015992:Body Mass Index; D015331:Cohort Studies; D016208:Databases, Factual; D004038:Diet, Reducing / Q000706:statistics & numerical data; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D009767:Obesity, Morbid / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D014505:Urban Population; D015431:Weight Loss