Multidisciplinary intervention in obese adolescents: predictors of dropout

Fidelix, Yara Lucy; Farias Júnior, José Cazuza de; Lofrano-Prado, Mara Cristina; Guerra, Ricardo Luís Fernandes; Cardel, Michelle; Prado, Wagner Luiz do

doi:10.1590/S1679-45082015AO3339

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Sumário

Original Article • EINSEinstein (São Paulo) 13 (3) • Jul-Sep 2015 • https://doi.org/10.1590/S1679-45082015AO3339 copy

Multidisciplinary intervention in obese adolescents: predictors of dropout

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

To identify biological and psychosocial factors associated with dropout in a multidisciplinary behavioral intervention in obese adolescents.

Methods

A total of 183 adolescents (15.4±1.6 years), pubertal (Tanner stage 3 or 4) and obese (34.7±4.0kg/m²), were enrolled in a 12-week behavioral intervention, which included clinical consultations (monthly), nutritional and psychological counseling (once a week), and supervised aerobic training (three times/week). The studied variables were weight, height, body mass index, body composition (skinfold), cardiorespiratory fitness (direct gas analysis), blood lipids and self-reported symptoms of eating disorders (bulimia, anorexia and binge eating), anxiety, depression, body image dissatisfaction and quality of life. Statistical analysis included binary logistic regression and independent t-tests.

Results

Of the adolescents, 73.7% adhered to the program. The greatest chance for dropout was observed among adolescents older than 15 years (odds ratio of 0.40; 95%CI: 0.15-0.98), with more anorexia symptoms (odds ratio of 0.35; 95%CI: 0.14-0.86) and hypercholesterolemia (odds ratio of 0.40; 95%CI: 0.16-0.91) at baseline.

Conclusion

Older adolescents, with more symptoms of eating disorders and total cholesterol have less chance to adhere to multidisciplinary treatments.

Patient dropouts; Adiposity; Lipids; Quality of life; Eating disorders; Adolescent

Variables	Adherence Mean (SD)	Dropout Mean (SD)	p value
Age (years)	15.2 (1.57)	15.9 (1.72)	0.01
Height (m)	1.65 (0.07)	1.63 (0.08)	0.21
Weight (kg)	95.2 (12.4)	92.5 (12.7)	0.20
BMI (kg/m²)	34.8 (4.0)	34.5 (4.0)	0.70
Fat mass (%)	51.3 (11.0)	53.0 (6.9)	0.23
Fat mass (kg)	48.7 (13.4)	49.7 (10.0)	0.62
Fat free mass (kg)	45.9 (10.9)	43.7 (8.4)	0.18
Total cholesterol (mg/dL)	167.3 (32.2)	172.8 (38.1)	0.36
LDL (mg/dL)	106.1 (28.8)	106.2 (32.0)	0.99
Triglycerides (mg/dL)	117.7 (68.2)	112.2 (57.2)	0.63
VLDL (mg/dL)	21.0 (12.8)	20.9 (8.8)	0.97
Glucose (mg/dL)	83.8 (11.9)	83.4 (9.5)	0.86
HDL (mg/dL)	49.0 (9.3)	52.0 (69.9)	0.22
Peak VO₂ (mL/kg/min)	25.7 (4.4)	26.6 (5.4)	0.39
Anorexic symptoms	19.2 (8.9)	21.9 (10.9)	0.15
Trait anxiety	45.6 (10.0)	45.1 (12.0)	0.78
Depression	17.3 (8.8)	17.8 (9.1)	0.77
State-anxiety	40.7 (9.8)	41.9 (10.5)	0.64
Binge	13.7 (7.6)	14.5 (8.9)	0.59
Bulimia symptoms	13.5 (5.3)	15.4 (6.6)	0.09
Bulimia severity	2.2 (2.5)	2.5 (3.2)	0.57
Body dissatisfaction	119.1 (32.1)	121.9 (37.4)	0.59
Physical functioning	71.1 (21.8)	71.7 (23.0)	0.89
Physical role	72.0 (30.1)	77.0 (29.9)	0.41
Pain	72.5 (22.1)	70.4 (19.9)	0.63
General health perception	60.8 (23.7)	57.4 (22.5)	0.47
Vitality	60.1 (21.6)	62.3 (23.9)	0.61
Social functioning	78.7 (21.6)	76.3 (26.5)	0.59
Emotional role	68.9 (35.2)	74.4 (35.8)	0.44
Mental health	70.6 (22.7)	72.6 (23.6)	0.66
Mean of dimensions	69.5 (17.1)	70.7 (17.9)	0.72

Variables*	Odds ratio	p value	95%CI
Sex	0.78	0.48	0.40-1.54
Shift	1.31	0.45	0.64-2.68
Age (years)	0.48	<0.01	0.24-0.97
Anorexic symptoms	0.50	0.09	0.22-1.13
Peak VO₂ (mL/kg/min)	1.25	0.54	0.60-2.56
Bulimia symptoms	0.82	0.63	0.37-1.82
Binge	0.97	0.94	0.44-2.14
Body dissatisfaction	1.00	1.00	0.45-2.21
Bulimia severity	0.60	0.21	0.27-1.33
Trait-anxiety	1.21	0.63	0.55-2.69
State-anxiety	0.79	0.66	0.28-2.55
Depression	0.83	0.63	0.37-1.82
Total cholesterol (mg/dL)	0.58	0.12	0.28-1.17
HDL (mg/dL)	0.88	0.72	0.44-1.77
LDL (mg/dL)	0.94	0.88	0.44-2.03
VLD-L (mg/dL)	0.58	0.25	0.23-1.47
Glucose (mg/dL)	0.95	0.89	0.48-1.90
Triglycerides (mg/dL)	0.81	0.55	0.40-1.64
Physical functioning	0.59	0.19	0.26-1.30
Physical role	1.23	0.61	0.55-2.74
Pain	1.54	0.28	0.69-3.46
General health perception	1.46	0.35	0.66-3.23
Vitality	0.73	0.44	0.33-1.63
Social functioning	0.84	0.66	0.38-1.86
Emotional role	0.53	0.12	0.23-1.19
Mental health	1.03	0.94	0.47-2.27

Variables*	Odds ratio	p value	95%CI
Age (years)	0.40	0.05	0.15-0.98
Anorexic symptoms	0.35	0.02	0.14-0.86
Total cholesterol (mg/dl)	0.40	0.05	0.16-0.91
Physical functioning	0.67	0.41	0.26-1.73
Emotional role	0.47	0.13	0.18-1.26

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[1] Corresponding author: Yara Lucy Fidelix – Avenida Getúlio Vargas, 1,360 – Bairro Novo – Zip code: 53030-010 – Olinda, PE, Brazil – Phone: (55 81) 3493-2956 – E-mail: yarafidelix@hotmail.com