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The “Every Size” strategy, a health-centered rather than weight-centered
program, may help chronic dieters reshape their thinking, shed unhealthy habits,
adopt new patterns of eating, become more physically active, and increase their
self-esteem. That’s according to Nancy L. Keim, a chemist with
“Chronic dieters are those who either have failed at a sequence of diets, or,
after successfully losing weight, gain back the pounds and start the dieting
cycle all over again,” explains ARS physiologist Marta D. Van Loan. “For obese
folks who can’t find a healthful weight-loss regimen that gives them lasting
results, this alternative to conventional dieting may offer greater and more
sustainable improvements to several key indicators of their health.”
Keim and Van Loan are with the ARS Western Human Nutrition Research Center at
Davis, California. The two scientists collaborated with Judith L. Stern and
Linda Bacon of the University of California, Davis, in a study of the “Health at
Every Size” approach.
Van Loan says the novel experiment rates as “one of the most rigorous
comparisons of conventional dieting versus the Every Size lifestyle.” The
results? Remarkable improvements for the obese, chronic dieters assigned to the
Every Size cohort, one of two teams for the study.
The Two Teams Square Off
Seventy-eight obese women, ages 30 to 45, participated in either
the health-centered Every Size team or the weight-centered traditional diet
team. The teams met for specialized, 90-minute educational sessions every week
for the first 6 months of the year-long study, then met for six once-a-month
sessions.
Both groups were instructed in nutrition basics. Women on the
conventional diet track were schooled in topics that are typically covered in
many popular weight-loss programs, such as how to monitor their weight, control
their eating, and exercise briskly.
Meanwhile, their Every Size colleagues learned how to build their self-esteem;
recognize and follow the body’s natural, internal cues to hunger and satiety (a
feeling of fullness); make healthy choices at mealtimes and in between; and
enjoy some form of physical activity—an approach that’s different from
exercising mainly to lose weight.
Two Years Later: The Results
A total of 38 women, 19 from each team, participated in a panel of
follow-up exams—lab tests and questionnaires—2 years after the study’s start.
Every Size volunteers had kept their weight stable, neither
gaining nor losing a significant number of pounds. In contrast, the dieters had
lost weight by the sixth month, but regained it by the 2-year checkpoint. Their
beginning weights and their weights 2 years later weren’t significantly
different.
The Every Size women held onto the progress that they had made in
several health risk factors such as cholesterol levels and systolic blood
pressure—the amount of pressure in blood vessels when the heart pumps blood
through them.
At the start and end of the study, total cholesterol and systolic
blood pressure were in the normal range for all the women. Within this range,
however, the Every Size women lowered their total cholesterol and their systolic
blood pressure and were able to maintain those reductions for the entire course
of the study.
In contrast, the dieters didn’t lower their total cholesterol at
any point in the study. And they weren’t able to maintain the healthful decrease
in systolic blood pressure that they’d achieved just after the 6-month
reducing-diet phase.
Think “Physical Activity”
What about physical activity?
At the 2-year point, Every Size team members had nearly quadrupled
the amount of time they spent in moderate, hard, or very hard physical activity,
compared to what they had reported at the study’s outset.
The dieters didn’t fare as well. At the 1-year point, they were
exercising more than at the start, but they didn’t sustain their improved level
to the 2-year checkpoint.
Although all the dieters made a lasting improvement in at least
one of the food-related habits called “eating behaviors,” the Every Size
volunteers improved in more of the categories.
For example, both groups did a better job of regaining control of
their eating after they’d broken some eating-related rule that they had imposed
on themselves. But the Every Size women made more progress—and sustained it—in
other facets of eating behavior.
The Every Size team members, for instance, had apparently come to
terms with issues such as bulimia (binge eating followed by purging), a “drive
for thinness,” and dissatisfaction with their body size.
Dieters made initial improvements in handling bulimia, dealing
with body size, and learning to follow the body’s natural signals of hunger and
fullness, but they didn’t maintain the progress they’d achieved in these areas.
The researchers also monitored de-pression, a common problem among
large-sized women whose low self-esteem may be related to their body image. Both
groups made significant strides in lessening depression, but only the Every Size
women were able to preserve a more optimistic outlook.
At the 2-year point, volunteers answered questions about how
helpful the program was to them. When asked whether they’d continued to
implement some of the tools they’d learned, 89 percent of the Every Size women
answered “regularly” or “often.” Only 11 percent of the dieters did so.
Focusing on health and on changing behavior, instead of on weight
loss, apparently acted as “keys to the successes of the Every Size team,” Van
Loan points out. The scientists discuss these and other conclusions in an
article in a 2005 issue of the Journal of the American Dietetic Association.
The National Institutes of Health and National Science Foundation provided
some of the funding for the study.
For many people, weight-loss diets “simply don’t work,” says Van
Loan. The Health at Every Size strategy “may break the cycle of unsuccessful
dieting” and open the door to happier, healthier lives.—By Marcia Wood, Agricultural Research
Service Information Staff.
This research is part of Human Nutrition, an ARS National
Program (#107) described on the World Wide Web at www.nps.ars.usda.gov.
Marta D. Van Loan
and Nancy L. Keim are with the
USDA-ARS Western Human Nutrition
Research Center, One Shields Ave., Davis, CA 95616; phone (530) 752-4160
[Van Loan], (530) 752-4163 [Keim], fax (530) 754-4376.
"Health at Every Size: New Hope for Obese Americans?" was published in
the March 2006 issue of
Agricultural Research magazine.
Article
Source:
Nutrition.gov
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