General Hospital Psychiatry
Volume 32, Issue 2 , Pages 132-140, March 2010

Do mental disorders and eating patterns affect long-term weight loss maintenance?☆☆

  • Tanja Marina Legenbauer, Ph.D.

      Affiliations

    • Department of Psychosomatic Medicine and Psychotherapy, LWL-Klinik Dortmund, Ruhr-University Bochum, 44287 Dortmund, Germany
    • Corresponding Author InformationCorresponding author. Tel.: +49 23145032396; fax: +49 2314503 2743.
  • ,
  • Martina de Zwaan, M.D.

      Affiliations

    • Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, 91054 Erlangen, Germany
  • ,
  • Barbara Mühlhans, Psy.D.

      Affiliations

    • Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, 91054 Erlangen, Germany
  • ,
  • Frank Petrak, Ph.D.

      Affiliations

    • Department of Psychosomatic Medicine and Psychotherapy, LWL-Klinik Dortmund, Ruhr-University Bochum, 44287 Dortmund, Germany
  • ,
  • Stephan Herpertz, M.D.

      Affiliations

    • Department of Psychosomatic Medicine and Psychotherapy, LWL-Klinik Dortmund, Ruhr-University Bochum, 44287 Dortmund, Germany

Received 24 September 2008; accepted 9 September 2009. published online 15 October 2009.

Abstract 

Objective

This study aimed to assess the impact of mental disorders on weight loss maintenance among initially successful weight losers who participated in a very-low-calorie diet program.

Method

A total of 251 obese individuals were assessed in a prospective longitudinal study over a period of 4 years. Mental disorders and eating patterns were assessed by structured interviews at baseline and by standardized questionnaires at baseline (T1), after 1 year (T2) and on 3-year follow-up (T3). Analyses were performed with an intention-to-treat method.

Results

Based on the intention-to-treat sample, 166 successful weight losers at T2 (weight loss ≥10%) were identified. Of those, 47 (28.3%) maintained a weight loss of ≥5% of their pretreatment weight, whereas 119 (71.7%) maintained a loss of less than 5% of their pretreatment weight at T3. History of substance abuse/dependence disorder and grazing prior to treatment increased the likelihood of successful weight loss maintenance. High levels of cognitive control, low levels of disinhibition on 3-year follow-up and initial body mass index also were associated with successful weight loss maintenance.

Conclusion

Strategies that helped individuals overcome earlier mental disorders might help to establish better self-regulation and maintain high cognitive control of eating and subsequently increase the possibility of maintaining weight loss in the long run.

Keywords: Predictor variables on weight loss, Depression, Binge eating, VLCD weight loss treatment, Successful weight loss, Weight loss maintenance

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 S. Herpertz has received honoraria or travel support from Lilly, Lundbeck, Pfizer and Sanofi-Aventis. F. Petrak has received honoraria and grant/research support from Pfizer, Berlin-Chemie, Lilly and Novo Nordisk Pharma.

☆☆ T.M. Legenbauer, M. de Zwaan and B. Mühlhans report no conflict of interest.

PII: S0163-8343(09)00175-3

doi:10.1016/j.genhosppsych.2009.09.001

General Hospital Psychiatry
Volume 32, Issue 2 , Pages 132-140, March 2010