Tuesday, June 10, 2014

More on the "Almost Impossible" Feat of Maintaining a Weight Loss

So spurred by the CBC report that called the maintenance of weight loss "almost impossible" last week I reposted a older piece of mine as a rebuttal.

This weekend I was re-reading the Look AHEAD data on weight and I came across another bit worth sharing. Have a peek at that graph up above. It categorizes the percentage of folks in Look AHEAD's control Diabetes Support and Education (DSE) arm and their Intensive Lifestyle Intervention (ILI) groups who 8 years later met different degrees of weight loss.

The most striking part of that graph to me has to be from the DSE controls. The DSE, for those who aren't familiar, wasn't a particularly involved intervention. Here's how it's described in the study,
"For the first 4 years, DSE participants were provided three 1-hour group meetings per year that discussed diet, physical activity, and social support, respectively [20]. These sessions offered information but not specific behavioral strategies for adhering to the diet and physical activity recommendations. Years 5 to 8 provided one such session per year. Persons who desired more help with weight loss were referred to their PCPs, who were free to recommend whatever interventions they considered appropriate."
It's quite heartening to see that after 8 years, for 35% of the DSE control group, 3 1-hour group talks a year were sufficient to help fuel a sustained weight loss of 5 percent or more of their presenting weight, and for 17% of them, enough to fuel and sustain a greater than 10 percent loss.

Now this study population may have a bit of an advantage. These weren't likely folks whose motivators were aesthetics. These folks were older, and no doubt hoping to help improve the management of their diabetes. I wonder if in turn they were more likely to set goals of improving their health as a whole and not as likely to focus on numbers on the scale to tell them how they were doing. And perhaps it's our inability as a society to share that focus that leads many of us to struggle with weight management.

What I'm getting at is that I think what makes maintaining weight loss seem "almost impossible" are the goal posts society has generally set to measure success. No doubt, if the goal set is losing every last ounce of weight that some stupid chart says you're supposed to lose then the descriptor "almost impossible" may well be fair. On the other hand, if the goal is to cultivate the healthiest life that you can honestly enjoy, subtotal losses, often with significant concomitant health improvements, are definitely within your reach.

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