Weight loss programs

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Hi All,

The below from the Washington Post is presented for our information.

Pdfs for the many reports from the journal are available.

This Just In: Most Diets Don't Work

By Sally Squires

Tuesday, January 4, 2005; Page HE01

Before you make a New Year's resolution to join an organized diet

program, consider this: A University of Pennsylvania study finds a

high cost per pound lost and very limited evidence for long-term

success of any of nine popular diet programs studied.

Oh, yes, and large proportions of people -- sometimes more than half -

- drop out within months of beginning the programs.

If you want to achieve a healthier weight, " the first step is to try

to do this on your own, " said A. Wadden, director of the

Weight and Eating Disorders Program at Penn and co-author of the

study, which appears in this week's ls of Internal Medicine. " If

that doesn't work, then get assistance. "

Backed in part by a grant from the National Institutes of Health,

Wadden and Penn physician Adam Gilden Tsai reviewed 1,500 weight loss

studies of adults and zeroed in on 10 commercial or self-help

programs.

Using those studies, plus additional data supplied by the programs

themselves, the team examined nine plans: Weight Watchers,

Craig, L.A. Weight Loss and eDiets.com; the self-help groups Take Off

Pounds Sensibly (TOPS) and Overeaters Anonymous (OA); and three

medically supervised commercial programs, Optifast, Health Management

Resources and Medifast/Take Shape for Life.

" With the exception of one trial of Weight Watchers, the evidence to

support the use of the major commercial and self-help weight loss

programs is modest or nonexistent, " the team concludes. " Controlled

trials are needed to assess the efficacy and cost-effectiveness of

these interventions. "

Price is likely to put many of the programs beyond reach of those

trying to achieve a healthy weight, the study found. The medically

supervised programs, which also provided food, cost the most, ranging

from $840 to $2,100 for three months, or " about $50 per pound lost, "

Wadden said.

Craig cost $1,249 for three months, including all daily food.

Both Weight Watchers and L.A. Weight Loss cost about $170 for three

months, while Ediets.com was $65, TOPS $26 and OA had no charge.

While the study found little evidence to prove that most commercial

or self-help weight loss programs work, here's what experts say can

help you to achieve a healthier weight by doing it yourself in 2005:

Pace yourself. Sure, it's tempting to start changing all your habits

at once, but Wadden and his colleagues have found that doing too much

too soon can be a program for failure. In fact, behavioral studies

suggest that new habits begun at the same time are also more likely

to be abandoned at the same time. So it's best to spend the first two

weeks getting some of your eating habits in order. " Then introduce

exercise in the third or fourth week, " Wadden said.

Keep records. Yes, you may feel like an accountant, but studies show

that recording daily eating and exercise increases your chances of

success. Burke, vice president of nutrition services at

eDiets.com, notes that participants who record the food they eat on

their site fare much better with weight loss than those who sign up

but fail to log on regularly. " Unless you use it, you're not going to

lose it, " she says.

Make big changes in small steps. To foster a sense of mastery over

your new habits, begin with something you know you can do. Maybe you

want to decrease calorie intake: Start with a level that isn't too

onerous -- say, 1,800 calories per day this week, then drop to 1,600

daily next week and so on, until you reach the appropriate level for

the weight loss you want to achieve.

Revel in your progress instead of obsessing about your long-term

goal. " Focus on what you achieve, " Wadden said. " So celebrate the 10

pounds lost, even if you need to lose 70 pounds. You can only feel

miserable about the latter and, hopefully, somewhat proud of the

former. "

Be the turtle, not the hare. Plenty of weight loss programs and best-

selling books promise quick success. But losing pounds too fast can

raise the risk of gallstones, constipation, cold intolerance and hair

loss. Plus, quick weight loss doesn't give you the chance to make the

fundamental lifestyle changes necessary for long-term success. About

half a pound to two pounds per week is considered a safe rate of

weight loss. It takes a deficit of about 3,500 calories to lose a

pound. But things don't always go according to plan: Hormonal

fluctuations and water retention can sometimes slow the scale's

decline even when you do everything right. One of the last

contestants to be booted off " The Biggest Loser " reality television

series lost two pounds in a week -- and she was working full time at

losing weight.

Reward yourself. Most people forget to give themselves a good pat on

the back for reaching an interim goal. Just make sure that reward

isn't food. Think about renting a movie you've always wanted to see;

go to a concert; buy a new CD; get a massage or new workout shoes or

clothes.

Enlist support for your efforts. " Recognize that you need a

supportive atmosphere to be successful with weight loss, " said

-Kovach, chief scientist for Weight Watchers. " So turn to co-

workers, family or friends for help. "

Cheers, Alan Pater