Abstract 18698: Poor Quality of Life Impacts Successful Adoption and Completion of a Behavioral Weight Management Program for Overweight and Obese Patients With Heart Failure

Abstract

Background: Clinical trials involving behavioral interventions for weight management in obese persons are often compromised by moderate levels of attrition. Previous studies have shown pretreatment variables (e.g. initial body weight, quality of life [QOL]) to be significantly related with successful completion of a behavioral weight management program, but is poorly understood in heart failure (HF) patients. Objectives: To assess personal and psychosocial differences between successful - defined as ability to complete a 3-month behavioral weight loss program - and unsuccessful participants in a RCT examining the effects of a high protein vs. standard protein diet on adiposity; and 2) identity predictors of program completion. Methods: Demographic and psychosocial assessments inclduing the Minnesota Living with Heart Failure Survey (higher score, worse QOL) were completed at baseline and 3 months. Comparisons were made between participants who completed the 3 month weight management program (n = 34) and participants who did not (n = 15). Results: Thirty four (70%) of the 49 participants - mean age 59.1 ± 9.8; weight 248.8 ± 29.7 lbs.; VO 2 max 12.5 ± 3.7 mg/kg/ml; 55% White; 20% Hispanics; 16% Blacks; 8% Asians - completed the weight management program. There were no age or gender differences between the two groups; Whites were less likely to complete the intervention compared to their counterparts (p = 0.47). There were statistically significant differences in QOL scores between completers and non-completers; overall QOL 40.8 ± 20.3 vs. 58.7 ± 24.2, p = 0.010; physical QOL 16.4 ± 9.3 vs. 24.7 ± 10.4, p = 0.008; emotional QOL 9.1 ± 7.0 vs. 14.5 ± 7.5, p = 0.020. After controlling for age, gender, race, initial weight, and functional status, QOL explained an additional 19% of the variance in successful completion of the weight management program. Conclusion: Personal and psychosocial variables may be useful as pretreatment predictors of success level and/or attrition in obese patients who participate in a RCT to test the effects of a behavioral weight management program. These factors can be used in developing readiness profiles for weight management, a potentially vital tool to address the issue of low success/completion rates in behavioral management of obesity.