Project Body Smart | Keep it simple, keep weight off.
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Keep it simple, keep weight off.

Research Review:

By Helen Kollias

Obesity rates are skyrocketing. Yet there are more diet programs than ever.

For instance, FadDiet.com lists things like:

  • The Chocolate Diet: This is basically a low-calorie diet, which puzzlingly includes several daily servings of popcorn, and you get up to 1 ounce of chocolate in the evening (wow!)
  • The Amputation Diet: Lose unsightly weight fast: Just chop it off!
  • The Lemon Cleanse: A squeeze of lemon juice, 2 oz of maple syrup, a pinch of cayenne pepper, 2 cups of water. That’s it for the day. As FadDiet.com remarks, “The diet plan is simple. You can’t eat anything! Ha ha ha! You are so bummin!”
  • The Cabbage Soup Diet: You eat cabbage soup all day. On day three, you also get to eat as many as eight bananas. You’ll be sexier with your lean new bod, but you won’t get to share it, because you’ll be sitting on the toilet all day.

It’s pretty clear that many diet programs flat-out suck. But there are a few decent ones, such as the “Eat less and move more” plan, or “For heaven’s sake, have a vegetable once in a while”.

Nevertheless, good or bad, most diets are doomed to fail. Why?

The problem is that people think the goal is weight loss — it’s not.

I know you’re thinking, “Helen you’re nuts! If I lose x kg (or y pounds) then I’ll be happy. This goal is weight loss!”

Hear me out. Let’s say you go on the best diet in the world for 4 (10, 30, or 52) weeks, The weight flies off and you lose all the weight you wanted and more! Awesome!

Once you’re “done” dieting, you go back to your old eating habits. What’s going to happen? You will eventually gain all the weight back and likely more.

While everybody focuses on how fast they lose weight, the real key to success is focusing how long the weight will stay off. And the real goal is to change how you interact with food and physical activity. Forever. Thus, with lifestyle programs, weight loss is a side effect and not the primary goal.

before JohnBPhoto_BeforeAfter before
Before After After after — doh!

Adherence – The key to long term weight loss

Adherence is science speak for “sticking with the program or guidelines”. So far scientists have come up with a few things that determine whether you will stick with a weight management program long-term [1-3].

  1. Self-efficacy: having faith/hope/belief that you will change. If you think you will stick with a program, then there is a pretty good chance you will.
  2. Intention: deciding to do what is needed to reach your goal, such as exercising regularly or changing your eating habits.
  3. Planning: following through and actually developing a way of changing your eating habits or losing the weight. Without planning, all the belief (self-efficacy) and intention in the world will get you nowhere. As my high school math teacher (or your grandma) would say, “The road to hell is paved with good intentions.”

Environment – Another piece of the weight loss puzzle

The first three factors are very important, but most of the time people forget another very important part of a weight loss plan – their environment.

For example, if you live right next door to a bakery, then chances are you’re going to eat a lot more bread than if you live on a boat.

I’m not suggesting you pack up and move to the middle of the Atlantic, though I’ve heard Hawaii is nice this time of year, but if you don’t have any cookies in your house it’s really hard to eat cookies.

Other things that fall under the environment umbrella that you may or may not be able to control are things like:

  • the size of a package of spaghetti
  • the variety of food available
  • how long you have to wait in line to get different foods
  • whether it’s easy for you to get outside to exercise
  • even your friends!

If you’re interested in reading more about how your environment affects weight, take a look at two blog posts that I wrote a while back: one aboutportion sizes and another looking at whether your friends are making you fat.

Research question

OK, so we’ve got self-efficacy, intention, planning, and controlling your environment.

This week I reviewed a study that looked at a new factor in keeping weight off: how complicated are your dietary rules?

Mata J, Todd PM, Lippke S. When weight management lasts. Lower perceived rule complexity increases adherence. Appetite. 2010 Feb;54(1):37-43. (Link to full study in PDF)

Methods

In this study the researchers observed 390 dieters. Even though the researchers tried to get a random sample of participants by putting ads in a wide variety of magazines, 99% of the participants were women, so the researchers only analyzed the women’s results.

Researchers put the dieters on one of two diets (or, as they call them, “weight management regimens”), Weight Watchers and Brigitte.

Weight Watchers is one of the most well known diet programs. It uses a point system for food. Once you’ve used all your points, you’re done eating for the day. If you exercise you get to eat more points, err I mean food, or you can save up your points for one big gluttonfest.

Brigitte is a diet from Germany that is based on a list of recipes with corresponding meal shopping lists. All you do is buy food from the shopping list, make the recipes from the food you’ve bought, eat the recipes you’ve made and repeat. Little thought, little flexibility and no calculations.

The researchers were not that interested in how effective each diet was. What they really wanted to know was whether there was a relationship between diet complexity and adherence.

Were people more likely to stick with a diet, and maintain their results better, if that diet program was simpler?

Results and discussion

Not surprisingly, perceived diet complexity affects how long people stick with a program.
If the dieters thought the rules for the program were too complicated they forgot the rules, weren’t always clear as to what to eat, and ended up quitting. That was the case with the Weight Watchers program.

If the dieters thought the rules for the program were simple, if they didn’t have to remember much, and if they knew what they should be eating at what times, they stuck with the program. That was the case with Brigiette. Generally, it seems that recipe based programs like Brigitte need very little brain power to stay on track.

Complexity and its discontents

Related research shows that having very complex rules can also lead to to disordered eating.

Dieters who have a long list of specific “rules” (e.g. no eating after 7 pm, no grains, only 1200 calories a day, only 20 grams of fat, etc.) may feel as though they have failed when they break or forget a rule. This can trigger a binge or simply falling off the wagon.

In both cases, the dieter gets discouraged and probably doesn’t succeed… or gets back on track with even more rigid, complicated rules… which they break again. And so on.

Conversely, having minimal, simple rules improves success. There’s less chance that people will forget or “break” rules. For instance, “eat smaller portions” is a lot simpler to remember and do than a laundry list of “Thou shalt not…”

Calorie counting, keeping track of cards and counting points have another problem besides seeming too complex.

It turns out when people try to lose weight drastically or go on a calorie restricted diet, they can get a bit mentally fuzzy. Calculating anything becomes a lot harder. (Note to self: do not diet and do taxes.) I’m sure all of you out there who have dieted agree that you’re not as mentally sharp when dieting.

So, you end up crabby, feeling deprived, forgetful, trying to remember how much 0.8 grams per kilogram is, lost in a Kafka-esque maze of rules… and hungry.

Not exactly a recipe for success, so to speak.

mensa-maze-cartoon

Conclusion

The key for long-term weight loss is sticking to a lifestyle rather than a diet.

That lifestyle needs to be straightforward and simple to follow (though not necessarily easy to follow).

If a diet program is too complicated or if people think it’s too complicated, then it’s not going to work: they’ll forget what they should be eating, fall off the wagon and gain the weight back. And they’ll feel badly about themselves and their overall chances of success.

Bottom line

In a world where faster is always touted as better, it’s no wonder that people end up on endless diets where they lose weight fast and put it back on nearly as fast.

As the researchers remark, “The long-term success of different weight management programs should be measured not just in terms of direct weight loss, but, also in terms of how long people stick to their program.”

Repeat after me: “Faster isn’t better. Simpler is better.”

Now if somebody just came up with a simple guide… say something like a Calorie Control Guide… I think they’d be on to something.

References

Jeffery RW, Drewnowski A, Epstein LH, Stunkard AJ, Wilson GT, Wing RR, Hill DR. Long-term maintenance of weight loss: current status. Health Psychol. 2000 Jan;19(1 Suppl):5-16. Review

Luszczynska A, Sobczyk A, Abraham C. Planning to lose weight: randomized controlled trial of an implementation intention prompt to enhance weight reduction among overweight and obese women. Health Psychol. 2007 Jul;26(4):507-12.

Schwarzer R, Schuz B, Ziegelmann JP, Lippke S, Luszczynska A, Scholz U.Adoption and maintenance of four health behaviors: theory-guided longitudinal studies on dental flossing, seat belt use, dietary behavior, and physical activity.Ann Behav Med. 2007 Apr;33(2):156-66.

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