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Weight Loss and Weight Maintenance

Which strategies spell success?

The August issue of the American Journal of Preventive Medicine contains a study examining weight loss and weight maintenance and how different techniques are necessary to achieve each of these (Access a prepublication copy at http://www.cfah.org/hbns/archives/viewSupportDoc.cfm?supportingDocID=1026).

The authors conducted a random sampling of 1,165 U.S. adults to differentiate or associate 36 practices for success in weight loss (defined as 10% of weight lost in preceding 12 months) and success in weight loss maintenance (defined as 10% of weight lost and maintained for 1 year). Interestingly, only 8 of the 36 practices addressed both weight loss and weight maintenance.

Most of the practices measured, such as self-weighing food and portion control, are not new. But this is the first nationally representative study to closely examine whether similar practices are associated with weight loss and weight loss maintenance.

The authors wrote: "The main conclusion in the current study - that the practices associated with weight loss are different from those associated with weight-loss maintenance, is potentially quite important. Few studies, for example, have identified practices that are associated with weight-loss maintenance but not initial weight loss. In the present study, those who used four practices (eat plenty of low-fat sources of protein, follow a consistent exercise routine, reward yourself for sticking to your diet or exercise plan, and remind yourself why you need to control your weight) more often were more likely to be successful in weight-loss maintenance but not in initial weight loss."

Weight Loss

According to the study results, nine key strategies can produce weight loss. Recommending these strategies to patients who are in the initial stages of the weight loss quest can be effective.

Remember to strongly encourage patients to tailor these suggestions to what works for them personally. For example, one patient may find success with Weight Watchers alone while another may need visits with a registered dietitian in addition to a group or online method. Providing real-life examples without violating patient confidentiality can also be helpful.

The nine identified strategies are:

    • Participating in a weight loss program
    • Seeking information about weight loss, nutrition or exercise
    • Eating healthy snacks like fruits and veggies
    • Limiting the amount of sugar consumed in foods and beverages
    • Planning meals and snacks ahead of time
    • Avoiding skipping meals, specifically breakfast
    • Incorporating a variety of exercise types
    • Taking part in exercise that you enjoy
    • Focusing on how much better you'll feel when you're thinner.

Weight Maintenance

Many patients successfully lose weight only to gain it back within a few months or a year. This trend was identified in this study. Participants who were successful in weight-loss maintenance practiced four key strategies:

·         Follow a consistent exercise routine.

·         Remind yourself why you need to control your weight.

·         Eat plenty of low-fat sources of protein like lean meat, poultry and fish.

·         Reward yourself for sticking to your diet or exercise plan.

Weight maintenance can be enhanced by reviewing these key points with patients who have successfully lost weight and by using emails and handouts to encourage them to incorporate the strategies in their daily life. Adoption of these behavioral changes will have begun in the weight-loss phase.

Some healthcare providers and studies also suggest that patients weigh themselves daily or a few times a week to make sure they are in a weight maintenance range. However, this needs to be carefully considered in correlation with a healthy and achievable weight for each patient.

In addition, screening for eating disorders and disordered eating behavior - which can begin in adolescence or childhood and continue well into adulthood - should be performed before advising regular weigh-ins.

Although this is not necessarily new information for us as clinicians, noting the differences between initial weight loss and weight maintenance can be helpful. Which of these weight loss and weight-loss maintenance practices do you follow yourself or share with your patients?

Robyn Kievit is a family nurse practitioner, a registered dietitian and a certified specialist in sports dietetics. She operates a private nutrition practice in Boston and is on staff at Emerson College. Email your nutrition and weight loss questions to robyn@robynkievit.com or visit her website at www.robynkievit.com. On Facebook and Twitter, search for nutritionmentor.

 


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Tzachi knaanAugust 05, 2011




     

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