Losing Weight--And Not Finding It Again, Part II
Obesity is recognized as a serious chronic disease, but there is pessimism about how successful treatment can be. One pessimistic view is that almost no one succeeds in long-term maintenance of weight loss. For this blog, I will define success as "individuals who have intentionally lost at least 10% of their body weight and kept it off at least one year."
Last year Kruger et al. reported that adults who avoided eating at fast-food restaurants were more successful at weight loss maintenance. Adults who consumed fewer than five fruit and vegetable servings per day and accrued 420 minutes or more per week of physical activity or consumed five or more fruit and vegetable servings and accrued 150 minutes or more per week of activity were more successful at weight loss maintenance.”
Wing and Phelan at Brown University established the national weight loss registry and reported recently that participants in the registry report having lost an average of 33 kg and have maintained the minimum weight loss (13.6 kg)for an average of 5.7 years. Thirteen percent have maintained this minimum weight loss for more than 10 years.
How has keeping unwanted weight off accomplished? Wing and Phelan note that “About one-half reported receiving some type of help with weight loss (commercial program, physician and nutritionist). Eighty-nine percent reported using both diet and physical activity for weight loss. The most common dietary strategies for weight loss were to restrict certain foods, limit quantities and count calories. Approximately 25% counted fat grams.
“Three strategies were reported very consistently: 1) consuming a low-calorie, low-fat diet, 2) doing high levels of physical activity, and 3) weighing themselves frequently. Recently, a fourth behavior was identified: consuming breakfast daily. Registry members maintain their weight loss by continuing to eat a low-calorie, low-fat diet.
“Another characteristic of registry members is high levels of physical activity. These levels of activity would represent approximately 1 hour per day of moderate-intensity activity, such as brisk walking.
Registry members also reported frequent monitoring of their weight. More than 44% report weighing themselves at least once a day.”
The vigilance regarding body weight can be seen as one aspect of the more general construct of degree of conscious control exerted over eating behaviors. There are some Web sites that serve as ‘group therapy’ session to aid in this effort.
Maintaining weight after a loss is difficult, but possible.