Study offers new way to diet: Just don't gain
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If you’ve tried to drop more than a few pounds and are disappointed when the scale won’t budge, a surprising new study may help you feel better.
Researchers from Duke University found that by focusing on not gaining weight, rather than losing, people are more likely to stay committed to a long-term plan and avoid the dreaded "weight creep" -- that is, gaining one or two pounds a year. Weight creep is part of what causes someone to go beyond simply being overweight or early obesity to more serious medical obesity and increased health risks.
Duke researchers targeted 194 premenopausal African-American women who were overweight, or Class 1 obese -- that is, with a body mass index between 25 and 34.9. African-American women historically have had even less weight-loss success than other groups, including African-American men, and Caucasian men and women. According to the Centers for Disease Control and Prevention, about 80 percent of black women are considered overweight or obese, compared to the incidence in white women of around 60 percent.
Their average age was 35.4 years (range between 24 – 44 years), with an average BMI of 30.2 (range between 25 and 34.9 and an average weight of 179 pounds). Participants were told this was NOT a weight loss study, and that their goal was lifestyle change to improve their overall well being and to maintain their current body shape.
The thinking was, if new strategies could help black women who were overweight or class 1 obese stabilize their weight, then the plan could be a long-term, scalable and economic way to battle the obesity epidemic.
Using the “Shape” intervention plan, a one-year evidence-based treatment program, participants made improved food choices, trimmed less than 200 calories a day (weight-loss programs typically aim for 500-1000 fewer calories per day), boosted daily activity, and participated in a variety of self-monitoring activities. Over the 12-month intervention, participants received a series of behavior change goals to create the necessary modest calorie deficit, along with weekly interactive voice response telephone calls, and a YMCA memberships. Monthly counseling calls from a registered dietician, along with personalized training materials rounded out this “self-care” directed program.
The “usual care” comparison group did not receive special weight, nutrition, or physical activity counseling, but did receive a wellness newsletter every six months for the 12 month study period.
The drop-out rate for participation was extremely low, particularly important to long-term success. The study group participants were not only engaged after 6 months, but at the 12- and 18-month time points as well. More than 90 percent completed all 4 study visits (including baseline). At the end of the 12-month study period, program participants had an average weight decline of about 2 pounds, compared to the usual care group.
Nearly two-thirds (62 percent) of the study group were at or below their baseline weight, compared to about 45 percent of the control group. At the end of 18 months, the study group maintained that change, while the usual care group crept up to a roughly 1 pound weight gain.
And about half (53 percent) of the study group sustained that change after a year-and a-half, compared to the control group, which dropped to 38.5 percent.
Though the study was done in African-American women, this strategy could likely produce positive results in the general population, as it is self-directed, economical, and easy to implement and scale in a variety of clinical settings. While most diet plans are focused on dropping pounds-- the recommended weight loss is 2 to 3 pounds per week -- this study suggests that you don't have to deprive yourself with a drastic program. Depending on personal health risk, weight loss might not be the necessary goal for many people trying to manage their weight.
These data support the evidence that “just don’t gain” might be the best advice -- and most realistic goal -- for those who aren't already severely overweight orwith a BMI of less than 35. Early intervention with weight maintenance might be the best weight control choice for those at a point of early treatment in an overweight, otherwise healthy, population.
Yet this study doesn't solve the challenge to every weight-control program: motivation. All study participants were interested and volunteered to participate. In fact, nearly half of the eligible study group were excluded because of lack of interest.
While the study documents a new strategy for early weight-control intervention, it's still up to individuals to want to take charge of their weight -- and want it enough to stop the "creep."