Jiandani Dishay, Wharton Sean, Rotondi Michael A, Ardern Chris I, Kuk Jennifer L
School of Kinesiology and Health Science, York University, Toronto, Canada.
School of Kinesiology and Health Science, York University, Toronto, Canada ; The Wharton Weight Management Clinic, Toronto, Canada.
BMC Obes. 2016 Mar 9;3:14. doi: 10.1186/s40608-016-0098-0. eCollection 2016.
Our objective was to identify factors that are independently associated with early attrition and successful weight loss (WL) in an obesity-management program.
Participants were 9,498 patients enrolled in treatment at the Wharton Weight Management Clinic for at least 6 months. Predictors of early attrition (<6 months) and successful WL (≥5 %) were analyzed using relative risk (RR) in men and women separately. Pearson's correlation was used to determine the relationship between WL and treatment time Weight loss and attrition analysis was restricted to patients who had more than two visits (n = 5415).
Older individuals had lower early attrition (RR Range:0.74-0.92, P < 0.05) and greater WL success (RR Range:1.40-1.65, P < 0.05) than younger individuals. Males with hypertension and females with depression had greater early attrition (RR Range:1.09-1.20, P < 0.05) and lower WL success (RR Range:0.48-0.57, P < 0.05) than those without these health conditions. Males with lower education had greater early attrition (RR = 1.11[1.03-1.19]) than males with higher education, but did not differ in WL. Females who smoked had greater early attrition (RR = 1.06[1.01-1.11]) than females who did not smoke, but did not differ in WL. Ethnicity was not related to early attrition, however, females of Black and Other ethnicities had lower WL success compared to White females (RR Range:0.58-0.74, P < 0.05). After adjusting for treatment time, all above associations were no longer significant and treatment time remained as the only independent predictor of WL success (P < 0.0001).
As WL is positively and independently related with treatment time, individuals at risk for early attrition may need alternative treatment options, in order to improve patient retention and improve WL success.
我们的目标是确定在肥胖管理项目中与早期退出和成功减重独立相关的因素。
参与者为9498名在沃顿体重管理诊所接受治疗至少6个月的患者。分别使用相对风险（RR）分析男性和女性早期退出（<6个月）和成功减重（≥5%）的预测因素。采用Pearson相关性分析来确定减重与治疗时间之间的关系。减重和退出分析仅限于就诊次数超过两次的患者（n = 5415）。
与年轻个体相比，年长个体的早期退出率较低（RR范围：0.74 - 0.92，P < 0.05）且减重成功率更高（RR范围：1.40 - 1.65，P < 0.05）。患有高血压的男性和患有抑郁症的女性比没有这些健康问题的人有更高的早期退出率（RR范围：1.09 - 1.20，P < 0.05）和更低的减重成功率（RR范围：0.48 - 0.57，P < 0.05）。受教育程度较低的男性比受教育程度较高的男性有更高的早期退出率（RR = 1.11[1.03 - 1.19]），但在减重方面没有差异。吸烟的女性比不吸烟的女性有更高的早期退出率（RR = 1.06[1.01 - 1.11]），但在减重方面没有差异。种族与早期退出无关，然而，与白人女性相比，黑人和其他种族的女性减重成功率较低（RR范围：0.58 - 0.74，P < 0.05）。在调整治疗时间后，上述所有关联均不再显著，治疗时间仍然是减重成功的唯一独立预测因素（P < 0.0001）。
由于减重与治疗时间呈正相关且独立相关，有早期退出风险的个体可能需要替代治疗方案，以提高患者留存率并提高减重成功率。
