Behavioral predictors of attrition in adolescents participating in a multidisciplinary obesity treatment program: EVASYON study

Abstract

The aims of this study were to identify the cognitive and behavioral predictors of dropping out and to estimate the attrition rate during different phases of an intervention program to treat overweight and obesity in adolescents. Overweight/obese adolescents (n=156, aged: 13-16 years; 71 male and 85 female subjects) were included in a multicomponent (diet, physical activity and psychological support) family-based group treatment program. At baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up, we measured adolescents' cognitive and behavioral dimensions, together with the parents' perception of their child's behavior. Of the 156 adolescents selected, 112 completed the full program (drop-out rate of 28.2%). The risk of dropping out during the extensive phase increased by 20% for each unit increase in the adolescent's social insecurity score (odds ratio=1.20, 95% confidence interval=1.07-1.34, P=0.002). The adolescents who had a high interoceptive awareness showed a significant decrease of 13.0% in the probability of dropping out (odds ratio=0.87, 95% confidence interval=0.77-0.99, P=0.040). Adolescents' social insecurity was the main predictor of drop-out in a multicomponent family-group-based obesity treatment program. To reduce attrition rates in these programs, the individual's social insecurity level needs to be reduced, whereas the family's awareness of eating-related behavior needs adjustment.

The Fit Family Challenge: A Primary Care Childhood Obesity Pilot Intervention

“…Our findings corroborate with those of 2 other studies that found food insecurity increased the odds of childhood obesity in young Hispanic children 36 and another study that found the risk of dropping out of a multidisciplinary obesity treatment program increased by 20% for each unit increase in the adolescent's social insecurity score. 37 High attrition rates are seen in both adult and pediatric weight management programs, 38,39 and our completion rates align with those in the literature.…”

Treatment of obesity, with a dietary component, and eating disorder risk in children and adolescents: A systematic review with meta‐analysis

“…The change in bulimic symptoms was measured using six different assessment tools reported in eight studies at post‐intervention only, two studies at follow‐up only, and one study at both timepoints. Eight studies reported a significant reduction in bulimic symptoms, and three studies reported no change post‐intervention. Meta‐analysis of the intervention arm from eight studies, with a combined sample of 375 participants, found a reduction in bulimic symptoms post‐intervention (Figure A; −0.33 [0.09], P < 0.001, I 2 72%).…”

“…Eight studies reported a significant reduction in bulimic symptoms, and three studies reported no change post‐intervention. Meta‐analysis of the intervention arm from eight studies, with a combined sample of 375 participants, found a reduction in bulimic symptoms post‐intervention (Figure A; −0.33 [0.09], P < 0.001, I 2 72%). This change was no longer statistically significant at follow‐up of up to 6 years from baseline (Figure B; −0.25 [0.24], P = 0.30, I 2 94%), as reported in three studies .…”

Pediatric obesity treatment, self‐esteem, and body image: A systematic review with meta‐analysis

“…Three studies did not report on personnel involved in intervention delivery. Parental involvement was reported as part of the intervention in 50 studies …”

“…The change in body image between pre‐intervention and postintervention was reported in 27 studies, between pre‐intervention and follow‐up in three studies, and 13 studies reported data at all three time points. Of the 40 studies reporting body image pre‐intervention and postintervention ranging in duration from 2 weeks to 24 months, body image was reported to be significantly improved compared with baseline in 22 studies, not significantly changed in 10 studies, five studies did not state whether or not the change was significant and three studies reported a significant improvement in one body image measure and no change in another.…”