Abstract
OBJECTIVE:
To investigate the impact on drop-out rates of several baseline clinical characteristics of a sample of overweight and obese outpatients.
DESIGN:
Retrospective clinical trial.
SUBJECTS:
The charts of 383 patients aged 15–82 y attending an outpatient clinic for the treatment of obesity were examined from the first clinical evaluation until 1 y of diet ambulatory treatment.
MEASUREMENTS:
We characterised the participants at baseline on the basis of their somatic characteristics, socioeconomic status, obesity-related diseases and dietary habits. The most significant factors resulting in univariate statistical analysis (waist, body mass index (BMI), full-time job, depressive syndrome, number of obesity-related diseases, daily frequency of fruit consumption) were then examined as independent variables in direct multiple logistic regression with the dependent variable drop-out.
RESULTS:
The 1-y drop-out rate was 77.3%. A total of 87 patients completed the follow-up study. The noncompleter patients had slightly lower BMI and waist circumference mean values, and they were further regularly employed in full-time jobs, while the completer patients were principally pensioners and housewives. Drop-outs had a lower number of obesity-related diseases and as a result were less depressed. By the logistic regression, full-time job is the best predictor of premature withdrawal (odds ratio=2.40). Age, gender, anthropometric measurements, lifestyle and dietary habits did not result as significant predictors of drop-out.
CONCLUSION:
The overweight and obese outpatients at higher risk of ambulatory treatment drop-out are more likely to work full hours, have less obesity-related complications and be less depressed. In our study, the full-time job condition seems to be the strongest predictor of premature withdrawal.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
WHO. Obesity: Preventing and Managing the Global Epidemic. World Health Organization: Geneva; 2000.
Melin I, Karlström B, Lappalainen R, Berglund L, Mohsen R, Vessby B . A programme of behaviour modification and nutrition counselling in the treatment of obesity: a randomised 2-y clinical trial. Int J Obes Relat Metab Disord 2003; 27: 1127–1135.
Faith M, Fontaine K, Cheskin L, Allison D . behavioural approaches to the problems of obesity. Behav Modif 2000; 24: 459–493.
Freeman A, Pretzer J, Fleming B, Simon KM . Comprehensive Handbook of Cognitive Therapy. Plenum Press: New York; 1990.
Richman R, Burns CM, Steinbeck K, Caterson L . Factors influencing completion and attrition in a weight control programme. In: Ailhaud G, Guy-Grand B, Lafontan M, Ricquier D (eds) Obesity in Europe 91. John Libbey: London; 1992. pp 167–171.
Lanz H, Peltonen M, Ågren L, Torgerson JS . A dietary and behavioural programme for the treatment of obesity. A 4-year clinical trial and a long-term post-treatment follow-up. J Int Med 2003; 254: 272–279.
Mattfeldt-Beman MK, Corrigan SA, Stevens VJ, Sugars CP, Dalcin AT, Givi MJ, Copeland KC . Participants' evaluation of a weight-loss program. J Am Diet Assoc 1999; 99: 66–71.
Perri MG, Sears SF, Clark JE . Strategies for improving maintenance of weight loss. Diabetes Care 1993; 16: 200–209.
Wadden TA, Foster GD, Wang J, Pierson RN, Yang MU, Moreland K, Stunkard AJ, VanItallie TB . Clinical correlation of short-term and long-term weight loss. Am J Clin Nutr 1992; 56: 271–274.
Ayyad C, Andersen T . Long-term efficacy of dietary treatment of obesity: a systematic review of studies published between 1931 and 1999. Obes Rev 2000; 1: 113–119.
Ohno M, Arai K, Tsukahara S, Miura J, Yokoyama J, Ikeda Y . Long-term effectiveness of combined therapy by behaviour modification and VLCD. A three-year follow-up. In: Oomura Y, Tarui S, Inoue S, Shimazu T (eds) Progress in Obesity Research. John Libbey and Company Ltd: London; 1991. pp 523–529.
Björvell H, Rössner S . long-term treatment of severe obesity: four year follow-up of results of combined behavioural modification programme. BMJ 1985; 291: 379–382.
Andersson I, Rössner S . Weight development, drop-out pattern and changes in obesity-related risk factors after two years treatment of obese men. Int J Obes Relat Metab Disord 1997; 21: 211–216.
Torgerson JS, Ågren L, Sjöström L . Effects on body weight of strict or liberal adherence to an initial period of VLCD treatment. A randomised, one-year clinical trial of obese subjects. Int J Obes Relat Metab Disord 1999; 23: 190–197.
Wadden TA, Letizia KA . Predictors of attrition and weight loss in patients treated by moderate and severe caloric restriction. In: Wadden TA, VanItallie TB (eds) Treatment of the Seriously Obese Patient. The Guilford Press: New York, London; 1992. pp 383–410.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edn. APA Press: Washington, DC; 1994.
Benn RT . Some mathematical properties of weight for height indices used as a measure of adiposity. Br J Prev Med 1971; 25: 42–50.
LiGIO'99. Linee Guida Italiane Obesità, © Task Force Obesità Italia (TFOI). Edn. Pendragon Perss: Bologna; 1999.
Togo P, Osler M, Sørensen TIA, Heitmann BL . Food intake patterns and body mass-index in observational studies. Int J Obes Relat Metab Disord 2001; 25: 1741–1751.
Cameron ME, Van Staveren WA . Manual on Methodology for Food Consumption Studies. Oxford University Press: Oxford; 1988. p 259.
Nes M, Van Staveren WA, Zajkas G, Inelmen EM, Moreiras-Varela O . Euronut Seneca study on nutrition and the elderly. Validity of the dietary history method in the elderly subjects. Eur J Clin Nutr 1991; 45 (Suppl 3): 97–104.
Gatto MRA, Inelmen EM, Ferrari S, Jimenez FG, Bisbini PL, Enzi G . Nutrients intake in elderly: descriptive results of a cross-sectional study. Age Nutr 1995; 6: 16–24.
Stunkard AJ . An overview of current treatments for obesity. In: Wadden TA, VanItallie TB (eds) Treatment of the Seriously Obese Patient. The Guilford Press: New York, London; 1992. pp 38–43.
Hansen D, Astrup A, Toubro S, Finer N, Kopelman P, Hilsted J, Rössner S, Saris W, van Gall L, James W . Predictors of weight loss and maintenance during 2 years of treatment by sibutramine in obesity. Results from the European multi-centre STORM trail. Int J Obes Relat Metab Disord 2001; 25: 496–501.
Enzi G, Inelmen EM . Obesità e società. In: Enzi G (eds). Obesità: fisiopatologia, clinica, terapia. Masson: Milan; 1997. pp 1–17.
Clark MM, Guise BJ, Niaura RS . Obesity level and attrition: support for patient-treatment matching in obesity treatment. Obes Res 1995; 3: 63–64.
Han TS, van Leer EM, Seidell JC, Lean MEJ . Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 1995; 311: 1401–1405.
Lean MEJ, Han TS, Morrison CE . Waist circumference as a measure for indicating need for weight management. BMJ 1995; 311: 158–161.
Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ . Waist circumference and abdominal sagittal diameter: best simple anthropometrics indexes of visceral adipose tissue accumulation and related cardiovascular risk in men and in women. Am J Cardiol 1994; 73: 460–468.
Enzi G, Pavan M, Digito M, Baldo Enzi G, Alfieri P, Zurlo F, Carraro R . Clustering of metabolic abnormalities and other risk factors for cardiovascular disease in visceral obesity. Diabetes Nutr Metab 1993; 6: 47–55.
Blair D, Habricht JP, Sinus EAH, Sylvester D, Abraham S . Evidence for an increased risk for hypertension with centrally located body fat and the effect of race and sex in this risk. Am J Epidemiol 1984; 119: 526–540.
Fujioka S, Matsuzawa Y, Tokunaga K, Tarui S . Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. Metabolism 1987; 36: 54–59.
Liu S, Manson JE, Lee I, Cole SR, Hennekens CH, Willet WC, Buring JE . Fruit and vegetable intake and risk of cardiovascular disease: the Women's Health Study. Am J Clin Nutr 2000; 72: 922–928.
Lasheras C, Fernandez S, Patterson AM . Mediterranean diet and age with respect to overall survival in institutionalised, non-smoking elderly people. Am J Clin Nutr 2000; 71: 987–992.
Yanovski SZ, Nelson JE, Dubbert BK, Spitzer RL . Association of binge eating disorder and psychiatric co-morbidity in obese subjects. Am J Psychiatry 1993; 50: 1472–1479.
Antony MM, Johnson WG, Carr-Nangle RE, Abel JL . Psychopathology correlates of binge eating and binge eating disorder. Compr Psychiatry 1994; 35: 386–392.
Yanovski SZ, Gormally JF, Leser MS, Gwirtsman HE, Yanovski JA . Binge eating disorder affects outcome of comprehensive very-low calorie diet treatment. Obes Res 1994; 2: 205–212.
Marcus MD, Wing RR, Hopkins J . Obese binge eaters: affect, cognitions, and response to behavioural weight control. J Consult Clin Psychol 1988; 56: 400–405.
Sherwood NE, Jeffery RW, Wing RR . Binge status as a predictors of weight loss treatment outcome. Int J Obes Relat Metab Disord 1999; 23: 485–493.
McManus K, Antinoro L, Sacks F . A randomised control trial of a moderate-fat low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Int J Obes Relat Metab Disord 2001; 25: 1503–1511.
Jackson M, Ball K, Crawford D . Beliefs about the causes of weight change in the Australian population. Int J Obes Relat Metab Disord 2001; 25: 1512–1516.
Bradley PJ . Conditions recalled to have been associated with weight gain in adulthood. Appetite 1985; 6: 231–237.
Foreyt JP, Goodrick GK . Factors common to successful therapy for the obese patient. Med Sci Sports Exerc 1991; 23: 292–297.
O'Neil PM, Currey HS, Hirsch AA, Riddle EE, Taylor CI, Malcom RJ, Sexauer JD . Effects of sex of subjects and spouse involvement on weight loss in a behavioural treatment program: a retrospective investigation. Addict Behav 1979; 4: 167–177.
National Research council. Diet and Health: Implications for Reducing Chronic Disease Risk. National Academy Press: Washington, DC; 1989.
Willet WC . Diet and health: what should we eat? Science 1994; 264: 532–537.
Willet WC, Sacks F, Trichopoulos A, Drescher G, Ferro-Luzzi A, Helsing E, Trichopoulos D . Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 1995; 61 (Suppl): 1402S–1406S.
Whichelow MJ, Preevost AT . Dietary patterns and their associations with demographic, lifestyle and health variables in a random sample of British adults. BR J Nutr 1996; 76: 17–30.
Appel LJ, Moore TJ, Obarzanek E . A clinical trial of the effects of dietary habits patterns on blood pressure. N Engl J Med 1997; 336: 1117–1124.
Steinmetz KA, Potter JD . Vegetables, fruit and cancer. Epidemiology. Cancer Causes Control 1991; 2: 325–357.
World Cancer Research Fund and American Institute for Cancer Research. Food, Nutrition and the Prevention of Cancer: A Global Perspective. American Institute for Cancer Research: Washington, DC; 1997.
Tavani A, La Vecchia C . Fruit and vegetables consumption and cancer risk in a Mediterranean population. Am J Clin Nutr 1995; 61 (Suppl): 1374S–1377S.
Klatsky AL, Armstrong MA, Kipp H . Correlates of alcoholic beverage preference: traits of persons who choose wine, liquor or beer. Br J Addict 1990; 85: 1279–1289.
Tjønneland A, Grønbæk M, Stripp C, Overvad K . Wine intake and diet in a random sample of 48.763 Danish men and women. Am J Clin Nutr 1999; 69: 49–54.
Prentice AM, Black AE, Coward WA, Davies HL, Goldberg GK, Murgatroyd PR . High levels of energy expenditure in obese women. BMJ 1986; 292: 983–987.
Lissner L . New approaches to assessing diets of diverse populations. Measuring food intake in studies of obesity. Public Health Nutr 2002; 5: 889–892.
Kant AK, Schatzkin A, Graubard BI, Schairer C . A prospective study of diet quality and mortality in women. JAMA 2000; 283: 2109–2115.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Inelmen, E., Toffanello, E., Enzi, G. et al. Predictors of drop-out in overweight and obese outpatients. Int J Obes 29, 122–128 (2005). https://doi.org/10.1038/sj.ijo.0802846
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0802846
Keywords
This article is cited by
-
Bilateral Subdiaphragmatic Vagal Nerve Stimulation Using a Novel Waveform Decreases Body Weight, Food Consumption, Adiposity, and Activity in Obesity-Prone Rats
Obesity Surgery (2024)
-
The effects of eating frequency on changes in body composition and cardiometabolic health in adults: a systematic review with meta-analysis of randomized trials
International Journal of Behavioral Nutrition and Physical Activity (2023)
-
Effectiveness of the promoting adequate and healthy eating (PAAS) program in primary care: community randomized controlled trial
Journal of Public Health (2023)
-
Circulating Anti-Müllerian hormone in a cohort-study of women with severe obesity with and without polycystic ovary syndrome and the effect of a one-year weight loss intervention
Reproductive Biology and Endocrinology (2022)
-
Both high fat and high carbohydrate diets impair vagus nerve signaling of satiety
Scientific Reports (2021)