***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background Drop-out is a major problem in weight loss studies . Although previous attrition research has examined some predictors of drop-out , theoretically grounded research on psychological predictors of drop-out from weight interventions has been lacking . Purpose To examine psychological predictors of drop-out from a weight reduction study in diabetes type 2 patients . Method A clinical trial was conducted with 101 overweight/obese ( body mass index > 27 ) diabetes type 2 patients . Patients were r and omly assigned to a self-regulation intervention , an active control group , and a passive control group .  Psychological , somatic , socio-demographic , and lifestyle variables were examined as predictors of drop-out from baseline to 6 months follow-up . Results Multiple logistic regression analysis indicated that low autonomous regulation or low ‘ goal ownership ’ was the best predictor of drop-out . Conclusion It is suggested that the assessment of ‘ goal ownership ’ prior to a weight reduction intervention could identify patients who are sufficiently motivated to participate . Patients who score low on ‘ goal ownership ’ may be offered pretreatment interventions to increase their motivation OBJECTIVE Dropouts from clinical trials  decrease quality and increase costs .  Free participation , paid participation , and contingency contracting are three study retention methods . Contingency contracting , or depositing a fee to be refunded contingent upon attendance in a clinical trial , has been reported to decrease dropouts without affecting weight loss . These three methods of retention were compared with a commercial weight loss clinic 's practice of charging nonrefundable fees . METHODS AND PROCEDURES  Dropouts  were compared in two studies testing mazindol , with one study using free care  and the other using contingency contracting ; two studies testing phenylpropanolamine , one using free care  and the other using  contingency contracting ;  and in studies with phenylpropanolamine on file with Thompson Medical Company using free care , paid participation , and contingency contracting . RESULTS The dropout rate was 50 % at 8 weeks in a trial of mazindol with free care vs. 7 % for contingency contracting ( p<0.001 ) . The two phenylpropanolamine studies gave the same weight losses , but the dropouts were 37 % at 8 weeks for free care vs. 11 % for contingency contracting ( p<0.001 ) . The studies of phenylpropanolamine on file at the Thompson Medical Company had 28 % dropouts at 8 weeks using free care vs. 19 % for paid participation ( p<0.001 ) , and 11 % for contingency contracting ( p<0.005 ) . Dropouts with contingency contracting ( 11 % ) were not different from the commercial weight loss program ( 13 % ) . DISCUSSION Contingency contracting can decrease dropouts , improve quality , and decrease costs without affecting weight loss in clinical trials for obesity It is a consistent finding that , among obese patients , the weight lost as a result of the most widely available treatments for obesity is almost always regained . This relapse appears to be attributable to the individual 's inability to persist with the behavioural strategies needed to maintain the new lower weight . Little research has investigated the psychological mechanisms that might account for this phenomenon . This study aim ed to identify psychological factors that predict weight regain .  Fifty-four women with obesity who had lost weight by attending community slimming clubs  were interviewed immediately after losing 10 % of their initial body weight , and then followed-up every 2 months for a period of 1 year by means of telephone interviews . The results identified two prospect i ve predictors of weight regain : one cognitive factor ( dichotomous thinking ) and one historical variable ( maximum lifetime weight ) . The finding that a specific cognitive style is a significant predictor of relapse has implication s for the treatment of obesity Background Recruitment and retention are key functions for programs promoting nutrition and other lifestyle behavioral changes in low-income population s. This paper describes strategies for recruitment and retention and presents predictors of early ( two-month post intervention ) and late ( eight-month post intervention ) dropout ( non retention ) and overall retention among young , low-income overweight and obese mothers participating in a community-based r and omized pilot trial called Mothers In Motion . Methods Low-income overweight and obese African American and white mothers ages 18 to 34 were recruited from the Special Supplemental Nutrition Program for Women , Infants , and Children in southern Michigan . Participants ( n = 129 ) were r and omly assigned to an intervention ( n = 64 ) or control ( n = 65 ) group according to a stratification procedure to equalize representation in two racial groups ( African American and white ) and three body mass index categories ( 25.0 - 29.9 kg/m2 , 30.0 - 34.9 kg/m2 , and 35.0 - 39.9 kg/m2 ) . The 10-week theory-based culturally sensitive intervention focused on healthy eating , physical activity , and stress management messages that were delivered via an interactive DVD and reinforced by five peer-support group teleconferences . Forward stepwise multiple logistic regression was performed to examine whether dietary fat , fruit and vegetable intake behaviors , physical activity , perceived stress , positive and negative affect , depression , and race predicted dropout as data were collected two-month and eight-month after the active intervention phase . Results Trained personnel were successful in recruiting subjects . Increased level of depression was a predictor of early dropout ( odds ratio = 1.04 ; 95 % CI = 1.00 , 1.08 ; p = 0.03 ) . Greater stress predicted late dropout ( odds ratio = 0.20 ; 95 % CI = 0.00 , 0.37 ; p = 0.01 ) . Dietary fat , fruit , and vegetable intake behaviors , physical activity , positive and negative affect , and race were not associated with either early or late dropout . Less negative affect was a marginal predictor of participant retention ( odds ratio = 0.57 ; 95 % CI = 0.31 , 1.03 ; p = 0.06 ) . Conclusion Dropout rates in this study were higher for participants who reported higher levels of depression and stress . Trial registration Current Controlled Trials Background : Data are limited as to whether participants in diet trials truly adhere to their assigned diet and the factors that affect their adherence . Methods : We evaluated success and adherence in a two-year dietary intervention r and omized controlled trial ( DIRECT ) in which 322 moderately obese participants ( mean age 52 yrs , mean body-mass-index ( BMI ) 31 kg/m2 , 86 % men ) were r and omized to one of three groups : low-fat , Mediterranean , or low-carbohydrate diets . Results : Overall compliance at month-24 was 85 % , with 90 % in low-fat , 85 % in Mediterranean , and 78 % in low-carbohydrate diet ( p = .042 between groups ) . Attrition was higher in women ( 29 % vs. 14 % men , p = .001 ) and current smokers ( 25 % vs. 14 % among maintainers , p = 0.04 ) . In a multivariate model , independent predictors of dropping-out were : higher baseline BMI ( OR = 1.11 ; CI : 1.03–1.21 ) and less weight loss at month-6 ( OR = 1.20 ; CI : 1.1–1.3 ) . In a multivariate model , greater weight loss achieved at month-6 was the main predictor associated with success in weight loss ( > 5 % ) over 2 years ( OR = 1.5 ; CI : 1.35–1.67 ) . Self-reported complete adherence score to diet was greater on low-carbohydrate diet ( p < .05 compared to low-fat ) until month-6 , but dropped overall from 81 % at month-1 to 57 % at month-24 . Holidays were a trigger to a significant decrease in adherence followed by a partial rebound . Changes in diet composition from month-1 to month-12 were more pronounced in the multi-stage low-carbohydrate diet-group ( p < .05 ) . Generally , the most irresistible restricted food items were cookies ( 45 % of dieters ) and fruits ( 30 % ) . Among the physically active ( n = 107 ) , 44 % reported a tendency to eat less after exercising compared to 10 % who tended to eat more . Conclusion : Initial 6-month reduction in weight is the main predictor of both long-term retention and success in weight loss . Special attention is needed for women , current smokers , and during holidays . Physical activity is associated with subsequent reduction in energy intake OBJECTIVE : A widely held clinical belief is that individuals with binge eating problems fare poorly in weight loss programs . The empirical evidence regarding the prognostic significance of binge eating , however , is mixed . The goals of this study were to examine psychological and behavioral characteristics associated with binge eating and the prognostic significance of binge eating for short- and long-term weight loss in a large sample of women treated for obesity . DESIGN : The data set used in the current study was a combined sample of women ( n=444 ) who participated in one of three behavioral weight loss research studies . MATERIAL S AND METHOD : Measures of dieting and weight history were obtained at baseline . Body weight , the Binge Eating Scale ( BES ) , a measure of perceived barriers to weight loss , the Beck Depression Inventory , the Block Food Frequency Question naire , and the Paffenbarger Physical Activity Question naire  were assessed at baseline , 6 months and 18 months . Regression analyses examined cross-sectional associations between the BES and the other variables at baseline , prospect i ve associations between baseline BES and changes in weight and the psychological and behavioral variables over time , and temporal covariations between BES and the other variables over time . RESULTS : Cross-sectional analyses showed baseline binge eating status to be strongly associated with dieting history , weight cycling , depressive symptomatology and perceived barriers to weight loss .  Women with binge eating problems were also more likely to drop out of treatment . Baseline binge status was not associated with 6-month weight loss , but was weakly predictive of less weight loss success at 18 months . Binge status at baseline did not predict changes in dietary intake , physical activity , perceived barriers to weight loss or depressive symptomatology at either 6 months or 18 months . In time-dependent covariance analyses , changes in BES scores were significantly associated with changes in body weight , independent of changes in dietary intake and physical activity . However , when depression scores are included in the analysis , the association between binge score and body weight was no longer statistically significant . CONCLUSION : These findings suggest that baseline binge status was a weak prognostic indicator of success in women who are moderately obese and are seeking treatment for weight loss . Although assessment s of binge status covary with weight loss and regain , the relationship appears to be mediated by psychological dysphoria This prospect i ve study examined the use of the eating inventory and its association with adherence , attrition , and dysphoric emotional states on patients treated with a very low calorie diet ( VLCD ) .  Subjects were 81 severely ( medically significant ) obese patients ( mean BMI ( weight in kilograms/height in meters squared ) for women 36.25 ; men 39.16 ) enrolled in a university-based weight reduction program employing a liquid protein supplement VLCD with behavior modification . The eating inventory 's factors hunger and restraint successfully discriminated attrition/adherence groups while disinhibition did not . Subjects with scores above the mean on disinhibition and hunger and below the mean on restraint had consistently poorer outcomes . The hunger factor was significantly related to dietary nonadherence , with those scoring in the highest quartile on this dimension eating three times the number of calories of those scoring in the lowest quartile . Disinhibition and hunger were significantly related to anxiety and depression while restraint was not . These findings provide support for the use of the eating inventory in screening and treatment of severely obese patients receiving very low calorie diets This naturalistic study assessed client changes during treatment and identified salient predictors of therapy attendance and outcome . Subjects were assessed on processes and stages of change , self-efficacy , social support , weight history ( including expectations , goals , and reasons for losing weight ) , and demographics at the beginning , middle , and end of a 10-week , behaviorally oriented work site program for weight control .  Significant shifts from contemplation to action occurred for clients remaining in treatment . There were also significant modifications in the use of change processes as a result of treatment : counterconditioning , contingency management , stimulus control , interpersonal control , and social liberation increased while medication use , wishful thinking , and minimizing threats decreased . Change processes employed during the early portion of the group treatment were the best predictors of treatment attendance and outcome , superior to self-efficacy , social support , weight history , and demographic variables . The results supported a transtheoretical model that emphasizes dynamic processes and stages as core dimensions for underst and ing how people change OBJECTIVE : To assess the factors that could predict a successful completion of a weight loss program . STUDY DESIGN : A single-centered , cross-sectional , prospect i ve study conducted over 4 y . SUBJECTS : Data were obtained on 1018 overweight subjects ( 788 women , 230 men ) aged 14.8–76.3 y ( mean 38.4 ) and body mass index ( BMI ) of 31.7 ( range 25.03–57.1 ) seeking help to lose weight at a specialist obesity clinic . MATERIAL S AND METHODS : A program involving a hypocaloric , Mediterranean diet was prescribed plus recommendations for free- 
    Output:
    
However , psychological and behavioural patient factors and processes associated with the treatment were more commonly associated with attrition than patient background characteristics .