DIET
November 19, 2012

Losing It: Turning Weight Loss on Its Head

Before you start a diet, it can help to learn how to keep weight off first.

Anyone who has ever fought the weight loss battle knows that losing the weight is easy – at least compared to keeping the lost pounds off. When it comes to weight maintenance, the statistics are grim and the chance of regaining the lost weight is high. However, a new approach, though counterintuitive, may be just what is needed to keep those lost pounds off forever. Learning how to avoid gaining weight back is best done before dieting.

Weight maintenance requires a different set of behaviors and skills than those required for losing weight. So Michaela Kiernan and her colleagues at Stanford University came up with an approach to weight loss that focused on teaching weight maintenance skills first, rather than focusing on weight loss skills.

The women who had been taught maintenance skills first had gained back an average of three pounds compared to seven pounds gained by the women who were assigned to the group that immediately began dieting and only learned about weight maintenance later.

They divided 267 overweight and obese women into one of two groups to test their theory. Approximately half of the women were given a 20-week behavioral weight loss program which emphasized an increased consumption of fruits and vegetables, increased exercise, and keeping a food diary. The group met for 90 minutes each week with facilitators who helped the women learn strategies for losing weight. After the 20-week program, this group met with trainers for another eight weeks to learn skills for maintaining their weight loss.

The other group of women began a similar program, except that they spent the first eight weeks being taught weight maintenance skills, but not actively dieting. They learned how to identify low-fat, low-calorie foods that tasted good and would help them not feel deprived once they started dieting; to treat themselves occasionally with high-fat, high-calorie foods; weigh themselves everyday to monitor their bodies’ natural weight fluctuations; experiment with losing five pounds before an anticipated weight gain (such as during a vacation or over the holiday); and to eat a little more when their weight dipped toward the lower end of their personalized five-pound range.

Both groups lost 17 pounds on average during the 28-week program. The researchers did not contact women in either group for a year. At that time the women were weighed again. The women who had been taught maintenance skills first had gained back an average of three pounds compared to seven pounds gained by the women who were assigned to the group that immediately began dieting and only learned about weight maintenance later.

The idea was to capitalize on the motivation that usually accompanies the beginning of a diet and teach the skills needed for the long haul then, before the hard work of denying oneself food began. In a press release, Kiernan said about the maintenance-first approach, “Those (first) eight weeks were like a practice run. Women could try out different stability skills and work out the kinks without the pressure of worrying about how much weight they had lost. We found that waiting those eight weeks didn’t make the women any less successful at losing weight. But even better, women who practice stability first were more successful in maintaining that loss after a year.”

Kiernan hopes to continue studying this approach to weight loss to see if people are able to maintain weight loss for over a year, and she would like to test it in a larger and more diverse population that also includes men. Also, this study did not include women with binge-eating behaviors, so further study would need to be done to determine whether maintenance-first skills would work for them.

The study is published in the Journal of Consulting and Clinical Psychology.

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