Weight loss and possible reasons for dropping out of a dietary behavioural programme in the treatment of overweight patients

Objectives: To evaluate the weight loss of a dietary/behavioural weight reduction programme and causes for drop-out. Methods: 90 overweight patients with a mean weight of 79 +/- 17 kg and BMI of 28.8 +/- 5 kg m(-2) who attended a clinic to lose weight were subjected to a dietary/ behavioural weight reduction programme. Treatment consisted in behavioural therapy with nutritional education, diet and physical activity. To evaluate the effectiveness of the treatment the following were considered: percentage of individuals who completed the treatment, weight reduction, average rate of weight reduction and percentage of individuals who completed the follow-up period. To determine the reasons for dropping out, an open-ended questionnaire was administered by telephone by trained clinical personnel. Results: 43% of patients completed the treatment, mean weight lass was 9 kg and the mean rate of weight loss was 0.8 kg week(-1). Reasons for dropping out were: vacations (23%), search for faster or fad diets (23%), social pressures (11%), excessive duration of the treatment (9%); failure to understand the diet (9%); differences within the group (7%); and illness and pregnancy (7%). Conclusions: Dietary/behavioural treatment is effective in clinical practice and especially adequate for men and young women. It is not satisfactory for individuals with very high BMI (> 35 kg m(-2)). Vacations, social causes and the search for 'miracle' diets were the principal reasons for drop-out.