How to lose weight

A weight-management strategy that emphasized
prevention of weight gain, rather than weight
loss, helped black women maintain their weight
for 18 months in a new study.
In the study published in JAMA Internal
Medicine, a group of 194 black women, ages
25 to 44 were placed in an intervention
program in which they received counselling on
weight maintenance techniques while the other
half received weight loss counselling.
Research suggests black women are typically
more satisfied with their bodies and seem to
care less about shedding excess weight, says
Gary Bennett, head of the Duke Obesity
Prevention Program in Durham, North
Carolina, and associates.
Prevention of weight gain may be a worthwhile
goal in black women because they might be
more receptive to intervention messages about
weight maintenance versus loss. Maintenance
also offers the advantage of requiring less-
intensive changes compared to weight loss
interventions.
“ if black women continue to gain weight year
after year, and they almost invariably do …
they go from that lower level of obesity, where
health risks are relatively low, to that higher
level of obesity,” says Bennett.
A weight loss focus could prove to be
especially challenging as premenopausal black
women gain more weight per year than any
other racial/ethnic group. By age 40 to 59,
twice as many black women have class 2
obesity.
To prevent weight gain, the participants
received customized health goals to follow for
18 months. The goals were simple and involved
regulating habits such as limiting the number
of sugar-sweetened drinks and eating more
fruits and vegetables. Researchers also
monitored the amount of time spent sleeping
and brisk walking.
“These goals make a slight calorie deficit,
enough to prevent weight gain,” Bennett said.
“You only need to reduce 100 to 200 calories a
day to prevent weight gain, whereas if you
want to lose, you have to reduce by 500
calories a day.”
After a year, 45 per cent of the women in the
weight loss group were at or below their
weight at the start of the program, compared
to 62 per cent of the maintenance group. After
18 months, the weight loss group continued to
gain weight while the maintenance group
remained the same.
Researchers did not find any differences in
blood pressure or cholesterol despite
preventing weight gain. But, they wrote, “It
may be that greater weight losses than those
reported … are required to achieve
improvements in cardiovascular disease risk
factors, and weight maintenance may need to
be sustained longer to achieve such health
benefits.”
The results of the study demonstrates that “a
moderate-intensity intervention can prevent
weight gain among a high-risk population,”
said Dr Regina Benjamin and co-authors Dr
Susan Z. Yanovski, of the National Institute of
Diabetes and Digestive and Kidney Diseases,
and Dr Denise G. Simons-Morton, of the
National Heart, Lung and Blood Institute.
“Although clinical interventions are important
to prevent weight gain in adults and reduce
weight in obese adults, we also need effective
strategies throughout the lifespan to prevent
obesity and its comorbid conditions, as seen at
baseline by Bennett et al.,” they added.
Bennett said that because the study program
was coordinated through primary care offices
and largely computerized, it was less expensive
than a weight loss intervention and should be
feasible in a range of communities.
For overweight women who can’t or don’t
want to lose weight, “maintaining and not
gaining weight should be the absolute clinical
priority,” concludes Bennett.
Couillard, an international health columnist,
works in collaboration with the World Health
Organization’s goals of disease prevention and
global health care education. Views do not
necessarily reflect endorsement. He can be
reached via: Email:
drcorycouillard@gmail.com , Facebook: Dr Cory
Couillard, Twitter: DrCoryCouillard