The early identification of poor treatment outcome in a women's weight loss program

Carels, Robert A.; Cacciapaglia, Holly; Douglass, Olivia M.; Rydin, Sofia; O’Brien, William H.

doi:10.1016/s1471-0153(03)00029-1

Cited by 65 publications

(57 citation statements)

References 40 publications

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“…In women,psychosocialvariablesshouldbefurtherexploredto findbetterpredictivemodels,whileinmenprospectivetrials should be undertaken to evaluate the proposed predictive model. Betterperceivedphysicalhealthwasapositivepredictorof %weightlossinwomenandcompletingVLEDtreatmentin men.Higherinitialratingsofphysicalhealthwerealsoassociatedwithlargerweightlossinastudyofwomenparticipating ina6-monthlifestyleinterventionprogram [35].Incontrast, perceived pre-treatment physical health was not associated withweightchangeafter16monthsinwomenparticipatingin a16-weekweightlossprogram [36].However,womeninthe latter study had a considerably lower mean BMI (31 kg/m 2 ) thanwomeninthepresentstudy(41kg/m 2 ).Thus,itispossiblethatbetterperceivedphysicalhealthpredictsweightloss in severely obese women with a high degree of illnesses but not in groups of overweight/moderately obese women. It is possiblethatseverelyobesepatientswhoperceivetheirphysicalhealthaspoorfinditmoredifficulttocopewiththelow energylevelandpotentialsideeffectsofVLEDandtherefore have a poorer outcome in our study.…”

Section: Predictors Of Attrition (Iii)mentioning

confidence: 82%

Predictors of Very-Low-Energy Diet Outcome in Obese Women and Men

et al. 2010

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Objective: The aim of this study was to explore baseline outcome predictors of a 12-week very-low-energy diet (VLED) treatment. Methods: Obese patients (177 women and 90 men) started treatment. Multivariate linear and logistic regressions were used to predict weight loss (%), successful outcome (≧ 10% weight loss) and attrition. Potential predictors were anthropometry, socioeconomic variables, established questionnaires on health-related quality of life, and eating behavior, and additional questions related to dieting. Results: Mean weight loss was 13.5% (standard deviation (SD) 5.6) in women and 15.1% (6.1) in men (p = 0.054). Greater weight loss in women was predicted by having more children, lower education, and better perceived physical health (R-square (R²) = 12.7%), and in men by better ambulation capacity, living with a partner/children, and snacking on ice-cream more often (R² = 39.4%). Successful outcome in women was predicted by less obesity-related psychosocial dysfunction, and in men by better functioning in social interaction and ambulation capacity. Attrition was predicted by lower age and larger hip circumference in women, and in men by lower perceived general health. Two-week weight loss was independently associated with all outcomes except attrition in women. Conclusion: Factors related to perceived physical health, social interaction, socio-economic factors, and obesity-related psychosocial problems predicted VLED outcome. The predictors differed by gender.

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Section: Predictors Of Attrition (Iii)mentioning

confidence: 82%

Predictors of Very-Low-Energy Diet Outcome in Obese Women and Men

et al. 2010

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“…For example, obese women in a 6-month weight reduction program who dropped out of the program (16%) experienced a 2% weight gain, on average, prior to dropping out. 23 An additional 14% of women failed to lose at least 1% of body weight by the sixth week of the intervention, and these women lost, on average, < 2% of their weight by program completion. Thus, unsatisfactory early weight loss was an early indicator of unfavorable treatment outcome and program attrition.…”

Section: Discussionmentioning

confidence: 98%

Early Weight-Loss Success Identifies Nonresponders after a Lifestyle Intervention in a Worksite Diabetes Prevention Trial

Miller¹,

Nagaraja²,

Weinhold³

2015

Journal of the Academy of Nutrition and Dietetics

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Background People with prediabetes are at increased risk for developing type 2 diabetes. Weight reduction through lifestyle modification can significantly reduce diabetes risk. Yet, weight loss varies among individuals and some people do not achieve clinically meaningful weight loss following treatment. Objective Evaluate the timepoint and threshold for achieving ≥ 5% weight loss following completion of a 16-week worksite, lifestyle intervention for diabetes prevention. Design Weight change before and after the behavioral intervention among participants randomized to the experimental group was examined. Participants/setting Individuals with prediabetes aged 18–65 years with a body mass index of 25–50 kg/m2 at Ohio State University were eligible. Intervention The 16-week, group-based intervention, adapted from the Diabetes Prevention Program, was delivered to 32 participants in the experimental group. Main outcome measures Percent weight loss was assessed weekly during the intervention and at 4- and 7-month follow-up. Statistical analyses performed Linear regression modeled the relationship between percent weight loss during month 1 of the intervention and percent weight loss at 4 and 7 months. Logistic regression modeled failure to lose ≥ 5% weight loss at 4 and 7 months using weekly weight change during the first month of intervention. Results Percent weight loss at intervention week 5 was significantly associated with percent weight loss at 4 and 7 months (all P<0.001). Only 11.1% and 12.5% of participants who failed to achieve a 2.5% weight loss threshold during month 1 achieved ≥ 5% weight loss at months 4 and 7, respectively. Conclusions The first month of lifestyle treatment is a critical period for helping participants achieve weight loss. Otherwise, individuals who fail to achieve at least 2.5% weight loss may benefit from more intensive rescue efforts or stepped care interventions. Trial Registration ClinicalTrials.gov identifier: NCT01682954

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“…Individuals who drop-out of treatment tend to have poorer outcomes than those who complete treatment [9] including poorer weight loss [2,[29][30][31][32] and poorer weight-loss maintenance [4]. Early termination often means the necessary skills and strategies required for weight loss and maintenance are not developed [21,33].…”

Section: The Impact Of Attritionmentioning

confidence: 99%

“…One of the few studies to do this reported that the participants lost to attrition were doing poorly during the treatment program, prior to discontinuation, and had experienced a 2% weight gain prior to quitting [32]. This information is important as it could be that doing poorly leads to drop-out, rather than drop-out resulting in poorer outcomes as is typically assumed.…”

Section: The Impact Of Attritionmentioning

confidence: 99%