A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional
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23 Journal Watch Bariatric Times • July 2016 h igher weight status (p=0.04) positively predicted discouragement with exercise. Higher weight status combined with the belief that exercise reduces weight was a significant p ositive predictor of discouragement (p=0.01). The authors concluded that individuals with higher weight status that believe that exercise is an e ffective way to lose weight are more likely to become discouraged when exercise does not lead to weight loss. Prescribing exercise for weight loss might contribute to discouragement. F uture studies should evaluate ways to encourage exercise without promoting the belief that exercise will yield weight loss. PMID: 26500086 Weight loss expectations and attrition in treatment-seeking obese women. Dalle Grave R, Calugi S, Compare A, E l Ghoch M, Petroni ML, Tomasi F, Mazzali G, Marchesini G. Obes Facts. 2015;8(5):311-8. Synopsis: The aim of this study was to investigate the role of weight loss goals on attrition in a cohort of women with obesity seeking treatment at eight Italian medical centres. A total of 634 women with obesity, consecutively enrolled in weight loss programmes, were included in the study. Weight loss goals were evaluated with the Goals and Relative Weights Questionnaire (GRWQ), reporting a sequence of unrealistic ('dream' and 'happy') and more realistic ('acceptable' and 'disappointing') weight loss goals. Attrition was assessed at 12 months on the basis of patients' medical records. At 12 months, 205 patients (32.3%) had interrupted their programme and were lost to follow-up. After adjustment for age, baseline weight, education and employment status, attrition was significantly associated with higher percent acceptable and disappointing weight loss targets, not with dream and happy weight loss. The authors concluded that in "real-world" clinical settings, only realistic expectations might favor attrition whenever too challenging, whereas unrealistic weight loss goals have no effect. Future studies should assess the effect of interventions aimed at coping with too challenging weight goals on attrition. PMID: 26444382 Should providers encourage realistic weight expectations and satisfaction with lost weight in commercial weight loss programs? a preliminary study. Ames GE, Thomas CS, Patel RH, McMullen JS, Lutes LD. Springerplus. 2014 Aug 28;3:477. Synopsis: This study investigated variables associated with attrition among 30 patients with obesity who c ompleted a liquid meal replacement program (LMR) and enrolled in a 52- week Small Changes Maintenance intervention (SCM). Patients lost a median 18 percent of body weight d uring LMR and completed assessments about weight expectations and weight satisfaction pre- and post-SCM. Of the 30 patients who started S CM, eight (27%) were lost to attrition. Odds of SCM attrition were higher in patients who lost ≤ 18.2% of pre-LMR weight (OR: 12.25, P=0.035), had lower satisfaction (≤7) pre-SCM ( OR: 10.11, P=0.040), and who expected further weight loss of 9.1 kg or more pre-SCM (OR: 10.11, P=0.040). SCM completers significantly increased weight loss e xpectations by a median of 2.3kg from pre-SCM to post-SCM (WSR P=0.049) that paralleled weight regained post-SCM (2.7kg). The authors found that after c ompletion of a medically-supervised commercial weight loss program, patients with the greatest expectations for further weight loss and the lowest weight satisfaction w ere more likely to drop out of SCM. They concluded that failure to participate in maintenance treatment may lead to regain of greater than half of lost weight over the next year. A mong SCM completers, lower expectations for further weight loss and greater weight satisfaction appeared to be associated with continued engagement in m aintenance treatment. PMID: 25279285