Karen Asp is a journalist, ACE-certified Fitness Professional, contributing editor for Woman’s Day and co-author of Understanding Your Food Allergies and Intolerances (St. Martin’s, 2012). She also writes for numerous other publications, including SELF, Glamour, Reader’s Digest, Parade, Better Homes & Gardens, Real Simple, Prevention, Redbook, Oxygen, Shape and Weight Watchers. Follow her on Twitter (@karenaspwriter).
New Year, New Message! Help Your Clients Maintain, Don’t Gain More Weight
Americans need only look in the mirror to realize they’ve got a serious weight issue. And the latest statistics don’t indicate that image is going to change anytime soon.
Consider, for instance, results from Gallup’s annual health and healthcare survey, which were released in November. While 51 percent of Americans want to lose weight, only a mere 25 percent are doing anything serious about it. Even more telling, not only did the eating habits of Americans get worse in 2013, the percentage of people doing regular physical activity also decreased from 2012 to 2013, according to other Gallup information.
What’s clear from the above data is that when it comes to conquering their growing weight woes, Americans aren’t getting the eat-less-exercise-more message. So what’s the solution? Enter the results from a recently published study that might offer a more appealing message: Don’t gain—just maintain.
The Skinny Behind This New Message
To find out whether maintaining weight might be a worthy intervention strategy, researchers recruited 194 premenopausal black women aged 25 to 44 with a body mass index (BMI) ranging from 25 to 34.9. (A BMI of 18.5 to 24.9 is considered normal, 25 to 29.9 is overweight, 30 to 34.9 is class 1 or low-risk obesity, 35 to 39.9 is class 2 or moderate-risk obesity, and 40 is class 3 or high-risk obesity.)
The women were divided into two groups. Half were placed in an intervention program designed to create a daily energy deficit of fewer than 200 calories. Researchers told these women that this wasn’t a weight-loss trial, but rather an approach to improve their overall well-being and maintain their current body shape. The women received tailored behavior-change goals, interactive telephone calls for weekly self-monitoring, monthly counseling calls from a registered dietitian, tailored training materials and a 12-month health-club membership.
Meanwhile, the other half simply received regular care from their physicians. They also received newsletters about general wellness topics, none of which discussed weight, nutrition or physical activity, every six months.
After 12 months, 62 percent of the women in the intervention program were at or below their starting weight compared to only 45 percent in the second group. Better yet, the intervention group maintained these weight changes even after 18 months, while the other group’s weight continued to climb.
The explanation about why maintaining worked so well is simple. “It’s easier to prevent weight gain than to lose weight,” says Gary Bennett, Ph.D., lead study author and director of the Duke Obesity Prevention Program at Duke University in Durham, N.C. “No matter how much you want to lose weight, you have to be motivated to do all the things to lose weight, including tracking your diet and being physically active, and if you’re not willing to do those things, you won’t lose weight.”
Maintaining weight, however, takes less effort, which is a message that could potentially appeal to a large percentage of people who lack motivation to slim down. “If this can work in the toughest-to-treat population, then there’s no reason this approach wouldn’t work for other people,” Bennett says, adding that black women not only have some of the highest rates of obesity in the United States, they also have some of the lowest motivation to lose weight.
Don’t think, though, that weight loss is a moot point. Bennett, in fact, isn’t even suggesting that maintaining weight is better than losing weight. “If you’re obese, especially if you’re on the high end, then weight loss is a better strategy,” he says.
After all, when BMI climbs over 35, you incur numerous health issues, including diabetes, sleep apnea and high blood pressure. “People with a BMI of over 35 need to focus on losing weight to help alleviate some of these conditions,” says Michael Nusbaum, M.D., medical director of The Obesity Treatment Centers of New Jersey in Livingston, N.J., and CEO and founder of Giffen Solutions, Inc., creator of smartphone apps and web portals.
Yet for people whose BMI is under 35, especially if they’ve struggled frequently with weight loss, maintain-don’t-gain may be a viable option. What kind of effects this will have on their health, though, isn’t entirely clear. “We don’t know how this will impact health, especially since it depends on where people are starting from,” Bennett says. “In our group of women whose BMI was less than 35, the evidence suggests that maintaining could help stabilize cardiometabolic problems like blood pressure.” While it’s unlikely these issues will improve, maintaining could at least prevent them from becoming worse.
The Difference Between Maintaining and Losing Weight
So are the “rules” for preventing weight gain different than those for losing weight gain? In some ways, yes.
Of course, whether the goal is to lose weight or simply maintain weight, diet and exercise are still the mainstays of any program. Yet the biggest difference concerns how small of a calorie deficit people have to achieve each day to maintain.
Although many weight-loss programs recommend a deficit of 500 calories a day, which can be challenging, women in the above study achieved an energy deficit of less than 200 calories a day. They could do this by increasing their physical activity or tweaking their diet or a combination of both.
Note, though, that increasing physical activity didn’t have to involve going to the gym. Instead, the biggest gains came from making commonsense tweaks to everyday habits. “We’ve all heard that you should take stairs over elevators or park farther from stores,” Bennett says. “While these activities won’t burn enough calories to lose weight, they could help people keep the weight off.”
Changes in the diet were also small. For instance, some of the strategies involved reducing consumption of sugary beverages like soda; switching to lower-calorie condiments; avoiding fast-food restaurants; and replacing high-calorie snacks with fruits and veggies.
In the end, although maintaining weight may not be as advantageous as losing weight, it could be a beneficial option for certain individuals. After all, what America doesn’t need is to see double when they look in the mirror again.