Binge eating disorder, retention, and dropout in an adult obesity program

Ks, Ho; Nichaman, Milton Z.; Taylor, Wendell C.; Lee, Eun Sul; Foreyt, John P.

doi:10.1002/1098-108x(199511)18:3<291::aid-eat2260180312>3.0.co;2-y

Cited by 35 publications

(22 citation statements)

References 11 publications

(5 reference statements)

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“…For example, attrition was positively [36][37][38] and negatively 39 associated with the number of previous diet attempts, positively 40 and negatively 41 associated with binge eating, and positively 42 and not associated 43,44 with initial weight/ BMI level. Having higher initial weight loss expectations 36,38 and reporting higher emotional disturbance 39 also predicted noncompliance.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment predictors of attrition and successful weight management in women

et al. 2004

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OBJECTIVE: This study analyzed baseline behavioral and psychosocial differences between successful and nonsuccessful participants in a behavioral weight management program. Success was defined by commonly used health-related criteria (5% weight loss). Noncompletion was also used as a marker of a failed attempt at weight control. SUBJECTS: A total of 158 healthy overweight and obese women (age, 48.074.5 y; BMI, 31.073.8 kg/m 2 ; body fat, 44.575.3%). INTERVENTION: Subjects participated in a 16-week lifestyle weight loss program consisting of group-based behavior therapy to improve diet and increase physical activity, and were followed for 1 y after treatment. METHODS: At baseline, all women completed a comprehensive behavioral and psychosocial battery assessing dieting/weight history, dietary intake and eating behaviors, exercise, self-efficacy, outcome evaluations, body image, and other variables considered relevant for weight management. Participants who maintained a weight loss of 5% or more at 16 months (or 10% or more of initial fat mass) were classified as successful. Nonsuccessful participants were those who dropped out and completers who had not lost weight at follow-up. RESULTS: Of all participants, 30% (n ¼ 47) did not complete initial treatment and/or missed follow-up assessments (noncompleters). Noncompletion was independently associated with more previous weight loss attempts, poorer quality of life, more stringent weight outcome evaluations, and lower reported carbohydrate intake at baseline. In logistic regression, completion status was predicted correctly in 84% of all cases (w 2 ¼ 45.5, Po0.001), using baseline information only. Additional predictors of attrition were initial weight, exercise minutes, fiber intake, binge eating, psychological health, and body image. A large variation in weight loss/maintenance results was observed (range: 37.2 kg for 16-month weight change). Independent baseline predictors of success at 16 months were more moderate weight outcome evaluations, lower level of previous dieting, higher exercise self-efficacy, and smaller waist-to-hip ratio. Success status at follow-up was predicted correctly in 74% of all starting cases (w 2 ¼ 33.6, Po0.001). CONCLUSION: Psychosocial and behavioral variables (eg, dieting history, dietary intake, outcome evaluations, exercise selfefficacy, and quality of life) may be useful as pretreatment predictors of success level and/or attrition in previously overweight and mildly obese women who volunteer for behavioral weight control programs. These factors can be used in developing readiness profiles for weight management, a potentially important tool to address the issue of low success/completion rates in the current management of obesity.

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Section: Discussionmentioning

confidence: 99%

Pretreatment predictors of attrition and successful weight management in women

et al. 2004

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“…Two studies even suggest that binge eaters perform more adequately in these programs. Thus, Ho et al 77 reported that binge eaters dropped out of a large treatment program for obesity only half as often as non-bingers. Gladis et al 78 assessed a behavioral weight loss treatment that included no special provision for binge eating.…”

Section: Treatment Of Binge Eating Disordermentioning

confidence: 99%

Two forms of disordered eating in obesity: binge eating and night eating

2003

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OBJECTIVE: Binge eating disorder (BED) and the night eating syndrome (NES) have been linked to obesity. This review summarizes their characteristics, implications of their diagnoses and treatment outcomes. METHOD: Selective review of the literature on BED and NES. RESULTS: BED was proposed as a distinctive disorder on the basis of two large multisite studies in the early 1990s. It is associated with more severe and earlier onset of obesity, earlier onset of dieting and greater psychopathology. It shows large placebo responses and reduction of bingeing in patients on waiting-list controls. Traditional weight reduction programs reduce bingeing at least as well as psychological treatments designed for this purpose. NES is a stress-related eating, sleeping and mood disorder that is associated with disordered neuroendocrine function. It follows a characteristic circadian pattern and has responded to an agent that enhances serotonin function. CONCLUSIONS: BED responds well to weight reduction programs. It is proposed that this diagnosis be used as a marker for psychological problems that deserve treatment in their own right. NES is an eating, sleep, and mood disorder with distinctive behavioral and neuroendocrine characteristics. Studies of treatment for NES are in their infancy but selective serotonin reuptake inhibitors (SSRI) show promise.

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“…In a 1992 review, Wadden and Letizia 4 concluded that binge eating, significant life stress (including financial problems) and small weight loss in the early phase of treatment were the most important predictors of attrition, but subsequent studies were conflicting. Attrition was negatively associated with binge eating, 5 was both positively 6 and negatively 7 associated with depression, was negatively associated with previous dieting, 8 was positively associated with emotional disturbance, 8 full-time job 7 and recently with greater weight loss expectations. 3,9 Very few studies are available on the reason for attrition as reported by obese patients during structured interviews after dropout.…”

Section: Introductionmentioning

confidence: 97%

Complexity of attrition in the treatment of obesity: clues from a structured telephone interview

et al. 2006

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Objectives: To investigate the causes of attrition reported by obese patients treated by medical centres. Design: Observational study. Setting: Obese patients enrolled in a long-term study involving 18 Italian medical centres. Participants: A total of 940 obese patients (727 female; mean age, 49 years; mean BMI, 38.6 kg/m 2 ). Measurements: Causes of attrition reported by dropouts during a structured telephone interview. Results: After a median observation period of 41 months (range, 25-50), 766 of 940 patients (81.5%) discontinued treatment. Sixty-two per cent of total dropout occurred in the first year of follow-up. Seventy-four per cent of dropouts reported a single primary reasons for treatment interruption. Two primary reasons were reported by 22.4% of patients, and three reasons by 3.4%. Practical difficulties, alone or in combination, were reported by more than half of dropouts (55%), and were the leading cause of attrition followed by perceived failure of treatment. Among practical difficulties, family problems or problems at work and logistics, coupled with health problems other than obesity, were the most frequent reasons of attrition, but also a perceived sense of abandonment or a bad interaction with therapists were frequently reported. Conclusion: Practical difficulties and psychological problems are the most important reasons of attrition reported by patients. A therapeutic alliance addressing these issues has a large potential to reduce treatment interruption and to improve outcome in obesity.

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Binge eating disorder, retention, and dropout in an adult obesity program

Cited by 35 publications

References 11 publications

Pretreatment predictors of attrition and successful weight management in women

Pretreatment predictors of attrition and successful weight management in women

Two forms of disordered eating in obesity: binge eating and night eating

Complexity of attrition in the treatment of obesity: clues from a structured telephone interview

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