title: Factors associated with participant retention in a clinical, intensive, behavioral weight management program.
abstract: BACKGROUND
  We sought to identify factors associated with participant retention in a 2-year, physician-lead, multidisciplinary, clinical weight management program that employs meal replacements to produce weight loss and intensive behavioral interventions and financial incentives for weight loss maintenance. We studied 270 participants enrolled in 2010 and 2011. Sociodemographic factors, health insurance, distance traveled, body mass index, comorbidities, health-related quality-of-life, and depression were explored as potential predictors of retention.
  
  
  RESULTS
  Mean age was 49 ± 8 years and BMI was 41 ± 5 kg/m(2). Retention was excellent at 3 months (90%) and 6 months (83%). Attrition was greatest after participants were transitioned to regular foodstuffs and fell to 67% at 12 months and 51% at 2 years. Weight decreased by 15 ± 12 kg and BMI decreased by 5.1 ± 4.0 kg/m(2) in 2-year completers. Older age, lower baseline BMI, and financial incentives for program participation were independently associated with retention. Fewer depressive symptoms at baseline were associated with retention.
  
  
  CONCLUSIONS
  This multidisciplinary, clinical, weight management program demonstrated high retention and excellent outcomes. Older age at baseline, less extreme obesity, and financial incentives were associated with program retention.
authors.affiliation: Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Rothberg
authors.affiliation: Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA.
authors.forename: Laura N
authors.initials: LN
authors.lastname: McEwen
authors.affiliation: Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Kraftson
authors.affiliation: Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA.
authors.forename: Nevin
authors.initials: N
authors.lastname: Ajluni
authors.affiliation: Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Fowler
authors.affiliation: Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Miller
authors.affiliation: Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA.
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Zurales
authors.affiliation: Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA ; Department of Epidemiology, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105 USA.
authors.forename: William H
authors.initials: WH
authors.lastname: Herman
keywords: Depression; Financial incentives; Obesity; Very low calorie diet; Weight loss; Weight loss maintenance