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Anthropometric, metabolic, psychosocial and dietary factors associated with dropout in overweight and obese postmenopausal women engaged in a 6-month weight loss programme: a MONET study

  • Virginie Messier (a1) (a2), Jessy Hayek (a3), Antony D. Karelis (a4), Lyne Messier (a1), Éric Doucet (a5), Denis Prud'homme (a5), Rémi Rabasa-Lhoret (a1) (a2) (a6) (a7) and Irene Strychar (a1) (a6) (a7)...

Abstract

The objective of the present study was to examine anthropometric, metabolic, psychosocial and dietary factors associated with dropout in a 6-month weight loss intervention aimed at reducing body weight by 10 %. The study sample included 137 sedentary, overweight and obese postmenopausal women, participating in a weight loss intervention that consisted of either energy restriction (ER) or ER with resistance training (ER+RT). Anthropometric (BMI, percent lean body mass, percent fat mass, visceral adipose tissue and waist circumference), metabolic (total energy expenditure, RMR, insulin sensitivity and fasting plasma levels of leptin and ghrelin), psychosocial (body esteem, self-esteem, stress, dietary restraint, disinhibition, hunger, quality of life, self-efficacy, perceived benefits for controlling weight and perceived risk) and dietary (3-d food record) variables were measured. Thirty subjects out of 137 dropped out of the weight loss programme (22 %), with no significant differences in dropout rates between those in the ER and the ER+RT groups. Overall, amount of weight loss was significantly lower in dropouts than in completers ( − 1·7 (sd 3·5) v. − 5·6 (sd 4·3) kg, P < 0·05); weekly weight loss during the first 4 weeks was also significantly lower. Dropouts consumed fewer fruit servings than completers (1·7 (sd 1·1) v. 2·7 (sd 1·53), P < 0·05) and had higher insulin sensitivity levels (12·6 (sd 3·8) v. 11·1 (sd 2·8) mg glucose/min per kg fat-free mass, P < 0·05). The present results suggest that the rate of weight loss during the first weeks of an intervention plays an important role in the completion of the programme. Thus, participants with low rates of initial weight loss should be monitored intensely to undertake corrective measures to increase the likelihood of completion.

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Corresponding author

*Corresponding author: Virginie Messier, fax +1 514 987 5670, email virginie.messier@ircm.qc.ca

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1Dansinger, ML, Gleason, JA, Griffith, JL, et al. (2005) Comparison of the Atkins, Ornish, weight watchers, and zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 293, 4353.
2Franz, MJ, VanWormer, JJ, Crain, AL, et al. (2007) Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 107, 17551767.
3Gardner, CD, Kiazand, A, Alhassan, S, et al. (2007) Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. JAMA 297, 969977.
4Tsai, AG & Wadden, TA (2005) Systematic review: an evaluation of major commercial weight loss programs in the United States. Ann Intern Med 142, 5666.
5Wu, T, Gao, X, Chen, M, et al. (2009) Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis. Obes Rev 10, 313323.
6Yancy, WS Jr, Olsen, MK, Guyton, JR, et al. (2004) A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med 140, 769777.
7DalleGrave, R, Calugi, S, Molinari, E, et al. (2005) Weight loss expectations in obese patients and treatment attrition: an observational multicenter study. Obes Res 13, 19611969.
8Grossi, E, Dalle Grave, R, Mannucci, E, et al. (2006) Complexity of attrition in the treatment of obesity: clues from a structured telephone interview. Int J Obes (Lond) 30, 11321137.
9Honas, JJ, Early, JL, Frederickson, DD, et al. (2003) Predictors of attrition in a large clinic-based weight-loss program. Obes Res 11, 888894.
10Wadden, TA, Foster, GD, Letizia, KA, et al. (1992) A multicenter evaluation of a proprietary weight reduction program for the treatment of marked obesity. Arch Intern Med 152, 961966.
11Andersson, I & Rossner, S (1997) Weight development, drop-out pattern and changes in obesity-related risk factors after two years treatment of obese men. Int J Obes Relat Metab Disord 21, 211216.
12Clark, MM, Guise, BJ & Niaura, RS (1995) Obesity level and attrition: support for patient-treatment matching in obesity treatment. Obes Res 3, 6364.
13Lantz, H, Peltonen, M, Agren, L, et al. (2003) A dietary and behavioural programme for the treatment of obesity. A 4-year clinical trial and a long-term posttreatment follow-up. J Intern Med 254, 272279.
14Teixeira, PJ, Going, SB, Houtkooper, LB, et al. (2004) Pretreatment predictors of attrition and successful weight management in women. Int J Obes Relat Metab Disord 28, 11241133.
15Neumark-Sztainer, D, Kaufmann, NA & Berry, EM (1995) Physical activity within a community-based weight control program: program evaluation and predictors of success. Public Health Rev 23, 237251.
16Bautista-Castano, I, Molina-Cabrillana, J, Montoya-Alonso, JA, et al. (2004) Variables predictive of adherence to diet and physical activity recommendations in the treatment of obesity and overweight, in a group of Spanish subjects. Int J Obes Relat Metab Disord 28, 697705.
17Carels, RA, Cacciapaglia, HM, Douglass, OM, et al. (2003) The early identification of poor treatment outcome in a women's weight loss program. Eat Behav 4, 265282.
18Clark, MM, Niaura, R, King, TK, et al. (1996) Depression, smoking, activity level, and health status: pretreatment predictors of attrition in obesity treatment. Addict Behav 21, 509513.
19Dennis, KE, Tomoyasu, N, McCrone, SH, et al. (2001) Self-efficacy targeted treatments for weight loss in postmenopausal women. Sch Inq Nurs Pract 15, 259276.
20Ek, A, Andersson, I, Barkeling, B, et al. (1996) Obesity treatment and attrition: no relationship to obesity level. Obes Res 4, 295296.
21Fowler, JL, Follick, MJ, Abrams, DB, et al. (1985) Participant characteristics as predictors of attrition in worksite weight loss. Addict Behav 10, 445448.
22Inelmen, EM, Toffanello, ED, Enzi, G, et al. (2005) Predictors of drop-out in overweight and obese outpatients. Int J Obes (Lond) 29, 122128.
23Kaplan, RM & Atkins, CJ (1987) Selective attrition causes overestimates of treatment effects in studies of weight loss. Addict Behav 12, 297302.
24Packianathan, I, Sheikh, M, Boniface, D, et al. (2005) Predictors of programme adherence and weight loss in women in an obesity programme using meal replacements. Diabetes Obes Metab 7, 439447.
25Yass-Reed, EM, Barry, NJ & Dacey, CM (1993) Examination of pretreatment predictors of attrition in a VLCD and behavior therapy weight-loss program. Addict Behav 18, 431435.
26Weinsier, RL, Nagy, TR, Hunter, GR, et al. (2000) Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the set-point theory. Am J Clin Nutr 72, 10881094.
27Lau, DC, Douketis, JD, Morrison, KM, et al. (2007) 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children. CMAJ 176, S113.
28Tremblay, A, Pelletier, C, Doucet, E, et al. (2004) Thermogenesis and weight loss in obese individuals: a primary association with organochlorine pollution. Int J Obes Relat Metab Disord 28, 936939.
29Brochu, M, Malita, MF, Messier, V, et al. (2009) Resistance training does not contribute to improving the metabolic profile after a 6-month weight loss program in overweight and obese postmenopausal women. J Clin Endocrinol Metab 94, 32263233.
30Messier, V, Malita, FM, Rabasa-Lhoret, R, et al. (2008) Association of cardiorespiratory fitness with insulin sensitivity in overweight and obese postmenopausal women: a Montreal Ottawa New Emerging Team study. Metabolism 57, 12931298.
31St-Pierre, DH, Faraj, M, Karelis, AD, et al. (2006) Lifestyle behaviours and components of energy balance as independent predictors of ghrelin and adiponectin in young non-obese women. Diabetes Metab 32, 131139.
32Strychar, I, Lavoie, M-E, Messier, L, et al. (2009) Anthropometric, metabolic, psychosocial, and dietary characteristics of overweight/obese postmenopausal women with a history of weight cycling: A MONET (Montreal Ottawa New Emerging Team) study. J Am Diet Assoc 109, 718724.
33Karelis, AD, Fontaine, J, Messier, V, et al. (2008) Psychosocial correlates of cardiorespiratory fitness and muscle strength in overweight and obese post-menopausal women: a MONET study. J Sports Sci 26, 935940.
34Ghiselli, EE, Campbell, JP & Zedeck, S (1981) Measurement Theory for the Behavioral Sciences. San Francisco, CA: W.H. Freeman.
35Rosenberg, M (1965) Society and the Adolescent Self-image. Princeton, NJ: Princeton University Press.
36Cohen, S, Kamarck, T & Mermelstein, R (1983) A global measure of perceived stress. J Health Soc Behav 24, 385396.
37Stunkard, AJ & Messick, S (1985) The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 29, 7183.
38McDowell, I & Newell, C (1996) Measuring Health: A Guide to Rating Scales and Questionnaires, 2nd ed.New York: Oxford University Press.
39Stewart, AL, Greenfield, S, Hays, RD, et al. (1989) Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. JAMA 262, 907913.
40Finley, CE, Barlow, CE, Greenway, FL, et al. (2007) Retention rates and weight loss in a commercial weight loss program. Int J Obes (Lond) 31, 292298.
41Cornier, MA, Donahoo, WT, Pereira, R, et al. (2005) Insulin sensitivity determines the effectiveness of dietary macronutrient composition on weight loss in obese women. Obes Res 13, 703709.
42Hoffman, RP, Stumbo, PJ, Janz, KF, et al. (1995) Altered insulin resistance is associated with increased dietary weight loss in obese children. Horm Res 44, 1722.
43Swinburn, BA, Nyomba, BL, Saad, MF, et al. (1991) Insulin resistance associated with lower rates of weight gain in Pima Indians. J Clin Invest 88, 168173.

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