Predictors of Lifestyle Intervention Attrition or Weight Loss Success in Women with Polycystic Ovary Syndrome Who Are Overweight or Obese

Lisa J Moran; Manny Noakes; Peter Clifton; Jon Buckley; Grant Brinkworth; Rebecca Thomson; Robert J Norman

doi:10.3390/nu11030492

Predictors of Lifestyle Intervention Attrition or Weight Loss Success in Women with Polycystic Ovary Syndrome Who Are Overweight or Obese

Nutrients. 2019 Feb 26;11(3):492. doi: 10.3390/nu11030492.

Authors

Lisa J Moran^{1

2}, Manny Noakes³, Peter Clifton⁴, Jon Buckley⁵, Grant Brinkworth⁶, Rebecca Thomson⁷, Robert J Norman^{8

9}

Affiliations

¹ School of Medicine, Robinson Research Institute, University of Adelaide, Adelaide, SA 5000, Australia. lisa.moran@monash.edu.
² Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic 3163, Australia. lisa.moran@monash.edu.
³ CSIRO Division of Health Sciences and Nutrition, Australia. manny.noakes@csiro.au.
⁴ Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5000, Australia. peter.clifton@unisa.edu.au.
⁵ Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5000, Australia. jon.buckley@unisa.edu.au.
⁶ CSIRO Division of Health Sciences and Nutrition, Australia. grant.brinkworth@csiro.au.
⁷ Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5000, Australia. r.thomson@adelaide.edu.au.
⁸ School of Medicine, Robinson Research Institute, University of Adelaide, Adelaide, SA 5000, Australia. robert.norman@adelaide.edu.au.
⁹ Fertility SA, Adelaide, SA 5000, Australia. robert.norman@adelaide.edu.au.

Abstract

Background/objectives: Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women. Weight management is a first-line treatment for PCOS according to international evidence-based guidelines. However, the factors associated with attrition or success in weight loss interventions are not known for women with PCOS. The objective of this study was to identify characteristics associated with attrition and weight loss success in women with PCOS and overweight or obesity undergoing weight loss interventions. Methods: Four randomised controlled clinical weight loss trials comprising energy restricted diets and/or exercise interventions of 2⁻8 months duration. The interventions were conducted over 2001⁻2007 in outpatient clinical research centres with n = 221 premenopausal women with PCOS and overweight/obesity recruited through community advertisement. The main outcome measures were attrition and ≥5% weight loss at 2 months and study completion. Results: Weight loss was 5.7 ± 2.9 kg at 2 months and 7.4 ± 5.3 kg after study completion (p < 0.001). Attrition was 47.1% and ≥5% weight loss occurred in 62.5% and 62.7% of women at 2 months and study completion respectively. Baseline depressive symptoms (OR 1.07 95% CI 0.88, 0.96, p = 0.032) and lower appointment attendance by 2 months (OR 0.92 95% CI 0.88, 0.96, p < 0.001) were independently associated with attrition. Lower appointment attendance over the whole study was independently associated with not achieving ≥5% weight loss at study completion (OR 0.95 95% CI 0.92, 0.99, p = 0.020). Conclusions: Despite high attrition, successful weight loss was achieved by 63% of women with PCOS in a clinical research setting. Higher baseline depressive symptoms were associated with greater attrition and higher appointment attendance was associated with lower attrition and greater weight loss success. These finding have implications for development of successful weight management programs in PCOS.

Keywords: attrition; diet; exercise; lifestyle; polycystic ovary syndrome; weight loss.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Caloric Restriction
Exercise
Female
Humans
Life Style*
Overweight / diet therapy*
Patient Compliance*
Polycystic Ovary Syndrome*
Weight Loss*