One of the true limiting factors in the fight against obesity is a paucity of published research on successful interventions and weight loss techniques. In large part, this is a deficit born of the difficulties inherent in crafting a legitimate, testable study design. So many different factors, both genetic and behavioral, conspire to make an individual overweight that trying to tease out one element for research purposes is nigh on impossible. When new research does emerge, as it did this week in the Journal of the American Medical Association, it usually comes in the form of behavioral strategies tested in humans or physiological experimentations, most often in rats. The new research this week fell into the former category.
In crafting their experiment, Duke researchers looked to compare two different strategies for maintaining weight loss among a cohort of obese and overweight individuals. Over 1,000 subjects with body-mass indexes between 25-45 went through an extensive six-month weight loss regimen. Their effort included working up to 180 minutes of weekly cardiovascular exercise, reduction in caloric intake, adoption of Dietary Approaches to Stop Hypertension or DASH, and a goal of reducing body weight by 1 to 2 pounds per week. Individuals lost, on average, 18.7 pounds over the course of the six month program.
The second phase of this study, where the hypothesis was to be tested, came when the individuals were randomly placed into one of three groups: either in weight-loss maintenance programs with once a month counseling sessions or an interactive web-based program that allowed for monitoring and goal setting, among other features, or a "self-directed" group that essentially received no guidance on weight maintenance. The participants' weight was then monitored over the course of 30 months.
While it should come as little surprise that all of the groups had regained some weight by the two and a half year mark, every group remained below their average weight upon entering the program. The regain was smallest for the group that received monthly inter-personal contact and support, and was highest in the self-directed group. For the first several months after the beginning of the study's 2nd phase, the interactive technology group actually performed almost exactly on par with the personal contact group, and it was only toward the end of the study that the technology seemed to lose some of its efficacy.
In a press release, lead researcher Dr. Laura Svetkey, professor of medicine at Duke University, explained:
We didn't set out to cure obesity, but we did want to offer participants a set of tools they could use to change their lives. It's not easy to counteract all the forces around us that encourage us to overeat and be sedentary, but we think this study moves us in the right direction.
Moving in the right direction, as Svetkey described it, is an important goal right now. What this study shows us is that it is possible to achieve gains in fitness, and maintain those gains over the course of time. While the interactive technology program may not have succeeded as highly as the personal touch of counseling, it nonetheless showed strong promise. The team's write up explained little about the nuts-and-bolts of the interactive experience, so it could very well be that a different program could have shown even more positive results. Plus, when one considers the scalability of a web-based weight maintenance program, it's hard to doubt its value. Those seeking help for weight loss and healthier living in general should be very encouraged by these advancements.
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