title: Predictors of weight loss maintenance and attrition during a 6-month dietary intervention period: results from the DiOGenes study.
abstract: There is a need to develop tools to predict individual weight loss maintenance and attrition prognosis. We aimed to identify predictors of weight loss maintenance outcome and attrition in subjects from eight European countries in the DiOGenes project. A total of 932 overweight/obese subjects (body mass index: 27-42 kg m(-2) ) were enrolled in an 8-week low-calorie diet (LCD). The 776 subjects (83%) who achieved at least 8% reduction in their initial body weight were randomized into five dietary arms varying in protein content and glycemic index for a 6-month weight maintenance period. Baseline characteristics, weight loss at weeks 1, 3 and 8 of LCD were assessed as predictors of weight loss maintenance and attrition using multivariate regression and correlation models. The multivariate model showed that the 6-month weight loss maintenance was predicted by: 7.889 - 0.343 × weight loss at week 3 + 1.505 × weight loss at week 8 + 2.422 × gender (0 = male and 1 = female gender) (R(2)  = 51%, P = 0.0001). A greater weight loss at week 8 was associated with a lower attrition during the subsequent 6-month dietary intervention period (OR = 0.92, 95% CI: 0.88-0.97, P = 0.001). Furthermore, the men showed an increased likelihood for attrition during the dietary intervention period (OR = 1.54, 95% CI: 1.07-2.20, P = 0.02). A greater weight loss during 8 weeks of LCD and female gender predict better 6-month weight maintenance of weight loss, whereas the baseline characteristics did not predict outcome. Attrition could be strongly predicted by gender and weight loss during LCD.
authors.affiliation: National Multiprofile Transport Hospital, Sofia, BulgariaDepartment of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, the NetherlandsHuman Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UKDepartment of Social Medicine, Preventive Medicine & Nutrition Clinic, University of Crete, Heraklion, Crete, GreeceDepartment of Clinical Nutrition, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal and Department of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, GermanyDepartment of Physiology and Nutrition, University of Navarra, Pamplona, SpainObesity Management Centre, Institute of Endocrinology, Prague, the Czech RepublicInstitute of Preventive Medicine, Centre for Health and Society, Copenhagen, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Handjieva-Darlenska
authors.forename: Sv
authors.initials: S
authors.lastname: Handjiev
authors.forename: T M
authors.initials: TM
authors.lastname: Larsen
authors.forename: M A
authors.initials: MA
authors.lastname: van Baak
authors.forename: A
authors.initials: A
authors.lastname: Lindroos
authors.forename: A
authors.initials: A
authors.lastname: Papadaki
authors.forename: A F H
authors.initials: AF
authors.lastname: Pfeiffer
authors.forename: J A
authors.initials: JA
authors.lastname: Martinez
authors.forename: M
authors.initials: M
authors.lastname: Kunesova
authors.forename: C
authors.initials: C
authors.lastname: Holst
authors.forename: W H M
authors.initials: WH
authors.lastname: Saris
authors.forename: A
authors.initials: A
authors.lastname: Astrup
keywords: attrition; gender; predictors; weight loss maintenance