Deanna J M Isaman1, William H Herman2,3, Amy E Rothberg2,4. 1. Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA. 2. Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA. 3. Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA. 4. Department of Human Nutrition, University of Michigan, Ann Arbor, Michigan, USA.
Abstract
OBJECTIVE: Obesity treatment is plagued by attrition. Estimates of attrition bias are needed. Thus, in this study, percent change from baseline BMI at 1, 2, and 3 years following enrollment in a 2-year weight management program using a very low-energy diet was calculated. Program data were supplemented with information from medical records. METHODS: Attrition was classified as occurring early (<6 months), late (6-21 months), at program completion (22-28 months), and after program completion (>28 months). Stepwise multivariable regression examined attrition and other covariates. RESULTS: A total of 881 subjects had ≥3 years of follow-up. BMI decreased by a mean (SD) of 11.8 (9.2), 8.6 (9.3), and 5.2 (10.0) kg/m2 at 1, 2, and 3 years after enrollment, respectively. At year 1, every 10-kg/m2 increase in baseline BMI was associated with a 2% (95% CI: 1%-3%) decrease in BMI. Individuals with early attrition decreased their mean BMI by 13% (11%-15%) less than program completers and by 9% (7%-11%) at 2 years. At 3 years, there was no significant difference in BMI between individuals with early attrition and program completers. However, BMI decreased 5% (3%- 8%) more in individuals who extended participation compared with program completers. CONCLUSIONS: Reported outcomes of weight management programs must account for program attrition.
OBJECTIVE: Obesity treatment is plagued by attrition. Estimates of attrition bias are needed. Thus, in this study, percent change from baseline BMI at 1, 2, and 3 years following enrollment in a 2-year weight management program using a very low-energy diet was calculated. Program data were supplemented with information from medical records. METHODS: Attrition was classified as occurring early (<6 months), late (6-21 months), at program completion (22-28 months), and after program completion (>28 months). Stepwise multivariable regression examined attrition and other covariates. RESULTS: A total of 881 subjects had ≥3 years of follow-up. BMI decreased by a mean (SD) of 11.8 (9.2), 8.6 (9.3), and 5.2 (10.0) kg/m2 at 1, 2, and 3 years after enrollment, respectively. At year 1, every 10-kg/m2 increase in baseline BMI was associated with a 2% (95% CI: 1%-3%) decrease in BMI. Individuals with early attrition decreased their mean BMI by 13% (11%-15%) less than program completers and by 9% (7%-11%) at 2 years. At 3 years, there was no significant difference in BMI between individuals with early attrition and program completers. However, BMI decreased 5% (3%- 8%) more in individuals who extended participation compared with program completers. CONCLUSIONS: Reported outcomes of weight management programs must account for program attrition.
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