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Heavy Losses

A new study shows that you can keep weight off. But there's no magic elixir--it's whatever works for you.

September 08, 1997|SALLY SQUIRES | THE WASHINGTON POST

Yo-yo dieters take heart. Just when it seemed that successful weight loss could be as elusive as an icy day in summer, a team of University of Pittsburgh researchers has found evidence suggesting otherwise.

In an attempt to better understand successful long-term weight loss, the team has studied nearly 800 people who shed a minimum of 30 pounds and kept the weight off for nearly six years.

These were not simply lucky first-time dieters. The participants in the study were hard-core, weight-gaining recidivists who had each lost an average total of 270 pounds during his or her life. Nearly half of the participants, whose average age was 45, had been overweight since early childhood, and an additional 25% had put on unwanted pounds from age 12 to 18.

Through the years "they had done a lot of weight cycling," said Mary Lou Klem, senior research fellow at the University of Pittsburgh School of Medicine and lead author of the ongoing study, reported in the American Journal of Clinical Nutrition.

Unlike the majority of dieters who usually regain their lost pounds and often add more, the study found that these people "have tried a lot of things to lose weight and finally found a combination that worked for them," Klem said.

Some weight-loss experts said the findings parallel work from other addiction fields, such as smoking cessation.

"Most people who quit smoking successfully do it on their own, and we have learned that it takes four or five tries," said Dr. Albert Stunkard, a psychiatrist and weight-loss researcher at the University of Pennsylvania. The weight registry study "shows that persistence pays off" in dieting, he said. "It's a wonderful, optimistic message and would be very nice to counter the terrible pessimistic message that people can't lose weight."

"This is a superb study," Stunkard said. "It confirms earlier smaller studies in a very dramatic way with this large sample size."

People in the study were recruited from national advertisements in newspapers and magazines for individuals who had successfully lost weight and kept it off. The researchers then confirmed the weight loss in a variety of ways, including documentation from participants' physicians, interviews with family members or friends and photographs.

The majority of participants in the survey came from families that had a tendency to be overweight, a fact that placed them at higher risk of becoming heavy themselves.

All the people in the study were veteran dieters who had attempted nearly everything to shed pounds.

"Let me count the ways I've tried to lose weight," said Johari Rashad, who works at the Department of Labor and has successfully trimmed more than 67 pounds from her 5-foot-3-inch frame. She tried a commercial weight-loss program that helped at first but then lost its effect. "I've done a modified fast that didn't work . . . and in one of my really crazy days, I took liquid protein that really didn't work and was dangerous besides."

Yet it was often these failures to control their weight that helped participants in the registry manage to figure out how to successfully shed pounds and keep them off.

Nearly all participants--some 77%--said they had a strong impetus for launching their weight-reduction course. For about a third of the participants, the trigger was a relatively minor health problem, such as varicose veins, sleep apnea, low back pain, aching legs or simply fatigue caused by their extra pounds.

Dieters often search for the perfect way to lose weight and keep it off. But the study found that there was no one successful route to shedding pounds. "It's further condemnation of the faddish diet books," said Kelly Brownell, a professor of psychology who studies weight loss at Yale University.

Each of their failed attempts, however, appeared to teach valuable lessons about past diet mistakes and to familiarize the dieters with weight-loss techniques that ultimately worked more effectively. No one found any "miracle method" to lose weight.

"This may go back to the theory that when you're trying to change behavior, you will try and fail, but if you try long enough you will ultimately be successful," Klem said, noting that for this group "it took them until their 40s [and older] to get successful."

Nearly half of those in the registry lost weight on their own. Slightly more than half the participants said they either consulted a physician for help or joined organized weight-loss programs such as Overeaters Anonymous, a 12-step program for compulsive eaters patterned after Alcoholics Anonymous, and Weight Watchers, the well-known commercial weight-loss system.

Most simply did what diet experts have been advising for years: They reduced the number of calories they ate and increased their physical activity. Nearly all restricted their intake of certain types or classes of foods.

Counting calories was important to about 40% of those who succeeded in losing weight. So was keeping track of fat grams, a technique employed by about 25% of those in the registry. About 20% used liquid diets to help curb their weight, but only 4% relied on any diet drugs, most of which were not available when participants lost their unwanted pounds. The prescription weight loss drug Redux, for example, was approved for use only last year by the Food and Drug Administration.

There was also a strong commitment to regular exercise, something that other studies have found is key to successful weight loss as well. People in the registry reported doing one to two activities nearly every day and also made lifestyle changes such as walking stairs rather than taking the elevator.

One of the surprising results of the study was that slightly more than 40% of people in the weight registry said keeping off the pounds was easier than actually shedding weight.

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