Psychological and sociodemographic predictors of premature discontinuation of a 1-year multimodal outpatient weight-reduction program: an attrition analysis

ychological and sociodemographic predictors of premature discontinuation of a 1-year multimodal outpatient weight-reduction program: an attrition analysis Original Research (1773) Total Article Views Authors: Ahnis A, Riedl A, Figura A, Steinhagen-Thiessen E, Liebl ME, Klapp BF Published Date March 2012 Volume 2012:6 Pages 165 - 177 DOI: http://dx.doi.org/10.2147/PPA.S28022 Received: 08 November 2011 Accepted: 08 December 2011 Published: 07 March 2012 Anne Ahnis1, Andrea Riedl1, Andrea Figura1, Elisabeth Steinhagen-Thiessen2, Max E Liebl3, Burghard F Klapp1 1Internal Medicine and Dermatology, Medical Department, Division of Psychosomatic Medicine, Charité – Universit tsmedizin Berlin, Campus Mitte, 2Internal Medicine with Gastroenterology and Nephrology, Specialty network of Gastroenterology, Endocrinology and Metabolic Diseases, Division of Lipid Metabolism, Charité – Universit tsmedizin Berlin, Campus Virchow-Klinikum, 3Medical Department, Division of Rheumatology and Clinical Immunology, Department for Physical Medicine, Charité – Universit tsmedizin Berlin, Campus Mitte, Berlin, Germany 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 – Universit tsmedizin 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 tre