Predictors of dropout in weight loss interventions: a systematic review of the literature

Abstract

Attendance and completion of weight loss intervention is associated with better weight loss outcomes; however, attrition is neither consistently reported nor comprehensively explored in the weight loss literature. A systematic review was undertaken to identify factors associated with attrition in weight loss interventions involving overweight or obese (body mass index ≥ 25) adults (18-65 years). Sixty-one studies published before May 2011 and addressing factors associated with weight loss programme attrition were identified. Conclusions were limited by the large number of variables explored, the small number of studies exploring each variable, the large variety of study settings and methodologies used, the inconsistent reporting of results, and the conflicting findings across studies. A consistent set of predictors has not yet been identified. The majority of studies relied on pre-treatment routinely collected data rather than variables selected because of their theoretical and/or empirical relationship with attrition. However, psychological and behavioural patient factors and processes associated with the treatment were more commonly associated with attrition than patient background characteristics. Future research should consider theoretically grounded social-psychological and behavioural processes as potential predictors of dropout. Identification of patients at risk of dropout will contribute to both the effectiveness and the cost-effectiveness of weight loss interventions.

Should weight loss and maintenance programmes be designed differently for men? A systematic review of long-term randomised controlled trials presenting data for men and women: The ROMEO project

“…Moroshko and colleagues did not find that being male or female was a significant influence on dropping out of weight loss interventions [5]. However, they did not use meta-analysis of sex-specific data from within randomised trials.…”

“…There was also a trend towards lower participation by men in group-based interventions (24%), compared with individual counselling (29%) or mail/e-mail/internet (34%); however, the male/female mix of the group-based interventions was not specified. In another systematic review [5], sex was not a predictor of dropout in weight loss interventions, suggesting that where men are included in intervention studies, they are no more or less likely than women to withdraw.…”

Patient factors associated with initiation of behavioral weight loss treatment: a prospective observational study in an integrated care setting

“…Although this expanded access offers substantial promise for increasing the reach of behavioral weight loss treatment, the potential of these programs to achieve population-level weight loss is diminished by the limited initial enrollment and high attrition that are observed in many weight loss treatments. Attrition from weight loss treatments has been the focus of considerable research attention [7], whereas less attention has been given to the first step in utilization: initiating treatment. Many patients with obesity are not seeking weight loss, and many of those who are trying to lose weight are not initiating empirically supported treatments in the first place [8,9].…”

Results from the dissemination of an evidence-based telephone-delivered intervention for healthy lifestyle and weight loss: the Optimal Health Program

“…This was the case in the current study, where OHP participant follow-up protocols were much less stringent than in the precursor trial. A recent review of attrition in weight loss trials showed that there were no consistent demographic, weight, or heath behavior profiles that were associated with program dropout [70]. In the OHP, those who completed the program vs. those who dropped out were largely similar, except that younger and heavier participants were more likely to withdraw.…”