Background: The aim of this study is in a general practice trial setting to identify predictive factors for weight loss after 1 year among young adults who are over-weight or obese and who have several psychosocial problems.
Methods: Twenty-eight general practitioners recruited 495 patients aged 20-45 years with psychosocial problems for a randomized general preventive study to increase self-efficacy to achieve a self-prioritised goal for a better life by discussions of resources and barriers for reaching the goal. The present study is a post hoc analysis of possible predictors of weight loss among all 218 patients who have over-weight or obesity. A 23-pages questionnaire was completed before and 1 year after randomization. 111 patients had a one-hour preventive health consultation with their general practitioners focused on life coaching and a follow-up consultation within 3 months, and 107 patients had no preventive consultation.
Results: Twenty-two patients stated during the preventive consultation that weight loss was a prioritised goal. They had a mean weight loss of 4.7 kgs compared with 1.6 kgs in the group without this goal and 1.6 kgs in the group without preventive consultation. In a logistic regression model, predictors of weight loss or no weight loss were a) pre-interventional consideration of weight loss within 30 days, b) having weight loss as a prioritised goal for improved quality of life, c) being female, d) being in the oldest half of participants, and e) having many psychosocial problems. In a linear regression model, the predictors together explained about 11% of the weight loss. Important predictors were: obesity (explained 4%), pre-interventional consideration of weight loss within 30 days (3%), and having a preventive health consultation with weight loss as a prioritised goal (2%).
Conclusions: Pre-interventional consideration of weight loss within 30 days and having weight loss as a prioritised goal during the health consultation were two important predictors for weight loss. By structured interventions focussing on the patients' priorities, self-chosen goals, their resources and barriers for reaching the goals, changes may be obtained; especially in participants with many problems who often do not accept participation in procedures on risks.
Clinicaltrials gov registration: NCT 01231256 , Aug. 22. 2010.
Trial registration: ClinicalTrials.gov NCT01231256.
Keywords: General practitioners; Life coaching; Motivation; Over-weight; Patient-centred; Psychosocial problems; Specific self-efficacy; Weight loss.