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Factors Associated with Attrition and Successful Weight Loss in a Clinical Weight Management Program
Abstracts / Can J Diabetes 39 (2015) S38eS74
on the rise over the last 2 decades in Canada. What is troublesome is that these conditions are influenced by a small set of wellestablished, modifiable causes such as an unhealthy diet, and lack of physical activity. Community-based health education interventions seem to have better impact on increasing men’s health literacy and motivation for healthy lifestyle. However, few studies have explored the effectiveness of these interventions among Canadian men. Objectives: 1) to assess the acceptability and feasibility of a community-based intervention aiming to promote healthy practices among men; and 2) to develop a set of recommendations to support men-sensitive healthcare decision making. Methods: Qualitative study using semi-structured interviews with 15 health professionals and 3 focus groups with overweight/ obese men. Verbatim were analyzed using a thematic content analysis. Results/Conclusion: Men-sensitive interventions need to include: 1) health information that is easily retrievable, actionoriented and delivered in simple and concise terms; 2) involve peers, friends and family; 3) shared decision making, comprehensiveness of care, informational continuity, support and humanity practices; 4) awareness campaign and information to address prejudice related to hegemonic masculinity; 5) interventions must be easily integrated into daily life, thus suggesting the inclusion of workplaces and flexible hours; and 6) healthcare managers and Health professionals continuing educational sessions on men’s health needs and expectations. We propose a men-sensitive educational intervention to guide future interventions and research on weight control and management in men.
P9.10 Assessment of the State of Bariatric Surgery in Canada: Prospective and Retrospective Approaches HONG JI*, ALLIE CHEN*, DEREK LEFEBVRE, JOSH FAGBEMI, CHERYL GULA Canadian Institute for Health Information, Toronto, ON, Canada Several jurisdictions recently identified bariatric surgery as a priority responding to the continuing rise in obesity rates and the increasing public attention to bariatric surgery. However, few studies, using pan-Canadian data, have assessed the quality of care and patient safety following the improved access to bariatric surgery. This study examines the current state of bariatric surgery in Canada and describes several aspects of patients’ hospital experiences and outcomes using mainly administrative data from the Canadian Institute for Health Information (CIHI). The main analytic cohort included about 6000 bariatric surgeries performed in Canadian hospitals, 2012-2013. The findings suggest that the typical bariatric surgery patient is a woman in her 40s who has obesity and other conditions such as diabetes, hypertension or sleep disorders. Gastric bypass was the most commonly performed bariatric surgery (53%), followed by sleeve gastrectomy (28%) and gastric banding (15%). Overall, 5% of bariatric surgery patients experienced complications during their hospitalization, and 6% were readmitted to hospital within 30 days of discharge. Prospective and retrospective approaches were applied to a separate cohort of about 3100 bariatric surgeries in 2009-2010 to identify hospital use within 3 years before and after bariatric surgery. Short-term increases in use of hospital care often follow bariatric surgery, including both follow-up care directly related to the surgery and deferred procedures, such as joint replacements or hernia repairs. The findings of this study inform policy makers and medical practitioners in their ongoing efforts to improve access to and outcomes of publicly covered bariatric procedures.
S69
P9.11 Factors Associated with Attrition and Successful Weight Loss in a Clinical Weight Management Program DISHAY JIANDANI*, SEAN WHARTON, JENNIFER L. KUK York University, Toronto, ON, Canada Background: High attrition rates are commonly seen in clinical weight management programs. Our objective was to identify predictors of early attrition in an obesity management program. Methods: Participants were 7,440 patients enrolled in treatment at Wharton Medical Clinic for at least 6 months. Differences in weight loss between groups (<6 months and 6 months) were identified using independent t-tests. Predictors of early attrition (<6 months) and successful weight loss (5%) were evaluated using Relative Risk (RR). Results: Older individuals and non-smokers had lower attrition rates (RR Range: 0.84-0.92; P<0.05) and greater weight loss success (RR Range: 1.31-1.81; P<0.05) compared to younger individuals and smokers. T2D was associated with lower attrition (RR Range: 0.79-0.86; P<0.05) where as a prior history of cancer was associated with higher attrition (RR Range: 1.41-1.69; P<0.05). Nonwhite ethnicity was related to lower weight loss success (5%) in both males (P¼0.02) and females (P¼0.002). However, age, ethnicity, smoking status and health outcomes did not predict attrition or successful weight loss over time. Individuals who were in treatment longer than 6 months had greater weight loss compared to those in treatment less than 6 months (P<0.05). However, there were no differences in the rate of weight loss between groups (P>0.05). Conclusion: Treatment time appears to be an important predictor of successful weight loss and lower attrition. Therefore, understanding why people leave treatment may be important as it may help improve treatment outcomes and improve attrition rates in clinical weight loss programs.
P9.12 Sleep and Metabolic Health in Adults with Obesity THIRUMAGAL KANAGASABAI*, RAMANDEEP DHANOA, JENNIFER L. KUK, CHRIS I. ARDERN York University, Toronto, ON, Canada Background: Metabolic syndrome is a common consequence of obesity, but up to a third of individuals with obesity are metabolically healthy (MHO). Both short and long sleep durations, and poor sleep quality are associated with weight gain and metabolic dysfunction. However, the extent to which sleep affects MHO status requires further study. Objective: To evaluate the relationship between sleep duration and quality with MHO. Methods: Data from the 2005-8 National Health and Nutritional Examination Survey was used (body mass index [BMI]: 30 kg/m2 or higher; N¼1,777; 20 y or older). Sleep habits of participants were obtained from the Sleep Disorders Questionnaire. MHO was defined as the absence of metabolic syndrome according to the Joint Interim Statement. Results: Overall measures of sleep duration and quality were not related to MHO; however, in fully adjusted models, those reporting ‘almost always’ to waking up during the night, feeling unrested during the day, feeling overly sleepy during the day, and trouble falling asleep had a more than 50% lower odds of being MHO (OR¼0.38 (95% CI: 0.19, 0.73), OR¼0.48 (0.27, 0.88), OR¼0.48 (0.24, 0.98), and OR¼0.51 (0.28, 0.93), respectively). Conclusion: Regular sleep disturbances, but not perceived quantity or quality of sleep, are associated with the MHO phenotype.
on the rise over the last 2 decades in Canada. What is troublesome is that these conditions are influenced by a small set of wellestablished, modifiable causes such as an unhealthy diet, and lack of physical activity. Community-based health education interventions seem to have better impact on increasing men’s health literacy and motivation for healthy lifestyle. However, few studies have explored the effectiveness of these interventions among Canadian men. Objectives: 1) to assess the acceptability and feasibility of a community-based intervention aiming to promote healthy practices among men; and 2) to develop a set of recommendations to support men-sensitive healthcare decision making. Methods: Qualitative study using semi-structured interviews with 15 health professionals and 3 focus groups with overweight/ obese men. Verbatim were analyzed using a thematic content analysis. Results/Conclusion: Men-sensitive interventions need to include: 1) health information that is easily retrievable, actionoriented and delivered in simple and concise terms; 2) involve peers, friends and family; 3) shared decision making, comprehensiveness of care, informational continuity, support and humanity practices; 4) awareness campaign and information to address prejudice related to hegemonic masculinity; 5) interventions must be easily integrated into daily life, thus suggesting the inclusion of workplaces and flexible hours; and 6) healthcare managers and Health professionals continuing educational sessions on men’s health needs and expectations. We propose a men-sensitive educational intervention to guide future interventions and research on weight control and management in men.
P9.10 Assessment of the State of Bariatric Surgery in Canada: Prospective and Retrospective Approaches HONG JI*, ALLIE CHEN*, DEREK LEFEBVRE, JOSH FAGBEMI, CHERYL GULA Canadian Institute for Health Information, Toronto, ON, Canada Several jurisdictions recently identified bariatric surgery as a priority responding to the continuing rise in obesity rates and the increasing public attention to bariatric surgery. However, few studies, using pan-Canadian data, have assessed the quality of care and patient safety following the improved access to bariatric surgery. This study examines the current state of bariatric surgery in Canada and describes several aspects of patients’ hospital experiences and outcomes using mainly administrative data from the Canadian Institute for Health Information (CIHI). The main analytic cohort included about 6000 bariatric surgeries performed in Canadian hospitals, 2012-2013. The findings suggest that the typical bariatric surgery patient is a woman in her 40s who has obesity and other conditions such as diabetes, hypertension or sleep disorders. Gastric bypass was the most commonly performed bariatric surgery (53%), followed by sleeve gastrectomy (28%) and gastric banding (15%). Overall, 5% of bariatric surgery patients experienced complications during their hospitalization, and 6% were readmitted to hospital within 30 days of discharge. Prospective and retrospective approaches were applied to a separate cohort of about 3100 bariatric surgeries in 2009-2010 to identify hospital use within 3 years before and after bariatric surgery. Short-term increases in use of hospital care often follow bariatric surgery, including both follow-up care directly related to the surgery and deferred procedures, such as joint replacements or hernia repairs. The findings of this study inform policy makers and medical practitioners in their ongoing efforts to improve access to and outcomes of publicly covered bariatric procedures.
S69
P9.11 Factors Associated with Attrition and Successful Weight Loss in a Clinical Weight Management Program DISHAY JIANDANI*, SEAN WHARTON, JENNIFER L. KUK York University, Toronto, ON, Canada Background: High attrition rates are commonly seen in clinical weight management programs. Our objective was to identify predictors of early attrition in an obesity management program. Methods: Participants were 7,440 patients enrolled in treatment at Wharton Medical Clinic for at least 6 months. Differences in weight loss between groups (<6 months and 6 months) were identified using independent t-tests. Predictors of early attrition (<6 months) and successful weight loss (5%) were evaluated using Relative Risk (RR). Results: Older individuals and non-smokers had lower attrition rates (RR Range: 0.84-0.92; P<0.05) and greater weight loss success (RR Range: 1.31-1.81; P<0.05) compared to younger individuals and smokers. T2D was associated with lower attrition (RR Range: 0.79-0.86; P<0.05) where as a prior history of cancer was associated with higher attrition (RR Range: 1.41-1.69; P<0.05). Nonwhite ethnicity was related to lower weight loss success (5%) in both males (P¼0.02) and females (P¼0.002). However, age, ethnicity, smoking status and health outcomes did not predict attrition or successful weight loss over time. Individuals who were in treatment longer than 6 months had greater weight loss compared to those in treatment less than 6 months (P<0.05). However, there were no differences in the rate of weight loss between groups (P>0.05). Conclusion: Treatment time appears to be an important predictor of successful weight loss and lower attrition. Therefore, understanding why people leave treatment may be important as it may help improve treatment outcomes and improve attrition rates in clinical weight loss programs.
P9.12 Sleep and Metabolic Health in Adults with Obesity THIRUMAGAL KANAGASABAI*, RAMANDEEP DHANOA, JENNIFER L. KUK, CHRIS I. ARDERN York University, Toronto, ON, Canada Background: Metabolic syndrome is a common consequence of obesity, but up to a third of individuals with obesity are metabolically healthy (MHO). Both short and long sleep durations, and poor sleep quality are associated with weight gain and metabolic dysfunction. However, the extent to which sleep affects MHO status requires further study. Objective: To evaluate the relationship between sleep duration and quality with MHO. Methods: Data from the 2005-8 National Health and Nutritional Examination Survey was used (body mass index [BMI]: 30 kg/m2 or higher; N¼1,777; 20 y or older). Sleep habits of participants were obtained from the Sleep Disorders Questionnaire. MHO was defined as the absence of metabolic syndrome according to the Joint Interim Statement. Results: Overall measures of sleep duration and quality were not related to MHO; however, in fully adjusted models, those reporting ‘almost always’ to waking up during the night, feeling unrested during the day, feeling overly sleepy during the day, and trouble falling asleep had a more than 50% lower odds of being MHO (OR¼0.38 (95% CI: 0.19, 0.73), OR¼0.48 (0.27, 0.88), OR¼0.48 (0.24, 0.98), and OR¼0.51 (0.28, 0.93), respectively). Conclusion: Regular sleep disturbances, but not perceived quantity or quality of sleep, are associated with the MHO phenotype.