Don’t scale back after reaching weight loss goal

The secret weapon against yo-yo dieting may be to keep the string short, a new study suggests.

Most successful dieters regain much of the weight they lose. But researchers in Providence, R.I., found that dieters can maintain weight loss by simply stepping on the scale every day and reacting quickly to cut back calories and boost exercise.

Led by Rena Wing, director of the Weight Control and Diabetes Research Center at The Miriam Hospital and professor of psychiatry and human behavior at Brown University Medical School, the researchers taught a group of already successful dieters a technique called “self-regulation” and then followed them for the next 18 months to see how they did.

Compared with a control group that received quarterly newsletters about eating and exercise in the mail during the course of the study period, those who got the training – either in person or over the Internet – were significantly more successful at not regaining five or more pounds during the intervention period, according to findings reported recently in the New England Journal of Medicine.

All the people in the study group had lost at least 10 percent of their body weight – the average was 20 percent, or 42 pounds, during the two years before the study started.

The strategies taught to the intervention groups included making sure to eat breakfast and getting an hour of physical activity. All the subjects were asked to weigh themselves daily on a scale provided by the researchers. They also reported their weight weekly to the researchers, either by phone or over the Internet.

“If you want to keep the pounds off, daily weighing is critical,” said Wing. “But stepping on the scale isn’t enough. You have to use that information to change your behavior, whether that means eating less or walking more. Paying attention to weight and taking quick action if it creeps up seems to be the secret to success.”

Participants were also introduced to a weight-monitoring system based on color codes. If they reported being within three pounds of their starting weight during the weekly check-ins, they received encouraging phone messages and small “green rewards” such as green mints or a dollar bill.

If they gained between three or four pounds, they were considered in the “yellow zone” and advised to tweak their eating habits or exercise routine. And if they put on five pounds or more, the test subjects were in the “red zone” and encouraged to restart their active weight-loss efforts. They were urged to open a red toolbox they had gotten at the start of the program that included a meal-replacement shake, a pedometer, a diet diary and a printed copy of their own weight-loss success story. They also were offered the chance to get one-on-one counseling by phone, e-mail or in person.

Both intervention groups attended weekly meetings for the first month of the study, and then monthly meetings either in groups or through a computer chat room.

At the end of 18 months, 72 percent of the people in the control group had gained five pounds or more, but only 55 percent of the Internet participants and 46 percent who got face-to-face counseling had regained that much weight.

“The Internet intervention worked, but the face-to-face format produced the best outcomes. Both were successful because the message that people got – pay attention to your weight, then take action to maintain it – was effective,” Wing said.

“We know that losing weight and keeping weight off is very tough for many people,” said Robert Kuczmarski, director of the Obesity Prevention and Treatment Program at the National Institutes of Health, which financed the research. “However, the results of this study show that there are definite actions that people can take before their weight begins to creep upward.”