Introduction: The increasing prevalence of obesity in conjunction with the lack of effective non-surgical treatments highlights the need for better treatment strategies. To improve patient selection for lifestyle intervention, we sought to determine the patient characteristics associated with favourable weight outcomes following 12 months of personalised management in the Endocrinologist-led Royal Melbourne Hospital Bariatric Medicine Clinic (RMH BMC).
Methods: A retrospective assessment of medical records, patient surveys and pathology results was performed in 313 patients who attended the RMH BMC between 2012 and 2018. The final cohort comprised 113 adults (age, 48.4(±14.2)y; BMI, 44.9(± 7.7)kg/m2) who completed 12 months follow-up. Thirty-six clinical, psychosocial and biological variables were investigated in relation to the primary outcome measure of weight loss (% bodyweight).
Results: Of all starting participants, there was a high loss to follow up rate of 64% (n = 200) whom did not complete 12 months of clinical care. Those remaining had a mean of 4.1 ± 8.7 kg or 3.3(± 6.8)% weight loss. In a multivariate correlation/regression analysis significant predictors of higher percentage weight loss were; clinic attendance (p=0.004), consultant at initial visit (p=0.009), clinician adherence (p=0.018), dietitian adherence (p=0.049), excess alcohol intake (p=0.005), older age at clinic entry (p=0.026), higher age of obesity onset (p=0.009), osteoarthritis of weight-bearing joints (p=0.002), higher Edmonton Obesity Stage (p=0.019), higher baseline HbA1c (p=0.001), higher baseline and fasting blood glucose (p=0.035). Significant negative predictors were a diagnosis of depression (p=0.045). All predictors were independently associated with weight loss.
Conclusion: Predictors of weight loss span different domains, reflecting the multifactorial nature of obesity. These findings suggest the medical management for weight loss is more likely to effective in patients lose who are older, became obese at an older age, have osteoarthritis or excessive alcohol intake.