Tuesday, July 12, 2011
While Russ gets the wekeepitoff.com site back up and running, I'm going to repost my columns from there on my blog here so I can refer to them when I need to.
It is accepted as common knowledge that to keep the weight off, you need to continue doing the things you did to get it off. If everyone says this and believes it, then it must be right.
That is the premise of a study to be published next month by Sciamanna et. al. in the American Journal of Preventive Medicine.
The authors asked, “what if there is a difference between the behaviors associated with successful weight loss and successful weight maintenance”?
As the authors point out, most maintenance-oriented programs focus on getting people to continue the behaviors that helped them lose weight. They do not focus specifically on behaviors known to help keep weight off. It turns out there IS a difference, after all.
And this is important, because getting people to focus on less helpful behaviors might be throwing them off track when they get to maintenance.
The authors surveyed 1165 US adults who responded to online and newspaper advertisements. 926 of these people said their BMI had been greater than 25 at some point (overweight).
To figure out what worked for weight loss they took these 926 people who had been overweight and split them into two groups. One group had lost at least 10% of their weight over the past year (98) and the other had not (828).
To figure out what worked for weight maintenance they took these same 926 people and split them into two groups. One group had lost at least 10% of their body weight more than a year ago and kept it off for at least a year (192). The other group had not kept the weight off or lost it in the first place (734).
They asked these people about what they do in their every day lives. There were questions about food management, physical activity, thinking about weight control, and about tracking methods.
Then they looked for patterns among what successful losers do and patterns among what successful maintainers do. And they found significant differences. For example, people who exercised consistently or ate plenty of lean protein were almost twice as likely to succeed in weight maintenance. People who engaged in a variety of exercise activities or planned their meals ahead were about two and a half times as likely to lose weight.
For losers, these were the behaviors most statistically significant (p 0.001):
Eating plenty of fruits or vegetables
Eating healthy snacks
Limiting the amount of carbohydrates eaten
Doing different kinds of exercise
For maintainers, these were the behaviors most statistically significant (p 0.001):
Eating plenty of low-fat protein
Following a consistent exercise routine
Reminding yourself why you need to control your weight
There was only one behavior highly significant among both losers and maintainers:
Thinking about how much progress you’ve made
But what really has the researchers excited is that there were 14 behaviors associated with either loss or maintenance but not both.
More important for loss than for maintenance:
Participate in a weight loss program
Look for information about weight loss, nutrition, or exercise
Eat healthy snacks
Limit the amount of sugar you eat or drink
Plan what you'll eat ahead of time
Avoid skipping a meal, including breakfast
Do different kinds of exercises
Do exercises you enjoy
Think about how much better you feel when you are thinner
More important for maintenance than for loss:
Eat plenty of low-fat sources of protein
Follow a consistent exercise routine
Reward yourself for sticking to your diet or exercise plan
Remind yourself why you need to control your weight
Write down what you eat and drink each day
What does this mean for us? It means that while transitioning from weight loss to weight maintenance we might need to adjust some of our behaviors. The two modes are distinctly different. It also means that once we’re in “maintenance mode,” if we do gain some weight back, we need to go back into “loss mode” until the weight is back in the happy range.
It means that we need to pay close attention to what works for us during this transition phase. I like to think of it as having training wheels on our maintenance programs. We need to take the time to figure maintenance out through trial and error.
This kind of study gives me tremendous hope. Hope that one day there will be dedicated, evidence-based programs designed specifically for weight maintenance. Hope that one day because of these programs more 20% of us will manage to keep the weight off.
Until that day we’re going to have to figure this out for ourselves from the primary literature and hobble along with the few weight maintenance programs there are - most a clumsy afterthought tacked onto the end of a weight-loss program that focuses on continuing weight-loss behaviors rather than emphasizing weight-maintenance ones.