Sasdelli, A. S., Petroni, M. L., Delli Paoli, A., Collini, G., Calugi, S., Dalle Grave, R., & Marchesini, G. (2018). Expected benefits and motivation to weight loss in relation to treatment outcomes in group-based cognitive-behavior therapy of obesity. Eating and Weight Disorders. doi:10.1007/s40519-017-0475-9
Purpose: We aimed to determine cognitive drivers, expected to play a role in target reach and/or attrition in obesity programs.
Methods: We recorded the expected bene ts of weight loss, weight targets, primary motivation for weight loss, perceived treatment needs, readiness and self-con dence to be successful and a battery of psychopathology questionnaires in 793 subjects with obesity (68% women; mean age 48.7; 46% obesity class III) enrolled into a group-based cognitive-behavioral treatment program. Their relevance on attrition and successful weight loss outcome were tested by logistic regression analysis.
Results: The expected bene ts of weight loss scored very high in all physical, psychological and social areas, with di erences between genders. Attrition rate was 24, 41 and 65% at 6-, 12-, and 24-month follow-up. Average weight loss was 5.8 ± 7.1 kg (− 4.8%) at 6 months, with 17% of cases (32% of continuers) maintaining weight loss > 10% at 24 months. After adjustment for confounders, attrition was reduced by concern for present health, motivation/consciousness of the importance of physi- cal activity and need for support; treatment discontinuation was favored by concern for body image, by expectations for drug treatment or bariatric surgery, and by high-challenging weight loss targets. Male gender, higher BMI and concern for present health predicted weight loss > 10%, whereas concern for body appearance was associated with lower probability of attaining the desired weight loss targets.
Conclusion: A more precise de nition of needs and expectations might help tailor treatment to individual patients, but attri- tion rates and target reach remain di cult to predict.
Level of evidence: Leve lV, descriptive studies.
Keywords: Attrition · Expectations · Psychological distress · Treatment needs · Weight targets