Rothberg Amy E, McEwen Laura N, Kraftson Andrew T, Ajluni Nevin, Fowler Christine E, Miller Nicole M, Zurales Katherine R, Herman William H
Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA.
Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106 USA ; Department of Epidemiology, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105 USA.
BMC Obes. 2015 Mar 1;2:11. doi: 10.1186/s40608-015-0041-9. eCollection 2015.
We sought to identify factors associated with participant retention in a 2-year, physician-lead, multidisciplinary, clinical weight management program that employs meal replacements to produce weight loss and intensive behavioral interventions and financial incentives for weight loss maintenance. We studied 270 participants enrolled in 2010 and 2011. Sociodemographic factors, health insurance, distance traveled, body mass index, comorbidities, health-related quality-of-life, and depression were explored as potential predictors of retention.
Mean age was 49 ± 8 years and BMI was 41 ± 5 kg/m(2). Retention was excellent at 3 months (90%) and 6 months (83%). Attrition was greatest after participants were transitioned to regular foodstuffs and fell to 67% at 12 months and 51% at 2 years. Weight decreased by 15 ± 12 kg and BMI decreased by 5.1 ± 4.0 kg/m(2) in 2-year completers. Older age, lower baseline BMI, and financial incentives for program participation were independently associated with retention. Fewer depressive symptoms at baseline were associated with retention.
This multidisciplinary, clinical, weight management program demonstrated high retention and excellent outcomes. Older age at baseline, less extreme obesity, and financial incentives were associated with program retention.
我们试图确定在一项为期两年、由医生主导、多学科的临床体重管理项目中与参与者留存率相关的因素。该项目采用代餐来实现体重减轻,并通过强化行为干预和经济激励措施来维持体重减轻效果。我们研究了2010年和2011年招募的270名参与者。探讨了社会人口统计学因素、健康保险、出行距离、体重指数、合并症、健康相关生活质量和抑郁作为留存率的潜在预测因素。
平均年龄为49±8岁,体重指数为41±5kg/m²。3个月时的留存率极佳(90%),6个月时为83%。在参与者过渡到常规食物后流失率最高,12个月时降至67%,2年时降至51%。在完成2年项目的参与者中,体重下降了15±12kg,体重指数下降了5.1±4.0kg/m²。年龄较大、基线体重指数较低以及参与项目的经济激励与留存率独立相关。基线时抑郁症状较少与留存率相关。
这个多学科的临床体重管理项目显示出高留存率和出色的效果。基线年龄较大、肥胖程度较轻以及经济激励与项目留存率相关。