October 30th, 2012
12:01 PM ET
With all the talk about obesity in America, you might be surprised to know that most people are pretty good at losing weight.
Weight loss programs have proven effective in helping people drop pounds. But keeping them off is another story.
Studies have shown that overweight participants typically give up their newly learned health habits and regain 30 to 50% of the weight they lost within one year, even if they participate in a post-weight loss maintenance program.
“There’s something we’re missing in terms of what it takes to maintain our weight,” says Michaela Kiernan, an expert in behavioral weight management at the Stanford Prevention Research Center.
Kiernan and her colleagues hypothesized that people would keep weight off better if they practiced doing so first. Their hypothesis was based on social cognitive theory – that having confidence in your ability to do something actually helps you do it.
More than 260 overweight and obese females were split randomly into two groups. Both groups participated in a six-month “intervention” period that included a weight loss program and a weight maintenance program.
In the “weight loss first” group, the women participated in a 20-week behavioral weight loss program, followed by an eight-week “problem-solving” maintenance program. Their maintenance program addressed obstacles the women might face in the upcoming year.
In the “maintenance first” group, the women participated in an eight-week “stability skills” maintenance program, where they were asked not to lose any weight.
They learned how to fine-tune their eating behaviors – savoring food mindfully, for instance, or leaving small amounts on their plate – “to get away from the idea that you’re either on a diet or off a diet,” Kiernan says. That group then participated in an identical 20-week weight loss program.
Both groups lost an average of 16 pounds during the six-month intervention program. But after 12 months, the “weight loss first” group had gained back an average of seven pounds. In comparison, the “maintenance first” group had only gained back three pounds.
The study capitalizes on two key factors for weight loss maintenance: Confidence and motivation, says Kim Gorman, weight management program director for the Anschutz Health and Wellness Center at the University of Colorado. Gorman was not involved with the research.
Asking “maintenance first” participants not to lose weight during the first eight weeks allowed them to learn important skills without fear, Gorman says.
“I say fear because so many of my folks lose a significant amount of weight and then fear a slight shift upward means the boat is sinking. I think (the study authors) contended with the emotional impacts associated with the scale … in short, they were prepared.”
Gorman was pleased to see that the “maintenance first” group didn’t lose their motivation for losing weight – evidenced by the fact that both groups dropped the same amount in six months.
Kiernan says the maintenance group may have benefited from that early energy. “Most of the time by the time they get to maintenance, they’re pooped,” she says. “This way it’s kind of a protected time to try things.”
Because the study incorporated new timing (maintenance first) and new skills (stability over problem-solving) for one group, it’s impossible to tell if one or both was behind the “maintenance first” group’s success. Going forward Kiernan would like to “untangle” those, she says. “Is it the content or the order?”
The researchers would also like to duplicate the study in men and see if technology – like e-mail alerts or online classes – could play a bigger role.
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