title: Predictors of dropout and bariatric surgery in Icelandic morbidly obese female patients.
abstract: BACKGROUND
  Little is known on how morbidly obese individuals who participate in different treatments differ in relation to anthropometrical measurements and psychological characteristics. In the present study we investigated attrition and treatment choice, i.e., bariatric surgery and conservative treatment, of morbidly obese subjects.
  
  
  METHODS
  Data was collected during screening from 292 morbidly obese women who participated in a weight loss program at an Icelandic rehabilitation center. Information were available on body composition, fasting blood samples, psychological characteristics, medication use, drop-out and whether patients underwent bariatric surgery after the weight loss program at the rehabilitation center. Inclusion criteria were age between 18 and 65 years and BMI>35 kg/m(2), exclusion criteria were alcohol- or drug addiction.
  
  
  RESULTS
  Of the 292 women who finished screening, 113 (39%) dropped out, 100 (34%) finished the weight loss program and 79 (27%) finished the weight loss program and consecutively underwent surgery. According to multivariate models individuals with BMI ≥50 kg/m(2) were 4.5 times more likely (P=0.003) to undergo bariatric surgery than individuals with BMI <40 kg/m(2). Individuals with severe depression were 2.4 times more likely (P=0.01) to drop out than individuals with no depression. Serum glucose (+36% for an increase by 1 mmol/L, P=0.036) and use of psychotropic medication (+73%, P=0.05) were also associated with higher odds of dropout.
  
  
  CONCLUSIONS
  A large proportion of morbidly obese individuals dropped out of a weight loss program at an Icelandic rehabilitation center and severe depression symptoms more than doubles this risk.
authors.affiliation: Unit for Nutrition Research, Landspitali National University Hospital & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
authors.forename: Audur
authors.initials: A
authors.lastname: Benediktsdottir
authors.affiliation: Unit for Nutrition Research, Landspitali National University Hospital & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
authors.forename: Thorhallur Ingi
authors.initials: TI
authors.lastname: Halldorsson
authors.affiliation: Reykjalundur Rehabilitation Center, Mosfellsbaer, Iceland.
authors.forename: Gudrun Jona
authors.initials: GJ
authors.lastname: Bragadottir
authors.affiliation: Reykjalundur Rehabilitation Center, Mosfellsbaer, Iceland.
authors.forename: Ludvig
authors.initials: L
authors.lastname: Gudmundsson
authors.affiliation: Unit for Nutrition Research, Landspitali National University Hospital & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland. Electronic address: alfonsra@hi.is.
authors.forename: Alfons
authors.initials: A
authors.lastname: Ramel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000523:psychology*; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D007055:Iceland; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D055105:Waist Circumference; D015431:Weight Loss; D061217:Weight Reduction Programs; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Attrition; Morbid obesity; Treatment choice