Sunday, April 07, 2013
I have a binder that I keep academic articles about maintenance in. I'm about to switch from a skinny binder to a small one. Last night I read a third paper about the same study, which was the STOP regain program for new maintainers where at 18 months half the participants were still within 5 lbs of goal weight. Half, not 5% you might have read in the media or 20% the academics say is closer to right. I'm a little obsessed with what these people learned. And digging deeper, reading the same papers over again and finding new ones, I do see things in a different light.
One particular mystery to me has been the depressive symptomology parameter. It was really tantalizing because I struggled with chronic depression for decades so I am concerned about it.
"these findings suggest that negative affect and tendencies to uncontrolled eating may be associated with problems in the long term maintenance of weight loss. Behavioral weight control programs teach participants to identify and try to change negative thoughts and to plan ahead to prevent lapses from becoming relapses. Those individuals who practice these skills may be better able to deal effectively with periods of overeating or slips from the program" (Wing et al. 2008)
So that was good to read. I was already tending toward the cognitive behavior approach in my maintenance FANS post. That is, you may not be able to choose your feelings, but you can work on your thought patterns and responses to events that lead to feelings.
And on this read through of the study I made a connection that seems rather obvious in hindsight. The primary predictor of maintenance success is consistent fitness, and fitness elevates mood. I'm not a fan of telling people to pump iron instead of Prozac; if you have distinct symptoms of depression you should get help because it is a disease just like cancer. But as a preventive measure exercise is good for the brain.
I used to feel people dismissed the importance of nutrition in a healthy lifestyle, that in losing weight I felt it was 60% nutrition and 40% fitness. But the value of fitness in maintenance is so important in preserving lean mass and revving the metabolism, sustaining mood and possibly in controlling appetite. So maybe it shifts between nutrition and fitness as you move into maintenance. Or maybe it's not one more than the other. I don't know, though. Maybe it's like marriage where 75%+75%=100%. Well, I'm leaving the blog title anyway.
The article is Maintaining Large Weight Losses: the role of behavioral and psychological factors (wing et al. 2008)