Predictors of attrition and weight loss in obese treatment-seeking males and females

An estimated 64.5% of the United States population is currently overweight, and 30.5% are obese. These individuals are at risk for numerous medical conditions, including hypertension, dyslipidemia, and type II diabetes. Behavioral treatment produces medically meaningful weight losses that are maintained, with continued treatment, for up to one year. Unfortunately, the mean rate of attrition from behavioral treatment is approximately 22% within six months of treatment. It would therefore be useful for clinicians to be able to identify patient characteristics that are associated with weight loss success. However, reliable predictors of attrition and weight loss have proven elusive to date. The proposed study investigated the ability of pre-treatment levels of self-efficacy, binge eating, depression, emotional eating, stress, hunger, disinhibition, and dietary restraint to predict attrition and weight loss in a sample of 179 males and females undergoing 40 weeks of group behavioral weight loss treatment. Cross-validation regression analyses revealed dietary restraint as a significant predictor of weight loss, in both derivation (n = 92) and confirmation (n = 87) samples. Analyses of the full sample revealed the consistent ability of restraint to predict both attrition and weight loss. Logistic regression analyses revealed that individuals who reported higher levels of restraint at baseline were 17% less likely to drop out of treatment. Those who were less depressed at pre-treatment were 11% less likely to drop out than those who were more depressed. We also discuss the potential utility of enhancing certain psychological variables (e.g., restraint, self-efficacy) during treatment in an effort to decrease attrition and increase weight loss in obese individuals.