Predictive factors for successful weight loss of an intensive specialist obesity clinic in a tertiary hospital

Abstract

A successful reducing weight ≥5 % has decreased complication of obesity. The factors of successful reducing weight loss of severe obesity by lifestyle intervention are not clarify. The purpose of this study was to identified factors predict successful weight loss and maintenance programs in obese patients in obesity clinic. This retrospective observational cohort study was conducted at a tertiary care hospital. A database of more over 18-year-old obese patients who underwent weight reduction clinic at Maharat Nakorn Ratchsima Hospital from October 2014 through September 2019 was retrospectively analyzed. The study population was divided into two categories (success and failure group) based on the outcome of weight reduction. Success group was defined by those who reported losing ≥ 5% body weight and maintain their weight loss at 1 years. The independent variables included as following: demographic data, body mass index, fat free mass, co-morbidities, dietary pattern, physical activities, weight monitoring, stress and sleeping pattern. Each of the variables was tested against outcomes variable using t-test and Fisher’s exact test. Continuous variables were expressed as mean±S.D. and categorical data were presented as proportions. Stepwise backward elimination multivariable logistic regression analysis was applied to identify independent predictors of reducing weight. The statistically significant was assumed at p-value <0.05. Results A total of 249 patients, 165 were successful group and 84 were failure group. Those patients with moderate stress (aOR 11.78; 95% CI 3.24-42.82) monitoring weight once a week (aOR 5.16; 95% CI 1.22-21.87) age 30–59-year (aOR 5.13; 95% CI 2.09-12.58) restricted having snack (aOR 3.74; 95% CI 1.71-8.17) having breakfast (aOR 3.24; 95% CI 1.03-10.18) sleep apnea (aOR 2.28; 95% CI 1.06-4.90). had higher odds of having the outcome of weight reduction. These factors were combined to predict successful weight loss by auROC 0.84. Then Application for weight loss program should focus on stress assessment, stress management, sleep apnea screening including developing of new approach to reducing weight of young adult. In addition, advice to weight monitoring, restricted having snack, having breakfast.