Can health indicators and psychosocial characteristics predict attrition in youth with overweight and obesity seeking ambulatory treatment? Data from a retrospective longitudinal study in a paediatric clinic in Luxembourg.

ABSTRACT
Objectives: The current study aimed to identify factors that could predict attrition in youth starting ambulatory treatment to control or lose weight.
Design: retrospective longitudinal study
Setting: paediatric clinic: ambulatory treatment program
Patients and measures: A youth sample (N=191; 89 boys; age 7-17 years) completed measures of demographic characteristics, health and psychosocial traits before starting an ambulatory weight management program. Anthropometric and biological markers related to obesity were also obtained. Test of mean differences and regression analyses were used to investigate the relationship between these variables and attrition after one year.
Results: Chi-square and t-test results showed both psychosocial and health indicators differentiated between participants who continued attending the treatment program and those that dropped out. More specifically, youth that dropped out of treatment were significantly older, had higher BMI-Z scores, higher levels of insulin, triglycerides and HOMA-IR, reported poorer health and more conduct problems, and were more dissatisfied with themselves and their bodies before starting treatment. Results of regression analyses revealed that weight status (anthropometric and biological markers), age and body dissatisfaction predict attrition (overall prediction success 73%; prediction success for continued attendance 90/91%; prediction success for dropout 42/44%).
Conclusion: Attrition, but especially the continued attendance in treatment, can be successfully predicted by age, weight status and body dissatisfaction. For patients who present with one or more risk factors, careful consideration is needed to decide which (combination of) in- or outpatient program may facilitate prolonged engagement of the patient and hence may be most effective in establishing weight loss.