title: Should providers encourage realistic weight expectations and satisfaction with lost weight in commercial weight loss programs? a preliminary study.
abstract: BACKGROUND
  Attrition is a problem among patients who participate in commercial weight loss programs. One possible explanation is that if patients are unable to reach a weight that they expect to achieve, they may be more likely to drop out of treatment. This study investigated variables associated with attrition among 30 obese patients who completed a liquid meal replacement program (LMR) and enrolled in a 52-week Small Changes Maintenance intervention (SCM). Patients lost a median 18% of body weight during LMR and completed assessments about weight expectations and weight satisfaction pre- and post-SCM.
  
  
  RESULTS
  Of the 30 patients who started SCM, 8 (27%) were lost to attrition. Odds of SCM attrition were higher in patients who lost ≤ 18.2% of pre-LMR weight (OR: 12.25, P = 0.035), had lower satisfaction (≤7) pre-SCM (OR: 10.11, P = 0.040), and who expected further weight loss of 9.1 kg or more pre-SCM (OR: 10.11, P = 0.040). SCM completers significantly increased weight loss expectations by a median of 2.3 kg from pre-SCM to post-SCM (WSR P = 0.049) that paralleled weight regained post-SCM (2.7 kg).
  
  
  CONCLUSIONS
  After completion of a medically-supervised commercial weight loss program, patients with the greatest expectations for further weight loss and the lowest weight satisfaction were more likely to drop out of SCM. Failure to participate in maintenance treatment may lead to regain of greater than half of lost weight over the next year. Among SCM completers, lower expectations for further weight loss and greater weight satisfaction appeared to be associated with continued engagement in maintenance treatment.
authors.affiliation: Obesity Medicine, Division of General Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA.
authors.forename: Gretchen E
authors.initials: GE
authors.lastname: Ames
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA.
authors.forename: Colleen S
authors.initials: CS
authors.lastname: Thomas
authors.affiliation: Obesity Medicine, Division of General Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA.
authors.forename: Roshni H
authors.initials: RH
authors.lastname: Patel
authors.affiliation: Obesity Medicine, Division of General Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA.
authors.forename: Jillian S
authors.initials: JS
authors.lastname: McMullen
authors.affiliation: Department of Psychology, East Carolina University, 1001 E 5th St., Greenville, NC 27858 USA.
authors.forename: Lesley D
authors.initials: LD
authors.lastname: Lutes
keywords: Attrition; Obesity treatment; Weight loss expectations