Predictors of attrition and weight loss success: Results from a randomized controlled trial - PubMed (original) (raw)

Randomized Controlled Trial

Predictors of attrition and weight loss success: Results from a randomized controlled trial

Anthony N Fabricatore et al. Behav Res Ther. 2009 Aug.

Abstract

Attrition is a common problem in weight loss trials. The present analysis examined several baseline and early-treatment process variables, as predictors of attrition and outcome in a clinical trial that combined pharmacotherapy and behavior therapy for weight loss. Participants were 224 obese adults who were treated with sibutramine alone, lifestyle modification alone, combined therapy, or sibutramine plus brief lifestyle modification. Predictors included baseline characteristics (e.g., demographic, weight-related, psychological, and consumption-related variables), plus attendance, adherence, and weight loss in the early weeks of treatment. Outcomes were attrition and weight loss success (i.e., >or=5% reduction in body weight) at 1 year. Multivariable models, adjusting for other relevant variables, found that younger age and greater baseline depressive symptoms were related to increased odds of attrition (ps <or= 0.003). Greater early weight loss marginally reduced the odds of attrition (p = 0.06). Predictors of weight loss success at 1 year were Caucasian ethnicity (p = 0.04), lower baseline depressive symptoms (p = 0.04), and weight loss during the first 3 weeks of treatment (p < 0.001). Thus, depressive symptoms at baseline were a significant predictor of both attrition and weight loss success. As a process variable, early weight loss appears to have more predictive value than early attendance at treatment sessions or early adherence.

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Conflict of interest statement

Disclosure: This analysis was funded in part by a research grant from Merck & Co., Inc. to Dr. Fabricatore. Additional support came from NIH grants K23 DK070777 to Dr. Fabricatore, and R01 DK56124 and K24 DK065018 to Dr. Wadden. Fabricatore has served as a consultant to Pfizer and Merck & Co., Inc, and has received research support from Merck & Co., Inc. Wadden has received research support from Merck & Co., Inc and from Abbott Laboratories. (The latter company manufactures sibutramine and provided the medication used in this study.) Heymsfield and Nguyen are employed by Merck & Co., Inc. The other authors have no potential conflicts to declare.

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