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Thursday, 8 March 2012

Losing weight – Important progress to support recommendations

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There are two major questions facing the public health nutrition community.  How do we prevent overweight and obesity?  And what do we do to reduce weight in those who are overweight or obese? See amongst other links the posting: Obesity a big problem...  ,  health evidence - bottom paragraph on obesity reduction in schoolsPublic health hot topics - motivational counselling for obesity

There is not a concensus on what to recommend for persons who are fighting the battle of the bulge.  Yes fewer calories makes sense but is hard to sustain.   There are advocates of low fat, and those for high fat,  low and high carb and low and high protein.   Some suggestion that lower carb, low sugar and healthy fats may be percolating to the top, but far from consensus yet (see   Harvard School of Public Health eating guidelines   for state of the science).   There is a growing consensus that physical activity alone is not a great method for weight loss, but is part of a program of support to maintaining healthy weights.

A recent BMJ article begins to look more closely at the practical issue of what actually works.  Individuals were randomly assigned to a variety of for-profit, professional, and compared with a group given passes to a fitness facility. An eloquent but simple design.  All groups lost weight over the study time period.  Professional support by physicians and pharmacists did not result in sustained loss at one year.  Commercial programs, led by Weight Watchers, were the most successful in both short term total loss and sustainability of loss.  They were also much less expensive that the less effective professional support options.  

It is just one study, but puts the commercial for profit weight loss programming against each other and against the “professional model”.  It should be enough to turn heads and stimulate replication studies looking at finer detail comparing subtle differences between different types of programs and variables within programs.   BMJ article on comparing weight loss programs

1 comment:

  1. Cathy Richards, RD8 March 2012 at 11:36

    There is a growing body of evidence that indicates metabolic syndrome parameters, as well as social and mental health, can be improved by focussing on HOW to eat, and not on WHAT to eat. It's called Eating Competence, by the great dietitian/child development guru Ellyn Satter. It focusses on eating foods you enjoy until you are satisfied, but only at routine meal and snack times. A great article that helps health professionals understand how to communicate the concepts is here:
    And Satter's brief overview of why Eating Competence, and not "healthy eating" (in it's typical interpretation) is here: