By Alan Mozes
NEW YORK, Jan 07 (Reuters Health) -- Obese men and women who undertake
strict dieting regimens followed by a long-term commitment to good eating habits
and regular exercise are better able than previously thought to keep a
significant portion of weight loss off 5 to 7 years down the road, researchers
have found.
"Despite the discouraging reports we've generally heard, the good news is
that people can maintain long-term weight loss," said study lead author Dr.
James W. Anderson, professor of medicine and clinical nutrition at the
University of Kentucky in Lexington. The report is published in the December
issue of the Journal of American College of Nutrition.
Anderson's team studied 112 men and women between the ages of 20 and 70
for a 7-year period between 1989 and 1996, placing them initially on a very
low-calorie diet program for an average of 5 months. The diet -- 520 calories
per day from "diet shakes" -- was supplemented with multivitamins. The study
participants also had weekly medical monitoring of their food intake and
physical activity levels, and attended a behavior modification instruction
program that focused on teaching long-term weight maintenance skills. Both
initial weight loss figures and follow-up numbers 5 to 7 years later were
recorded.
It was found that after the initial average weight loss of 29.7 kg (about
65 pounds), the dieters rapidly regained a large percentage of their loss within
the first 3 years. However, between the 4th and 7th years, the participants'
weight loss stabilized at an average of 23% of the initial loss.
Furthermore, by defining 'successful weight maintenance' as the ability to
keep off at least 10% of the dieter's initial body weight, it was determined
that after 3 years, 31% of the 112 participants were successful in maintaining
their losses, and after 7 years 25% were similarly successful -- with men and
women achieving the same rates of success.
"Exercise, low-fat food choices, using meal replacement (milk shakes or
entrees), and eating fruits and vegetables contribute to these successes in
weight maintenance," Anderson said in a statement.
In an interview with Reuters Health, Anderson attributed the higher than
expected success rates to the "development of habits and lifestyle changes" that
the diet and maintenance program helped to promote.
"Our approach to weight maintenance has changed over the last 5 to 10
years," said Anderson. "We've realized that this is not an education process --
it's a treatment process. People can rent videos and get all sorts of education,
but what is required is to sustain behavior in a situation where there is
accountability and coaching."
Anderson advised that for this reason individual dieters are more likely
to lose and keep off the weight if they are in a "structured program" such as
the one used in the study. "It's difficult for most people to do it on their
own, with self-help books and that sort of thing," said Anderson. "They need to
work with a dietician and a weight-loss program." He pointed to the American
Obesity Association website (www.obesity.org) and the National Institute of
Health website (www.nih.gov/index/html) as good sources of information on
programs for healthy dieting.
But Anderson cautioned that when looking into such information on various
weight-loss programs, the prospective dieter will run into "all sorts of crazy
and unproven approaches to weight loss with the gimmick of a no-diet program" --
playing off the fear many obese people have of the word 'diet' itself.
Nonetheless, Anderson noted that if "you don't want to say the 4 letter 'D' word
that's fine... but that's where it's at. 'Diet' and 'fruits' wouldn't win any
popularity contests, but that's where we need to go."
