Socio-demographic, anthropometric, and psychosocial predictors of attrition across behavioral weight-loss trials

Eat Behav. 2016 Jan;20:27-33. doi: 10.1016/j.eatbeh.2015.11.009. Epub 2015 Nov 14.

Abstract

Preventing attrition is a major concern in behavioral weight loss intervention studies. The purpose of this analysis was to identify baseline and six-month predictors associated with participant attrition across three independent clinical trials of behavioral weight loss interventions (PREFER, SELF, and SMART) that were conducted over 10 years. Baseline measures included body mass index, Barriers to Healthy Eating, Beck Depression Inventory-II (BDI), Hunger Satiety Scale (HSS), Binge Eating Scale (BES), Medical Outcome Study Short Form (MOS SF-36 v2) and Weight Efficacy Lifestyle Questionnaire (WEL). We also examined early weight loss and attendance at group sessions during the first 6 months. Attrition was recorded at the end of the trials. Participants included 504 overweight and obese adults seeking weight loss treatment. The sample was 84.92% female and 73.61% white, with a mean (± SD) age of 47.35 ± 9.75 years. After controlling for the specific trial, for every one unit increase in BMI, the odds of attrition increased by 11%. For every year increase in education, the odds of attrition decreased by 10%. Additional predictors of attrition included previous attempts to lose 50-79 lbs, age, not possessing health insurance, and BES, BDI, and HSS scores. At 6 months, the odds of attrition increased by 10% with reduced group session attendance. There was also an interaction between percent weight change and trial (p<.001). Multivariate analysis of the three trials showed education, age, BMI, and BES scores were independently associated with attrition (ps ≤ .01). These findings may inform the development of more robust strategies for reducing attrition.

Trial registration: ClinicalTrials.gov NCT00277771 NCT00330629 NCT00896194.

Keywords: Attrition; Binge eating; Weight loss.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Behavior Therapy*
  • Binge-Eating Disorder / diagnosis
  • Body Mass Index
  • Educational Status
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity / psychology
  • Obesity / therapy*
  • Overweight / psychology
  • Overweight / therapy*
  • Patient Dropouts / statistics & numerical data*
  • Psychiatric Status Rating Scales
  • Surveys and Questionnaires
  • Weight Loss*

Associated data

  • ClinicalTrials.gov/NCT00277771
  • ClinicalTrials.gov/NCT00330629
  • ClinicalTrials.gov/NCT00896194