[jiffypop]

i just can't resist a research challenge!! it took longer than i thought it would take, but here's the abstract of the paper that started it all. just a quick look suggests that the data should not be generalized to the entire universe. the program was OPTIFAST and is now known as the Novartis Nutrition program http://www.optifast.com/.

so, IMO the main finding of this study was that 5% of people who use supervised liquid weight loss programs keep their weight off. and it doesn't apply to members of WW or whatever. not that their rates are fabulous, but they're certainly better than this 5%!!!!

and, for all of you who like this sort of information, Stampfer and Colditz started the Nurses Health Study, and hired a young epidemiologist/MD named Walter Willett. Willett's nutrition conclusion arise from the data from the nurses, from the Physician's health study, and from the study on other women healthcare professionals [which has some serious socioeconomic biases built into the population, but we'll skip that for now].

ENJOY!




Three-year follow-up of participants in a commercial weight loss program. Can you keep it off?

Grodstein F, Levine R, Troy L, Spencer T, Colditz GA, Stampfer MJ.Arch Intern Med. 1996 Jun 24;156(12):1302-6.

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass., USA.

BACKGROUND: One third of Americans are obese, according to the 1988-1991 National Health and Nutrition Endpoint Survey III survey. Obesity increases the risk of death and a variety of chronic diseases. Numerous commercial weight loss programs demonstrate short-term success. OBJECTIVE: To assess maintenance of weight loss achieved during dieting. METHODS: We surveyed 192 participants in the Sandoz Nutrition (Sandoz Pharmaceuticals, Minneapolis, Minn) diet program approximately 3 years after participation. Initial date were supplied by the diet clinics and follow-up data, including weight at various points after the program, participation in other weight loss programs, and lifestyle variables, such as exercise, smoking, and television watching, were collected by a mailed questionnaire. RESULTS: On average, the group lost 22 kg during the diet program. After the follow-up period, the mean weight (mean, 102.6 kg) was only modestly less than the group's original weight at the start of the diet (mean, 105.9 kg). Twelve percent of the subjects maintained 75% of their weight loss after leaving the diet program, 57% maintained at least 5% of the loss, and 40% gained back more than they had lost during the diet. The frequency of exercise after the diet program was the strongest predictor of weight loss maintenance, while television viewing predicted a gain in weight. CONCLUSION: Given the apparent lack of substantial, long-term success at weight reduction, perhaps greater emphasis should be placed on prevention of obesity.

PMID: 8651838 [PubMed - indexed for MEDLINE]

[MrsJim]

Well...now I can *really* say that I'm part of that 5%! I participated in a similar Optifast study through Stanford University (I was in one of the final groups which started in 1990) and during the 12-week VCLD period went from 265# to around 203#...at the end of the 18-month study I was down to around 180 (if memory serves). Unfortunately most of the study participants had gained most or all of their weight back by the end of the study...interesting...

[Tig]

I had sniffed at the 5% - good to know the source! MrsJim is a Celebrity! She is THE 5%!!!!

CONCLUSION: Given the apparent lack of substantial, long-term success at weight reduction, perhaps greater emphasis should be placed on prevention of obesity.

My immediate thoughts:

• That is what Maintenance is all about
• Duh

[MrsJim]

Ya know, I was thinking about this last night, and I believe that this is NOT the origin of the "5%" figure...as much as I would enjoy being a celeb and all (NOT...unless I could be, like, Wayne Newton - caught a show on the Travel Channel this weekend and I WANT TO BE WAYNE NEWTON with all his money and the yacht and the plane and the zoo and of course the horses...but I digress )

I have somewhere in my collection a little paperback book titled "Just a Pretty Face: Being Fat in America" by Marsha Millman (interesting book if you can find it - it was published in 1979 and I'm SURE it's out of print) where the 5% figure was bandied about several times - I don't have the book in front of me but a chapter of the book took place at a 'fat camp'. Many of the kids had spent multiple summers at the camp (at a then-cost of $2,000 per camper) and a counselor was quoted as saying something like "They say that 95% of dieters gain their weight back, but even so, they can't hurt us. Every parent who sends their kids here think they will be one of the 5%."

(actually I spent the summer of 1979 at one of those camps - Camp Camelot at Whittier College, CA - and it was one of the BEST summers of my LIFE...I had to earn half the money to go and for the first time, I wasn't the fat, unpopular sister - in fact I became quite the little joiner since I could play the guitar...after the first few days I was having too much fun to think much about all the ice cream and candy and other junk I was missing - unfortunately I was in the minority there - there were quite a few campers who were constantly plotting to bring in contraband candy I flew home proudly wearing size 12 Calvin Klein Jeans - remember those were all the rage back then? Ah memories....)

[Meg]

Ooohhh .. Jif and Karen! Belated thanks for the research! I always wondered who the “they” is who make all these pronouncements. Gotta say that I’m not real impressed with how this translates to all the rest of us. OK, let’s ditch the 95% number — it’s meaningless anyway, since we all have the power to control our own destinies. It’s not like a certain number of us are preordained to regain weight. I believe with all my heart that every one of us can keep the weight off for the rest of our lives if we so choose.

I’ve been thinking a lot about maintenance lately, sparked especially by some correspondence with the lovely Jif. I told her (and I’ll repeat myself here) if I were to write a book about maintaining a weight loss, I’d call it Now Comes The Hard Part. Regardless of how we get the weight off or how long it takes, we’re all pretty much in the same boat in keeping it off. I’m willing to bet that we’re all pretty good at weight loss since we’ve all done it so often. It’s the keeping it off that’s the hard part. Now I’ll never lie to someone and say that losing weight is easy — it’s hard, sweaty work. But so is maintenance and no one ever talks about this part.

So many weight loss plans end when you reach your goal weight. And that’s why so many of us end up gaining the weight back. This is for life for every one of us. I was guilty of living in a fantasy world where I thought that I could eat what I wanted (and not gain) when I got to goal because somehow I’d be cured of all my eating issues. Wow! If I only weighed 135 pounds, I just know that I’d never binge eat again! I’d never want to eat a dozen cookies again! I’d never eat when I wasn't hungry! I’d delicately pick at salads and pass by desserts effortlessly.

Wrong. Wrong. Wrong. Stupid. Stupid. Stupid. I’m still the same person with the same eating issues — just in a smaller body.

Let’s imagine that “they” have invented the Magic Weight Loss pill. You take it at bedtime and poof! you wake up in the morning having lost all the weight. What then??? I don't know about you guys, but I would have eaten a bag of Oreos to celebrate. In other words, I wouldn’t have learned a darn thing about keeping the weight off. Losing the weight is the dress rehearsal for the Big Show — keeping it off for the rest of our lives. So we have to take everything that we learned about losing weight and use it every day to maintain our weight.

What good would it do any of us to get the weight off without the tools and skills and knowledge to keep it off? Karen’s written before about her experiences with the Optifast diet — as part of a study, they got a lot more support than most yet still 95% couldn’t keep the weight off (correct me if I’m wrong with any of this, Karen!) It’s damn hard even with all the support in the world.

But it’s not impossible! And this takes me back to what I started off with — this is within our power. I’m so sad when I hear a heavy woman say that she “can’t” lose weight. I want to grab her and say “of course you can if you so choose!” It’s all a matter of choices. Do I eat choose to eat this cookie? Do I choose to go the gym? Do I choose to plan my meals the night before? Do I choose to weigh and measure my food and make a cult out of Fitday? True, we may not WANT to make the choices necessary to lose weight (and that’s everyone’s prerogative, of course). But we CAN do it.

If we’ve made all the right choices and have lost the weight, then it’s totally within our power to keep making those right choices and keep the weight off for life. Regardless of any statistics. One of the reasons that I joined the National Weight Loss Registry is to help establish new statistics for weight maintenance. How about we make this group the 100% Club — 100% of us keep the weight off for life? (hey, maybe "they” would come and study us!)

[jiffypop]

soooo. it's a good thing i didn't take a cookie from the break room? or another handful of pretzels? because i'm not hungry. i guess i'll just sit here and drink my HUGE container of iced tea!!!! <sigh>

[diphthong]

You all seem to discuss something timely to what's going on in my mind.

This week I've been thinking about commitment. We can commit to our spouse/partner, an employer for exchange of salary, our children the moment we become pregnant, and even our pets. So why can some people commit to do a "diet" but fall off after the diet is done?

Is it as simple as committing for the remainder of our lives, like marriage, our obligation and fidelity to *ourselves?* We have the free will to exercise our choices, but does the 50% marriage failure (USA), also reflect our attitudes as a society (not individuals) the same as the failure rate of maintaining weight loss? Or do you think, it's a matter of "informed" choices, example by those who influence our lives and integrity, and our resulting attitudes when taking on a commitment that *should be* for our lifetime?

So what are your thoughts about commitment?

dip

[Tig]

I think I may be in a unique class. I thought about "dieting" but it never really went very far. I remember posting the grapefruit diet on my fridge...never did anything about it - just posted it. So I never lost any weight and then regained. I just gained and gained! More efficient.

Then in October 2000 I joined WW at work with a friend because SHE needed to lose weight and I just went along to support her. She dropped out and I continued. Just kept on. And on. No way am I going to let any of that weight go back on. Ever. Is that commitment? Or Old Lady Stubbornness? I know that I am absolutely tickled with my energy level and with how I look and feel.