Adieu, Yo-Yo Dieting

I recently posted a piece about the absence of severe health problems associated with yo-yo dieting. It showed that weight-cycling was not associated with an increase in cardiovascular or all-cause mortality. Nevertheless, overweight people would clearly like to be able to lose weight and then keep it off. And this is possible, given adequate ‘support’, according to a study from New Zealand. Writing in the Canadian Medical Association Journal, researchers compared the two support programs and two diets of different composition, aimed at finding an effective combination facilitating long-term weight maintenance.

The subjects were 200 overweight women (age range, 25-70) who had lost at least 5% of their body weight within the previous 6 months. They were randomly assigned to an intensive support program or to an inexpensive nurse-led program. 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. 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. All participants also received advice about high-carbohydrate diets or relatively high-mono-unsaturated-fat diets.

A total of 174 participants were followed for 23 years. The average weight loss (about 4.4 lb or 2 kg) was the same in those in the intensive and support programs, and with both types of diet. Unsurprisingly, the total and low-density-lipoprotein (LDL) cholesterol were significantly higher in those on the high-mono-unsaturated-fat diet. All other results were similar among the support programs and diets.

This study showed that a relatively inexpensive program is as effective as a more resource-intensive program in maintaining weight over a 2-year period. In their discussion, the authors contrast the enormous costs of obesity's complications with the relative simplicity of the interventions. It makes sense.