Psychological and sociodemographic predictors of premature discontinuation of a 1-year multimodal outpatient weight-reduction program: an attrition analysis
Open Access
- 1 March 2012
- journal article
- research article
- Published by Taylor & Francis Ltd in Patient Preference and Adherence
- Vol. 6, 165-177
- https://doi.org/10.2147/ppa.s28022
Abstract
Objective: Attrition rates of up to 77% have been reported in conservative weight-reduction programs for the treatment of obesity. In view of the cost of such programs to the health system, there is a need to identify the variables that predict premature discontinuation of treatment. Previous studies have focused mainly on somatic and sociodemographic parameters. The prospective influence of psychological factors has not been systematically investigated to date. Methods: A total of 164 patients (138 of whom were women) with a mean age of 45 years and a mean body mass index of 39.57 participated in a 1-year outpatient weight-reduction program at the Charité – Universitätsmedizin Berlin University Hospital. The program included movement therapy, dietary advice, psychoeducational and behavioral interventions, relaxation procedures, and consultations with a specialist in internal medicine and a psychologist. Patients also underwent regular laboratory and psychological testing. The results were evaluated using a t-test, χ2-test, and logistic regression analysis. Results: Seventy-one of the 164 patients (61 women, mean age = 43 years, mean body mass index = 39.53) withdrew before the end of the program (attrition rate = 43.3%). While there were no differences between the somatic and metabolic characteristics of those who withdrew and those who remained, the sociodemographic and psychological factors had some relevance. In particular, “expectation of self-efficacy” (Fragebogen zu Selbstwirksamkeit, Optimismus und Pessimismus [SWOP]), “not working,” “tiredness” (Berliner Stimmungsfragebogen [BSF]), “pessimism” (SWOP) and “positive reframing” (Brief-COPE) were found to play a role in whether participants subsequently dropped out of the treatment. “Support coping” (Brief-COPE) and “older age” prior to the start of treatment were identified as variables that promoted treatment adherence. Conclusion: The results are discussed in light of previous findings and with regard to whether the modules of the weight-reduction program should be adapted.Keywords
This publication has 31 references indexed in Scilit:
- National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participantsThe Lancet, 2011
- Faktorstruktur und psychometrische Eigenschaften des ICD-10–Symptom-Rating (ISR) an Stichproben psychosomatischer PatientenPPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie, 2009
- Weight Loss Treatment and Psychological Well-beingJournal of Health Psychology, 2007
- Complexity of attrition in the treatment of obesity: clues from a structured telephone interviewInternational Journal of Obesity, 2006
- Surgical treatment of obesityWiener Medizinische Wochenschrift, 2004
- One-year follow-up effects of two obesity treatments on psychological well-being and weightBritish Journal of Health Psychology, 2001
- Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)Jama-Journal Of The American Medical Association, 2001
- Die Sense of Coherence Scale von Antonovsky - Teststatistische Überprüfung in einer repräsenta-tiven Bevölkerungsstichprobe und Konstruktion einer Kurzskala -PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie, 2000
- Weight development, drop-out pattern and changes in obesity-related risk factors after two years treatment of obese menInternational Journal of Obesity, 1997
- Obesity Level and Attrition: Support for Patient‐Treatment Matching in Obesity TreatmentObesity Research, 1995