Browsing by Subject "Attrition"

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    The effect of habitual sleep duration on weight loss during a behavioral weight loss intervention in a Mediterranean population
    (Elsevier, 2025-09-19) Rodríguez Martín, María; Szczerbinski, Lukasz; Garaulet Aza, Marta; Dashti, Hassan S.; Fisiología; Facultades de la UMU::Facultad de Biología
    Background Sleep duration affects metabolic health and regulates appetite, but its role in behavioral weight loss interventions remains unclear as prior studies are limited by small sample sizes, cross-sectional designs, and inconsistent findings. Objectives This study aims to examine the associations between nighttime sleep duration and weight loss during a behavioral intervention in adults with overweight or obesity in Spain. Methods This secondary analysis included adults with overweight or obesity from the Obesity, Nutrigenetics, Timing, and Mediterranean study, a 25-wk behavioral weight loss program. Participants self-reported sleep duration at enrollment and were categorized as short (<7 h), recommended (7–8 h), or long (>8 h) sleepers. Outcomes included percentage of weight loss, clinically meaningful or successful weight loss (≥5% of initial body weight), rate of weight loss (high/rapid rate ≥0.53 kg/wk), and attrition. Associations were examined using logistic regression and linear mixed-effects models adjusted for age, sex, baseline weight, intervention duration, and clinic site. Results Among 3628 participants (mean age 41.2 ± 14.1 y; 77.6% women), 23.7% reported sleeping >8 h, 60.9% reported sleeping 7–8 h, and 15.4% reported sleeping <7 h per night. Long sleepers had significantly lower average weight loss (7.42% of baseline weight) compared with recommended sleepers (7.90%, P = 0.015). Long sleep was associated with 21% lower odds of achieving a weight loss ≥5% of baseline weight [odds ratio (OR): 0.79; 95% confidence interval (CI): 0.66, 0.96], 25% lower odds of rapid weight loss (OR: 0.75; 95% CI: 0.63, 0.89), and 21% higher odds of attrition (OR: 1.21; 95% CI: 1.03, 1.43) compared with recommended sleep. No significant associations were observed for short sleepers. Linear mixed-effects models indicated lower weight loss among long sleepers [β: 0.099; standard error (SE): 0.040; P = 0.015], but not for short sleepers (β: −0.031; SE: 0.048; P = 0.514). Conclusions Habitual long sleep duration is associated with reduced weight loss success and increased risk of attrition in a behavioral weight loss intervention. This trial was registered at clinicaltrials.gov as NCT02829619.