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Putting an End to Yo-Yo Dieting
A simple program of weigh-ins and supportive phone calls was as effective as a more elaborate approach.
Losing weight is hard, but keeping it off is harder — most successful dieters regain some or all lost weight within a few years. To pinpoint the best approach to weight-loss maintenance, New Zealand researchers recruited 200 overweight women (age range, 25–70) who had lost at least 5% of their body weight within the previous 6 months.
The women were randomized in a 2x2 factorial design to either high-carbohydrate or high-protein–high-fat diets and to either intensive multidisciplinary support or ordinary nursing support. Most participants were still obese (mean body-mass index, about 32 kg/m2). The nursing support involved weigh-ins every 2 weeks, single supportive phone calls on alternate weeks, monthly support groups, and assigned "buddies" for additional support. The intensive program added 11 one-on-one sessions with a nutritionist and exercise trainer and optional twice-weekly circuit training at a local gym.
After 2 years, all four groups sustained modest additional weight loss (about 5 pounds on average), with no differences between diets or between support assignments. Most women reported that they would like the study interventions to continue indefinitely.
Comment: It may not take bells and whistles to sustain weight loss — just ongoing friendly support. The authors contrast the enormous costs of obesity’s complications with the relative simplicity of the interventions. However, as volunteers, these women undoubtedly were far more motivated to succeed than most overweight people.
— Abigail Zuger, MD
Journal Watch General Medicine
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