Sarcopenic Obesity Predicts Early Attrition in Treatment-Seeking Patients with Obesity: A Longitudinal Pilot Study.

Dima Kreidieh,Leila Itani,Dana El Masri,Hana Tannir,Marwan El Ghoch

doi:10.3390/jcdd7010005

Dima Kreidieh, Leila Itani + Show 3 more

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https://doi.org/10.3390/jcdd7010005

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Abstract

Attrition is a major cause of failure in obesity treatment, which is still not fully understood. The identification of factors related to this outcome is of clinical relevance. We aimed to assess the relationship between sarcopenic obesity (SO) and early attrition. Early attrition was assessed at six months, and two groups of patients were selected from a large cohort of participants with overweight or obesity enrolled at the Outpatient Clinic of the Department of Nutrition and Dietetics at Beirut Arab University (Lebanon). Body composition was measured using a bioimpedance analyser (Tanita BC-418) and participants at baseline were categorized as having or not having SO. The “dropout group” included 72 participants (cases) compared to 31 participants (controls) in the “completer group”, with the former displaying a higher prevalence of SO than the latter (51.0% vs. 25.8%; p = 0.016). In the same direction, Poisson regression analysis showed that SO increased the relative risk of dropout by nearly 150% (RR = 1.45; 95% CI = 1.10–1.89; p = 0.007) after adjustment for age, gender, body mass index (BMI), age at first dieting, sedentary habits and weight-loss expectation. In conclusion, in a “real-world” outpatient clinical setting, the presence of SO at baseline increases the risk of dropout at six months. New directions of future research should be focused on identifying new strategies to reduce the attrition rate in this population.

Highlights

In 2018, the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) declared that sarcopenic obesity (SO) [1,2,3,4,5,6]—which is represented by the coexistence of obesity [7,8] and sarcopenia [9]—should be considered a priority by both researchers and clinicians [10]
This opened up new directions in research which aims to determine whether this disadvantaged metabolic phenomenon in individuals with SO may have, in some way, a negative impact on clinical outcomes during weight management programmes [4]
This being said, attrition is one of the major causes of failure on weight management programmes for obesity, with rates that range between 10% and 80% according to the type and the design of the treatment [14,15,16,17]

Summary

Introduction

In 2018, the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) declared that sarcopenic obesity (SO) [1,2,3,4,5,6]—which is represented by the coexistence of obesity (i.e., increase in body fat mass deposition) [7,8] and sarcopenia (i.e., decrease in muscle mass and strength) [9]—should be considered a priority by both researchers and clinicians [10]. Preliminary findings recently evidenced that SO is associated with a reduction in energy expenditure (e.g., resting metabolic rate) [13] This opened up new directions in research which aims to determine whether this disadvantaged metabolic phenomenon (e.g., resting metabolic rate) in individuals with SO may have, in some way, a negative impact on clinical outcomes (e.g., attrition, weight loss or maintenance) during weight management programmes [4]. The identification of new factors that lead to premature programme termination and the implementation of effective strategies to prevent the latter are needed to reduce attrition rates, considered vital in ensuring long-term success in weight management program

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