From Our 2012 Archives
A Diet That Asks You Not to Lose Weight (at First)
By Rita Rubin
Reviewed by Brunilda Nazario, MD
Oct. 30, 2012 -- Perhaps the best time to learn how to avoid regaining lost pounds is before you shed a single one, according to a new study.
As anyone who's ever been on a diet knows, losing weight is easier than keeping it off. "Long-term maintenance remains elusive," the researchers write.
The problem, they say, is that people tend to abandon the changes they've made during a weight loss program, such as healthy eating, physical activity, and keeping a record of everything they eat. Typically, people regain 30% to 50% of the weight lost in the first year after stopping the program.
The researchers wondered what would happen if overweight or obese women got a chance to practice the skills needed to keep weight off without having to worry about slimming down first. They enrolled 267 overweight or obese women ages 21 and older.
Capitalizing on Motivation
"People come in really motivated," researcher Michaela Kiernan, PhD, says of those about to start a weight loss program. The premise of her study, Kiernan says, was to "get them to channel that good energy on maintenance."
So Kiernan, a senior research scientist at the Stanford Prevention Research Center, and her collaborators assigned the women to two groups: One was "maintenance first," and the other "weight loss first."
Both groups met for 28 weeks, but the maintenance-first group spent the first eight weeks learning maintenance skills, while the weight loss-first group spent the last eight weeks learning how to keep the weight off by learning problem-solving skills.
The weight loss method was identical for both groups.
The maintenance-first group was told not to lose weight during the first eight weeks of the study. During this time they learned a set of skills designed to optimize day-to-day satisfaction with lifestyle and self-regulatory habits.
The maintenance-first group also took part in experiments -- one week they pretended they were on vacation and ate five high-calorie meals -- designed to help them master skills used to maintain their weight, such as tweaking their diet or activity levels without keeping records, an approach Kiernan calls "relaxed awareness."
At the end of their 28-week programs, the women in both groups had lost a similar amount of weight, about 17 pounds, or about 9% of their starting weight. The researchers then left the participants on their own for a year. When the women were weighed at the end of that year, the maintenance-first women had regained only three pounds on average, compared to seven pounds for the weight loss-first women.
"I think this just opens up the range of alternatives that people have," says Kiernan, adding that she'd like to conduct a similar study with men and with a more diverse group of women.
Social psychologist Paul Fuglestad, PhD, is a post-doctoral fellow at the University of Minnesota who studies weight loss interventions. He says he suspects the content of the maintenance-first approach, more than the timing, did the trick.
"I think that it just made people a little more satisfied with the maintenance/weight control process," Fuglestad says. "It seemed like it would be something more realistic that people could embrace and follow for the long-term."
Kiernan's study was published online in the Journal of Consulting and Clinical Psychology.
SOURCES: Kiernan, M. Journal of Consulting and Clinical Psychology, published online Oct. 29, 2012. Michaela Kiernan, PhD, senior research scientist at the Stanford Prevention Research Center. Paul Fuglestad, PhD, a post-doctoral fellow at the University of Minnesota.
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