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JKM > Volume 37(3); 2016 > Article
Kim, Park, and Park: Review on predictors of dropout and weight loss maintenance in weight loss interventions

Abstract

Objectives

Dropout and weight regain are common problems in most obesity treatments. The purpose of this study was to review previously published study results of the predictive factors associated with dropout during weight loss treatment and weight loss maintenance after successful weight loss.

Methods

Authors searched for the articles related to dropout and weight loss maintenance, published from 2007 to 2016 found on Pubmed, Scopus, RISS, and KISS. A total of 19 articles were finally selected. From the study results, unchangeable and changeable predictors were extracted, and these predictors were examined according to dropout and weight loss maintenance categories.

Results

The unchangeable predictors of dropout were younger age, lower education level and female, whereas the changeable predictors of dropout were lower initial weight loss, symptoms of depression and body dissatisfaction. The strongest factor for predicting the dropout was initial weight loss. The unchangeable predictors of weight loss maintenance were old age, male and family history of obesity, whereas the changeable predictors of weight loss maintenance were regular exercise, dietary restraint, self-weighing and low depressive symptoms. Initial weight loss, depressive symptoms, body image, dietary restraint, physical activity, weight loss expectation and social support were considered to be dominant factors for weight loss treatments.

Conclusions

Our review results suggest that unchangeable and changeable predictors of dropout and weight loss maintenance should be carefully examined during treatments of obesity.

Fig. 1
A Review of predictors of drop out and weight loss maintenance.
jkm-37-3-62f1.gif
Table 1
Study on Predictors of Dropout during Weight Loss Treatment.
Author (year) Title Predictors
Fabricatore (2009)13) Predictors of attrition and weight loss success Results from a randomized controlled trial. age−
years since onset of overweight−
education level−
symptoms of depression+
self-esteem−
attendance at week 3−
weight loss at week 3−
Gunnarsdottir (2010)14) Predictors of dropping out in a weight loss intervention trial. antidepressants+
soft drinks+
Elfhag (2010)15) Initial weight loss is the best predictor for success in obesity treatment and sociodemographic liabilities increase risk for drop-out. education level−
being an immigrant+
lack of occupation+
body dissatisfaction+
weight cycling+
Moroshko (2011)16) Predictors of dropout in weight loss interventions a systematic review of the literature. age−
education level−
body image−
previous dieting attempts+
physical activity−
self efficacy−
social support−
weight loss expectations+initial weight loss−
travel distance to clinic+
financial difficulties+
Hadziabdic (2015)17) Factors predictive of drop-out and weight loss success in weight management of obese patients. female > male
education level−
initial weight+
Yackobovitch-Gav an (2015)18) Factors associated with dropout in a group weight-loss programme: a longitudinal investigation. initial weight loss−
Goode (2016)19) Socio-demographic, anthropometric, and psychosocial predictors of attrition across behavioral weight-loss trials. age−
education level−
initial weight+
binge eating+
previous dieting attempts+
financial difficulties+

(+; positive correlation, −; negative correlation, 〈 〉; the sign of inequality)

Table 2
Study on Predictors of Weight Loss Maintenance after Successful Weight Loss
Author (year) Title Predictors
Rena (2008)20) Maintaining Large Weight Losses: The Role of Behavioral and Psychological Factors. physical activity+
self-weighing+
hunger−
dietary disinhibition−
depressive symptoms−
Collings (2008)21) A prospective study of predictors of successful weight maintenance by women enrolled in community-based weight-loss programs. Bulimia and Obesity. body image+
Sonja (2011)22) Psychological factors influencing weight loss maintenance: an integrative literature review. weight loss expectation−
weight loss goals+
dichotomous thinking style−
eating to regulate mood−
dietary disinhibition−
perceived benefits outweighing costs+
depressive symptoms−
body image+
Osayi (2011)23) Factors associated with long-term weight loss and weight maintenance: analysis of a comprehensive workplace wellness program. male gender+
age+
stress−
dietary restaint+
exercise combined with diet+
Stubbs (2011)24) Problems in identifying predictors and correlates of weight loss and maintenance: (+) physical activity self-monitoring a positive coping style social support normalization of eating patterns reduction of comorbidities flexible coping strategies eating breakfast
(−) negative life events family dysfunction higher levels of depression dietary disinhibition binge eating
Delahanty (2012)25) Genetic predictors of weight loss and weight regain after intensive lifestyle modification, metformin treatment, or standard care in the diabetes prevention program. SNPs−;
NEGRI rs2815752, BDNF rs6265, PRARGrs1801282, TMEM18 rs6548238, KTCD15rs29941
Lee (2014)26) Related factors of long-term maintenance of weight loss in obese patients. dietary restaint+
Regular exercise+
Regular weight check+
Family history of obesity+
Brantley (2014)27) Psychosocial predictors of weight regain in the weight loss maintenance trial health-related quality of life+
stress−
Abildso (2014)28) Predictors of weight loss maintenance following an insurance-sponsored weight management program. Self-weighing+
dietary restaint+
physical activity+
Nikolić (2015)29) Initial weight loss after restrictive bariatric procedures may predict mid-term weight maintenance: Results from a 12-month pilot trial. Initial weight loss+
Santos (2015)30) Predicting long-term weight loss maintenance in previously overweight women: A signal detection approach. body image+
exercise autonomous motivation+
Ross (2016)31) Successful weight loss maintenance associated with morning chronotype and better sleep quality. morning chronotype+
sleep quality+

(+; positive correlation, −; negative correlation, 〈 〉; the sign of inequality)

Table 3
Predictors of Drop-out and Weight loss Maintenance.
Process Changeable predictors Unchangeable predictors
drop out Initial weight loss−13)16)18)
depressive symptoms+13)14)16)body image−13)15)16)
binge eating+19)
soft drink+14)
physical activity+16)
weight loss expectation+16)
social support−16)
Initial attendance−13)
education level−13)15)16)17)19)
age−13)16)19)
finantial difficulties+15)16)19)
previous weight loss attempts+16)19)15)
Initial weight+17)19)
female > male17)
weight maintenance Regular exercise·physical activity+20)23)24)26)28)30)
hunger20)dietary restraint+20)22)23)24)26)28)
self-weighing·self-monitoring+20)24)26)28)
depressive symptoms20)22)24)
stress+23)24)27)
body image+21)22)30)
health-related quality of life+24)27)
positive coping strategies+22)24)
morning chronotype+32)
sleep quality+31)
weight loss expectation−22)
Initial weight loss+29)
social support+24)
weight loss goal+22)
benefits outweighing costs+22)
age+23)
male > female23)
Family history of obesity+26)
SNPs−25)

(+; positive correlation, −; negative correlation, 〈 〉; the sign of inequality)

참고문헌

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17 Ortner Hadziabdic M, Mucalo I, Hrabac P, Matic T, Rahelic D, Bozikov V. Factors predictive of drop-out and weight loss success in weight management of obese patients. Journal of Human Nutrition and Dietetics. 2015; 28:2. 24–32.
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18 Yackobovitch-Gavan M. Factors associated with dropout in a group weight-loss programme: a longitudinal investigation. Journal of Human Nutrition and Dietetics. 2015; 28:2. 33–40.
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19 Goode RW, Ye L, Sereika SM, Mancino J. Socio-demographic, anthropometric and psychosocial predictors of attrition across behavioral weight-loss trials. Source of the DocumentEating Behaviors. 2016; 20:27–33.
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20 Rena RW. Maintaining Large Weight Losses: The Role of Behavioral and Psychological Factors. Journal of Consulting and Clinical Psychology. 2008; 76:6. 1015–1021.
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21 Collings AS. A prospective study of predictors of successful weight maintenance by women enrolled in community-based weight-loss programs. Bulimia and Obesity. 2008; 13:1. 38–47.
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24 Stubbs J, Whybrow S, Teixeira P, Blundell J, Lawton C. Problems in identifying predictors and correlates of weight loss and maintenance: implications for weight control therapies based on behaviour change. Obesity Reviews. 2011; 12:9. 88–708.
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25 Linda MD, Qing P, Kathleen AJ, Karol EW, Jeanne MM, Alan S, et al. Genetic predictors of weight loss and weight regain after intensive lifestyle modification, metformin treatment, or standard care in the diabetes prevention program. Diabetes care. 2012; 35:2. 363–366.
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26 Lee JH. Related factors of long-term maintenance of weight loss in obese patients. Ulsan Univ.;2014.


27 Brantley PJ. Psychosocial predictors of weight regain in the weight loss maintenance trial. Journal of Behavioral Medicine. 2014; 37:6. 1155–1168.
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28 Abildso CG, Schmid O, Byrd M, Quartiroli A, Fitzpatrick SJ. Predictors of weight loss maintenance following an insurance-sponsored weight management program. Journal of Obesity. 2014; 736080
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29 Nikolić MA, Kruljac IB, Kirigin LC, Mirošević GB, Ljubičić NA, Pezo Nikolić BD. Initial weight loss after restrictive bariatric procedures may predict mid-term weight maintenance: Results from a 12-month pilot trial. Bariatric Surgical Practice and Patient Care. 2015; 10:2. 68–73.
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30 Santos I, Mata J. Predicting long-term weight loss maintenance in previously overweight women: A signal detection approach. Obesity. 2015; 23:5. 957–964.
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31 Kathryn MR, Graham JT, Wing RR. Successful weight loss maintenance associated with morning chronotype and better sleep quality. Journal of Behavioral Medicine. 2016; 39:3. 465–471.
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