The high global prevalence of overweight and obesity poses significant health risks. The elevated likelihood of developing other health conditions, strain on healthcare systems, and rising prevalence underscore the crucial need to persist in enhancing weight loss interventions.
Being a nutritionist, I am keen on understanding the reasons behind individuals discontinuing weight loss programs. I aim to incorporate these insights when working with clients, particularly those seeking significant weight loss or those who have attempted various diets before seeking my guidance.
Weight loss programs do not work for everyone, and it is common for individuals to discontinue them before reaching their intended completion or goal. Research shows that dropout rates from weight loss programs vary from 10% to 80% [1-4]. Hence, it is crucial to address this significant issue. The concern with discontinuing participation is that participants may fail to attain their primary program objectives, which could affect their future participation in weight loss programs and potentially lead them to abandon their weight loss efforts.
Studies have examined factors that could be linked to the causes of dropping out. [2]. In the UK, women aged 18-49 are the primary group most likely to drop out, with over half (54%) of them being overweight or obese. This weight issue among women in this age range can lead to various health implications, such as changes in the reproductive cycle affecting fertility, and an elevated risk of cardiovascular disease and type 2 diabetes [5]. Statistics show that obese women in this population have a 78% higher risk of infertility, while overweight women have a 27% increased risk compared to women of the same age group with normal weight.
Furthermore, obesity during pregnancy is linked to both short-term and long-term health hazards for the mother, including hypertension, pre-eclampsia, and gestational diabetes [6]. The mother's maternal obesity or overweight can lead to both short-term and long-term health issues. Additionally, infants born to overweight or obese mothers have a higher likelihood of developing long-term health problems, like an elevated risk of type 2 diabetes in the future.
Success rates or dropout rates in weight loss programs for women with polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is frequently seen in women of reproductive age (18-49 years). International guidelines recommend weight management as the primary treatment for this condition. A study investigated the factors related to the success or discontinuation of weight loss programs among overweight or obese women with PCOS. The study revealed that although many women dropped out, 63% of participants successfully lost weight.
It was discovered that women displaying signs of depression, such as low self-esteem, were more prone to discontinuing the program. On the other hand, women with higher attendance rates at appointments were less likely to drop out and achieved greater success in weight loss. This research underscores the significance of evaluating psychological health in order to provide enhanced psychological assistance to individuals with lower psychological well-being. This support can help them in adopting and maintaining healthy lifestyle habits and managing their weight effectively.
Success rates of weight loss programs among individuals who are married or in a relationship, or have children, and the likelihood of dropping out
Embarking on and adhering to a weight loss program can be challenging when your household members, like your spouse, are not participating. Research indicates that individuals who discontinue weight loss programs are more likely to be married or in a relationship. The study revealed that 81% of married individuals or those in a relationship dropped out, compared to 67% of single participants. Furthermore, having children was identified as a factor that could raise the likelihood of dropping out of the program.
Women are believed to prioritise their children's needs and accommodate the food preferences of family members, which can make it challenging for them to adhere to their own dietary objectives. Therefore, as a nutritionist, it is crucial to assist in overcoming this obstacle, facilitating the implementation of dietary modifications that cater to all household members. Other factors that may be beneficial to take into account include:
If the mother is employed full-time, she likely prefers quick and simple meals due to time constraints.
It is important to determine if the mother is solely responsible for cooking or if she receives assistance, as this may impact the need for separate meals for the children.
Knowing the number and ages of the children is essential to offer recipe suggestions that cater to everyone in the household.
Involving your partner in your weight loss journey, either by participating in your lifestyle changes or providing necessary support, can enhance the effectiveness of the program. If your partner isn't actively participating but wants to be supportive, keep them informed about your progress, challenges, and goals. This communication ensures that your partner understands your experience, can offer appropriate support, and knows how they can help reduce temptations and make the challenging aspects more manageable.
While certain studies indicate that couples have a higher chance of success when they jointly alter lifestyle habits, contrasting research suggests otherwise. This could be attributed to the potential influence of one partner on the other if they opt to discontinue healthy practices.
Can age impact the success or dropout rate of weight loss programs?
According to the research [1], yes, age is a factor to consider. The research revealed that participants aged 50 and above were less prone to discontinuing a weight loss program and more likely to achieve success in comparison to younger individuals aged 18-49. One potential explanation for these age-related variances in dropout rates could be that younger individuals face obstacles such as time constraints, work commitments, childcare responsibilities, financial instability, and difficulty taking time off work, which may hinder their ability to attend consultations regularly, unlike older participants. [7]. Moreover, there is a belief that the younger age group may have less motivation to enhance their health. [8].
After reviewing the research findings, it is evident that the primary obstacles faced by individuals in the younger age group are their limited flexibility in schedules and various personal responsibilities such as work commitments and caregiving duties for children and parents. These factors contribute to a reduced focus on self-care. The key point to take away from this is that nutritionists should acknowledge the busy lifestyles of individuals in this age bracket and offer flexible consultation hours that cater to their specific needs, whether it be early mornings or late evenings after their children have been put to bed.
Important factors to consider that could result in individuals discontinuing weight loss programs (beneficial for those providing nutritional guidance):
Individuals who are experiencing depressive symptoms
Individuals who are partnered or have kids
Age: Younger individuals
Additional factors that could serve as causes for discontinuing a weight loss program:
The method of the program: lack of contact/engagement with clients
The number of appointments: lack of appointments
High expectations for large weight loss
Previously attempted numerous diets and did not succeed, or have since put the weight back on
Not enough knowledge on nutrition, or lack of cooking skills
To conclude:
It is typical for people to discontinue weight loss programs without reaching their original objectives. As indicated in this article, nutritionists and other healthcare experts play a vital role in adjusting and offering guidance to individuals who sign up for weight loss programs. It is crucial to acknowledge potential obstacles that could hinder program success, while also recognizing that each person's lifestyle, personal obligations, goals, knowledge, understanding, past experiences, and skills vary.
References:
Jiandani, D., Wharton, S., Rotondi, M. A., Ardern, C. I., & Kuk, J. L. (2016). Predictors of early attrition and successful weight loss in patients attending an obesity management program. BMC Obesity, 3(1).
Moroshko, I., Brennan, L., & O'Brien, P. (2011). Predictors of dropout in weight loss interventions: a systematic review of the literature. Obesity Reviews, 12(11), 912-934.
Pirotta, S., Joham, A., Hochberg, L., Moran, L., Lim, S., Hindle, A., & Brennan, L. (2019). Strategies to reduce attrition in weight loss interventions: A systematic review and meta‐analysis. Obesity Reviews, 20(10), 1400-1412.
Teixeira, P. J., Going, S. B., Houtkooper, L. B., Cussler, E. C., Metcalfe, L. L., & Blew, R. M. et al. (2004). Pretreatment predictors of attrition and successful weight management in women. International Journal of Obesity, 28(9), 1124-1133.
Ezzati, M., Lopez, A. D., Rodgers, A., Vander Hoorn, S., Murray, C. J., & Comparative Risk Assessment Collaborating Group. (2002). Selected major risk factors and global and regional burden of disease. The Lancet, 360(9343), 1347-1360.
Sui, Z., Grivell, R. M., & Dodd, J. M. (2012). Antenatal exercise to improve outcomes in overweight or obese women: a systematic review. Acta obstetricia et gynecologica Scandinavica, 91(5), 538-545.
Honas, J. J., Early, J. L., Frederickson, D. D., & O'brien, M. S. (2003). Predictors of attrition in a large clinic‐based weight‐loss program. Obesity research, 11(7), 888-894.
Fabricatore, A. N., Wadden, T. A., Moore, R. H., Butryn, M. L., Heymsfield, S. B., & Nguyen, A. M. (2009). Predictors of attrition and weight loss success: Results from a randomized controlled trial. Behaviour research and therapy, 47(8), 685-691.
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