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Thursday, October 12, 2006

Study: Self-Regulation Maintains Weight Loss


Daily use of the scale can keep the obesity monster at bay, study finds

This Fox News/WebMD story features the results of a new study showing how people who lose weight can keep the weight off most effectively and the answer may surprise you.

Lead researcher Dr. Rena R. Wing, who is a Professor of Psychiatry and Human Behavior at Brown University and works at the Providence, Rhode Island-based Miriam Hospital, was looking for a way to explain why people who experienced weight loss seemed to inevitably begin to gain the weight back and what successful maintainers did to keep the weight off for good.

“Most dieters regain about a third of the weight lost during the next year and are typically back to baseline [their pre-diet weight] in 3 to 5 years,” Dr. Wing explained.

You might recall that Dr. Wing is also one of the co-founders of the National Weight Control Registry (NWCR) project which features over 5,000 people who have lost at least 30 pounds and kept it off for a minimum of one year. I have been critical of their apparent bias against people who are livin' la vida low-carb and I stand by that assertion based on the dietary recommendations included in this study which you will read about in a moment.

But I think they are on to something regarding people who weigh themselves regularly, which I blogged about the preliminary results of this very study one year ago. Now the full results and conclusions have been published.

Dr. Wing and her colleagues observed 314 adults who had shed an average of 42.5 pounds of their body weight within the past two years and split them up into three categories of weight loss maintenance for an 18-month period:

GROUP 1: Met in person weekly.
GROUP 2: Met in an online chat weekly,
GROUP 3: No meetings, just a quarterly newsletter on diet and health.

While GROUP 3 was obviously the control group, GROUP 1 and GROUP 2 both received additional practical application support for keeping the weight off by being encouraged to weigh themselves daily, exercise for at least one hour a day, and to stick with eating a healthy diet. In addition, they were required to report their weekly weigh-in results and were given specific instructions and encouragement for how to best maintain their weight to prevent weight gain.

Study participants were officially weighed at six months, one year and 18 months to determine their progress. GROUP 1 and GROUP 2 were designated into one of three color categories according to how well they were doing at maintaining their weight:

GREEN ZONE: Gained less than 3 pounds
YELLOW ZONE: Gained between 3-5 pounds
RED ZONE: Gained 5+ pounds

The GREEN ZONE group received "green" gifts such as green tea or money to encourage them to keep up the great work. The YELLOW ZONE group were urged to get into the GREEN ZONE as soon as possible. Finally, the RED ZONE group were nudged to get the pounds off by following regular execise and (get this!) by going on a low-fat/low-calorie diet (UGH!) (despite the fact that an internal study by the NWCR showed that more and more of their participants are choosing a low-carb nutritional approach to lose weight, they still INSIST on putting people on an artificial low-fat/low-cal diet! Why would I do that if I lost weight on the low-carb lifestyle?).

Those RED ZONE people were also provided with individualized diet counseling by telephone or e-mail to encourage them to bring their weight back down. They were supplemented with other diet resources, such as weight loss books, journals and any other tool to help them in bringing the weight under control

At the end of the 18 months, the weight gain results were in:

GROUP 1: 5.5-pound GAIN
GROUP 2: Nearly 10-pound GAIN
GROUP 3: Nearly 11-pound GAIN

The percentage of those who gained at least 5 pounds in each group:

GROUP 1: 45 percent
GROUP 2: 55 percent
GROUP 3: 72 percent

GROUP 1 and GROUP 2 had a statistically even chance of gaining at least five pounds, but the average weight gain was lowest among those who met live and in person regularly.

Dr. Wing concluded that self-regulation through weekly meetings with others desiring weight maintenance along with regular weighing on the scale is the best way to prevent the inevitable weight gain that comes for most people who lose weight.

This study was published in the October 12, 2006 issue of The New England Journal of Medicine.

Some retrospect on this study from someone who lost 180 pounds two years ago, gained about 10 pounds and has lost an additional 25 pounds so far this year (and I'm STILL losing!).

I agree that you must keep a constant eye on your weight if you ever hope to keep the weight maintained forever. If you aren't watching the pot, then it very well could boil over on you at any moment. Keeping your eye on where you stand at any given moment is an important factor in weight maintenance.

I've even tried to make it a game by challenging myself to get five pounds BELOW my goal weight so I can have a little cushion room to work with if I decide to indulge for a meal or skip my exercise for one day. Of course, I can't do those things until I create the cushion, but that gives me the extra motivation to make that happen.

Here's my question for Dr. Wing: Why do people who lose weight HAVE to gain weight at all? Every single participant on average gained at least 5.5 pounds. WHY? What is the reason they did this? If people make a commitment to a permanent lifestyle change and stick with that plan for the rest of their lives, then why oh why would there be ANY weight gain at all?

I hate this assumption that people who lose weight are destined to gain it all back. I know, I know, the statistics bear that out at fact in most cases, but I think it's a self-fulfilling prophecy. People KNOW that the vast majority of those who lose weight don't keep it off, so they think they are normal when the weight gain hits them. It's as if gaining weight has become the norm following weight loss that people stop doing those things that helped them lose weight to begin with. I don't get it.

At the end of the day, people who lose weight have put themselves in a better position to be healthy for the rest of their lives. But it is something they must continue to work on forever and ever without letting up one bit. I for one NEVER expect to gain back the weight I worked too hard to lose and I will do everything I can to make that happen and prove it can be done.

You can e-mail Dr. Rena Wing about her study at rwing@lifespan.org.

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11 Comments:

Blogger PJ at TDLC said...

Did you get the grim humor that the red group, "put on the low fat high carb diet," gained massive weight. Now since they were encouraged to go on this diet the moment they gained over 5 lbs, that means the rest of the weight they put on was during the period where they were being encouraged to "diet" that way! Funny. Not.

10/12/2006 9:48 AM  
Blogger Viking Dan said...

Micromanagement like daily weighings will probably drive you insane. You should be aware of changes though once a week weighings are probably fine.

10/12/2006 10:14 AM  
Blogger Calianna said...

I"m still losing, but I have no intention of gaining this weight back again either. Not this time.

I lost weight long ago on low carb but began gaining again, because I gave up eating low carb. It was little compromises that did it - a little bread here, a sweet there, and pretty soon the monster carb addiction was back, bigger than ever! Couple that with all the dire news about saturated fat being so deadly (*rolls eyes*), and I was too scared to go back to low carb for decades, eventually more than doubling my weight. :(

I know it's going to work this time, because this time, the things I used to crave don't even appeal to me any more - the sweets and starches taste terrible to me now.

Besides, I did this in increments. The sugar addiction was the hardest thing to kick. But thank God, that problem was the first to be alleviated, and I lost a huge chunk of weight (and several sizes) in just a few months, merely by avoiding obvious sugars and sweets.

That was over 4 years ago, and even though I was still eating starches up until just a few months ago, and still had boatloads of weight to lose, what I'd lost during those few months stayed off, and my weight stayed fairly stable all that time, simply because I stayed away from sugars and sweets.

That really is the key to it. Don't compromise what you know you should be eating, because as sure as you do, you'll find yourself slipping back into the old eating habits.

The definition of insanity is to keep doing the same thing over and over, expecting different results. So the solution to weight loss is to stick with what gave you the desirable results (whatever plan you lost weight on), instead of slipping back into the old eating habits, because the results of those old habits aren't going to be a bit different this time either. This is why it's so important to find a plan to begin with that you can live with for the rest of your life.

10/12/2006 10:26 AM  
Blogger Sweet Tart said...

I agree that weekly weighing is a good way to help keep your weight steady. But I have found that while it works for weight maintenance, it was too emotionally difficult for me. Without stepping on the scale I know I'm about 5 pounds over what I'd like to be right now, but looking at that number on the scale sends me into a tizzy. I know how I have to eat and exercise to keep my weight in line and I just adjust according to how my clothes fit and how I feel.

10/12/2006 11:50 AM  
Blogger Rob said...

I don't agree with constant weighing. Too many variables within the body can happen so mentally it can be a bad thing.

Once again, acculturation is alive and well. We're pretty much hardwired to eat what we eat by the age of 8. Thus, it's very hard to stay on any type of diet for any length of time that is counter to what mom made us eat early in life, regardless of what type of reward is promised. The diet studies like this bear that out.

The Zero Carb Daily

10/12/2006 2:04 PM  
Blogger AnOldHouse said...

Unlike many, I'm not somehow "menaced" by a number on the scale. It's just a number. I tend to weigh myself daily because I like to know what's going on. I know there are daily fluctuations, sometimes by as much as 5 pounds while staying perfectly to plan. This doesn't bother me at all because I know that and I expect that. And then it's gone the next day.

For those who the scale appears to be a menace, it's really not the scale at all, but emotional complications from being overweight and/or emotional eating problems, and the scale is just the messenger.

10/12/2006 4:13 PM  
Blogger Bowulf said...

I am with anoldhouse. It is just another clue on how I am doing. It's like did I run in that last mile in 7 or 8 minutes or how I look in the mirror. All that information is bundled together for personal inward "right path" or "wrong path" signal. It's not like I change what is in the past, but I can use that information going forward. For myself, insanity would be burying my head in the sand and ignoring a factor of my wellbeing like I did in the past. I spent 10 years running from the scale and its message -- now I appreciate its place in my life just like I appreciate my watch on my run.

10/12/2006 4:49 PM  
Blogger Calianna said...

I weigh just about every day too, mainly because since there are fluctuations in my weight on a daily basis, I'm trying to figure out which foods/activities are causing overnight gain or even stalling out the downward trend.

By keeping a record of what I've eaten, and how much I weighed each day, I hope to get an idea of what works for me, what really works for me, and what doesn't work at all for me.

10/12/2006 8:04 PM  
Blogger Bowulf said...

I had to laugh at the one-year renewal survery NWCR sent to me yesterday. I just filled my copy last night, and it was still almost entirely focussed on if I cared about eating fatty foods or how many Calories I was eating. Something tells me I skewed the results again. :-)

10/13/2006 8:59 AM  
Blogger Jimmy Moore said...

I got mine, too, Kent! I'll be blogging about it soon. And they claim there is no bias against low-carb--HA!

10/13/2006 9:04 AM  
Blogger AnOldHouse said...

I signed up for the NWCR a couple of weeks ago and encourged some others to do so as well.

I'm all for skewing their data in favor of low-carb!

How long does it take to get your first round of questionnaires in the mail?

-David

10/13/2006 12:53 PM  

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