noodle’s doodles

By Nanci Hellmich, USA TODAY

VANCOUVER, B.C. — One of the largest clinical studies on keeping off the pounds after weight loss supplies more evidence that even when the battle of the bulge is won, the war is far from over.

Researchers at Brown University in Providence say the safety zone around weight maintenance is about 5 pounds. That’s the marker indicating it’s time to stop in your tracks and immediately reverse course before all is un-lost.

“The key factor is you must continue to monitor your weight after you’ve lost it, and if you start to regain, then immediately rein in your eating and step up your exercise,” says Rena Wing, a professor of psychiatry at Brown University and lead researcher on the new study called Stop Regain.

The researchers presented the new data Sunday at the annual meeting of the NAASO, the Obesity Society, an organization of professionals working in obesity research, treatment and prevention. NAASO stands for the North American Association for the Study of Obesity.

Scientists have long sought clues to the mystery of how to keep diet-weary Americans from regaining weight they’ve lost. Researchers here are talking about why that’s so hard to do for both behavioral and biological reasons.

“Weight-loss maintenance is the No. 1 problem in the treatment of obesity,” Wing says. “The question is: Can we stop regain? The answer is a resounding yes.” The government-financed Brown University study of about 300 people over 1½ years encouraged participants who had lost weight to do the following:

• Step on a scale every day.

• Try to be physically active at least an hour a day.

• Participate in face-to-face weight-maintenance classes or Internet programs that offer support and instruction.

• And if they regain 5 pounds, put on the brakes by following a better eating and exercise plan.

Fast start, then reversal

Several studies released at last year’s obesity meeting showed that dieters on aggressive programs lose an average of 20 to 22 pounds — or about 10% of their starting weight — in the first six months and then quit losing. Many then start to gain the weight back, which is frustrating to dieters and weight-loss professionals.

In considering behavioral obstacles, NAASO members considered other research Sunday on the effect of stress on 69 African-American women who had lost weight.

That study found that the women were more likely to regain weight if they were stressed or a little down, because that’s when they ate more high-calorie, high-fat foods, says Paula Rhode of the University of Kansas School of Medicine. She says the study focused on black women because they are at a high risk for obesity and obesity-related diseases. “These findings suggest that adding stress-management strategies to weight-loss programs may help prevent or delay weight regain,” Rhode says.

But experts now know that there’s a lot more to the problem than coping or lifestyle.

The National Weight Control Registry is a research study of adults who have succeeded at long-term weight loss. Its members include thousands of Americans who have lost and kept off at least 30 pounds for more than six years. They report taking these steps to avoid gaining weight: • Exercise regularly. They walk 4 miles a day or burn the equivalent in calories in another form of physical activity. • Limit calories to an average of about 1,800 a day. • Consume a relatively low-fat diet and have breakfast every day. • Do regular weigh-ins. • Eat in a consistent way. That means not overindulging on the weekends. • Keep track of what is eaten.

“Weight loss is not just about behavior and willpower; it’s biological,” says obesity society president Louis Aronne. “There is a coordinated mechanism in the body — designed to prevent you from starving to death — that makes weight loss difficult.”

Aronne explains that dieters’ own hormones start working against them as the body fights to get back to its former weight. In an effort to keep the dieter from starving, a hunger hormone called ghrelin increases and a fullness hormone called leptin decreases.

“So weight loss is not easy because the body is essentially working against you,” Aronne says.

But some people are able to overcome the obstacles. Researchers have learned a lot from members of the National Weight Control Registry, a study of about 5,000 people who lost an average of 73 pounds and kept off at least 30 pounds for more than six years.

As one of the founders of the registry, Wing used the data from the registry to design the latest study.

She and colleagues recruited 314 people who had lost 10% or more of their body weight in the past two years in a variety of ways, including following Weight Watchers, Atkins and other programs. The average weight lost was 44 pounds; some dropped more than 100 pounds.

Participants were randomly assigned to one of three groups. A control, or baseline, group received only a periodic newsletter with weight maintenance tips. A second group went to classes regularly for 18 months. The third group used the Internet to get educational information similar to the material covered in the classes. (Related story: The Internet as a weight loss tool )

The class and Internet groups were taught secrets of success from registry members and encouraged to follow their examples. They wrote their own weight-loss success stories to refer back to if they started gaining.

The dieters in the treatment groups kept track of their weight and plotted it on a chart that had green, yellow and red zones. Each week, the classroom participants called an automated answering service, and the other group entered their weight on the Stop Regain website.

If they were within 2 pounds of their goal, they were in the green zone and received small rewards once a month, such as green gum, a green Frisbee or a dollar bill.

If they went 3 to 4 pounds over that weight, they were in the yellow zone, which meant they should start watching their diet more closely and exercising more.

If they gained 5 pounds or more, they hit the red zone. Those in the face-to-face treatment group received a call from a weight-control counselor who would help them get back on track. Internet dieters got an e-mail from a specialist.

To combat the extra weight, dieters were advised to read their own weight-loss story and reinstate those behaviors or follow a low-calorie plan that included exercise.

The fruits of their labors

The findings after 18 months:

• About 70% of the newsletter group regained 5 pounds or more; 54% of the Internet group regained that much, as did 38% of the face-to-face group.

• The median weight gain was 10 pounds for the newsletter group; 6 pounds for the Internet group; 2.5 pounds for the face-to-face group.

• Among those who weighed in daily, 61% maintained their weight within 5 pounds. But weighing daily only helped those in the class and Internet groups.

• People who were the most successful exercised for about an hour a day.

“Face-to-face classes and the Internet support program were helpful because participants were taught how to make changes in eating and activity to immediately reverse small weight gains,” says Deborah Tate, assistant professor at the University of North Carolina and a co-investigator on the study.

The program really worked for some participants.

I’m a long way off this stage but thought it was really useful.  Maybe we should have a maintenance forum and encourage weekly weigh ins to keep track of the 5lb marker

Week 3 is where I thought I’d unravel.  The novelty has worn off the diet and exercise and it’s just normal life.  This was the week when I would decide (subconsciously) if this was the ‘lifestyle change’ we all long for and not the quick fix.

It meant that real life started to come back into play.  I had to miss bootcamp one night to go to a gig.  I’ve been out several times this week and tried to sick very close to my diet but I suspect salad from a restaurant is not quite as healthy as the ones I make at home (who knows what’s in those yummy dressings).  I also had a glass of wine.  This isn’t bad except that it was mostly out of peer pressure.  My husband and I go out regularly with this other couple.  We go out and get drunk and party at the weekends.  Our relationship with this couple is based on this activity above anything else.  They are tolerating my 1 month off the booze but I know that when August hits, they’ll all be expecting me to go back to binge drinking and cocktails.  I don’t want this (have you seen the calories in cocktails!!).  I want to become one of those people who can have a couple of glasses of wine and call it quits and can alternate alcoholic and non-alcholic drinks.  This will have massive long term health benefits for me.  Living in Hong Kong, the expat lifestyle is basically to go out to eat and get drunk as often as your hangovers will let you.  It’s been lots of fun for 2 years but now I see all the damage….on the scales.

So, back to the point:  This week I didn’t crumble.  I stuck at it albeit with some small indiscretions (glass of wine, some popcorn at the movies) but I didn’t let them throw me off track.  The results?  Today was weigh in day and I’ve lost 2 more pounds!! I’m 2 pounds off my mini goal with 2 weeks to my holidays!  Whoopeeeee  

First off…I maintained this week.  I’m pretty happy with that since I lost quite a lot in week one so I guess this was a ‘balancing out’ week (or something?!).

I see so clearly now that the weekends are my major downfall.  I didn’t do badly but I could have been much better with my routine.  Firstly, I ate 2 meals on Saturday and 2 on Sunday.  My whole meal routine goes totally out of the window.  I went out with friends on Friday.  I didn’t drink a drop of booze even though I accepted a new job (good for me), but I did eat out.  I made the best possible choices but I know it’s never going to be as healthy as something I make myself.  

We got a new PC on Friday and it’s really super cool.  I spent most of the weekend playing with the new toy and installing programs.  As a result (plus a genuine sore knee) I didn’t work out and I messed up my sleep patterns (bed late, up late).  I haven’t exactly done anything wrong (no naughty treats etc) but it was all a bit too much like the old me.

So enough about the past.  Today is Monday…it’s bootcamp day.  I’m going to go and kick my ass tonight.  I’m back on track.  The sun is shining! 

Good luck fellow buddies!!   

I planned to only weigh myself once a week, on Sundays, but that’s not happened.  I want to see the results of my hard work and see it now!

After a really good start last week, I’m not seeing anything in the weight department this week.  I’m just hovering around the same.  Now I fully expected this.  This happens each and every time I loose weight.  I drop 5lbs+ in the first week and then stick for a while.  I’ve never stuck with it long enough to get over this part.  Obviously this time, I’m not giving up so easily so I decided to look for evidence beyond the scales to fuel the motivation. 

Firstly, I am feeling so much better.  I am sleeping better and feel more energetic.  My fitness level has already improved in a week and a half and I can run 3Km without wanting to die.  My clothes feel more comfortable.  My skin looks a little better.  I love feeling full after a normal sized meal and I’m learning to listen to the ‘full up’ alarm.  I’m saving money buying food instead of eating out.  I haven’t had a hangover for 2 weeks.

 All little things that add up.  I commented on a blog yesterday that looking good was just the icing on the cake and our health and longevity is the ultimate prize.  I guess it’s sometimes hard to truly know what this means as a relatively healthy 28 year old.   

To all those that have maintained this week (or not), please let me know what signs you can see that this process is working… 

My official weigh in this morning showed big losses this week, almost 7lbs in fact.

Please don’t get worried, I’m really not doing anything out of the ordinary.  Yes my calories are around the 1200 marker (more or less) and I’m eating every time I’m hungry.  Beginners luck I guess.  The best news is that I’ve moved from the ‘obese’ to ‘overweight’ category on the BMI.  I’ve never been so happy to be called overweight!  ha ha!

This weekend was a struggle.  I was out all day Sat (gym, swim and cinema), so had to eat in a restaurant.  Plus I woke up late so sort of had a brunch and eveing meal.  But the evening meal had lots of calories so made up for missing a meal.  I tried to make good choices and wasn’t tempted by the bread basket!

 Today I had breakfast and a snack then went shopping.  I was in a part of town I didn’t know so well and I started to get hungrier and hungrier.  I had no idea where to eat and felt myself just about to cave into some crappy food then my scales flashed before my eyes and I grabbed the metro to a part of town I knew for a salad.  Hubby didn’t complain and ate salad too!  I felt much better for sticking to it. 

I don’t expect to loose so much every week, and I know it’s a bit extreme, but it is very satisfying to see my hard work paying off.  I even had a extra snack tonight to make sure I’m reaching 1200 cals.  I’m not here for the quick fix….I’m in this for the whole ride!

I broke my drinking fast last night.  A friend of mine had some bad news and I went to meet her for a drink.  I couldn’t bring myself to order a diet coke with her weeping into her whisky while her boyfriend was flying home to bury his dad.  Living out in Asia, that call is everyone’s worst fear .  It seems to have made it more personal for everyone.  

 So I broke it.  Who cares? I was pleased that I maintained a level of control.  I opted for red wine because I know it’s got some health giving properties, plus I don’t drink it often so I wouldn’t gulp it.  I kept it to 2 (very large I must say) glasses. 

 I think I’m learning about that ellusive quality: moderation!  It felt good to make the decision that I was going to have a drink with my friend in this circumstance and keep control of it.  I don’t want to sound like I should be on my way to AA, but my relationship with drink is the same as food…no moderation.  Until now, that is.

Thinking long term, I need to know how to balance life and loosing weight.  Right now, it’s all I think about, I’m consumed by calorie counting, this site, exercising etc and it’s keeping me right on track.  But this will fade when I reach my target and I can only hope I have all the skills to keep the sense of balance.  I guess this is why they call it a lifestyle change.

I’ll drink to that! 

I, like most on here, can’t actually figure out how I got to where I am.  I considered my previous diet OK.  It was: no breakfast, no snack, salad/sandwich for lunch, no snack, big dinner plus occasional treats.  This did not apply at the weekend which was a bit like: drink - eat - hangover - eat - drink - etc. 

 Now I’m starting to see the problems for myself (note mild sarcasm).  OK, I always knew the booze and kebabs wasn’t a good plan, but the rest of the week?  Well, we all know the virtues of breakfast but I have also started to realise that not snacking was another big problem.  I’m still finding it hard to allow myself to snack, but I haven’t yet been ’starving’ when I get to my meal times now that I am having 2 snacks a day.  I honestly managed to train myself so well that those evil snacks were my only problem!!  Now I feel like I’m eating all day, and I’m still cutting my calories in half.  I love it!

Still dreading going back on the booze though….I’m bound to want to eat something bad!  I’m avoiding that for now (booze free July!).  Anyone got any good ideas?  I can’t see me carrying carrot sticks into cocktail bars! 

Monday was the start of battle! 

 I signed up for a 5 week bootcamp.  It’s 2 nights per week for ‘just an hour’!  Last night was my first one.  Wow!  I knew it was going to be tough but the office also accidentally signed me up for the itermediate class.  It basically consisted of running up and down the street with some kind of exercise in between, then running up and down stairs, then lots of push ups, jumping jacks and things I’ve never heard of.  Grueling!

I felt sure I was going to vomit - and bear in mind that I’m not completely knew to exercise - but I persevered and by the end I was very proud of myself.

 I know that the others in the group (all super-fit) were probably just shaking their head at me but no one could complain that I didn’t give it my all.

This morning, I ache a little but I’m more determined than ever.  I weighed myself but I’m not officially posting my weight until the end of the week because I don’t trust the scales over such a short space of time.  Roll on Sunday!!

I realised today that people ALWAYS tell me that I’ve lost weight.  I must get a ‘compliment’ about my weight 3-4 times every week, or basically every time I haven’t seen anyone for more than a few weeks.  The truth is that I have been consistently 50lbs overweight for years.  Yes, I fluctuate now and again, but I’m fairly constant.

 Why do people insist on telling me that I’ve lost weight?  My guess is that it’s because I’m overweight and they think this is the highest possible compliment.  At first I used to think, ‘hmm, this dress must be really flattering’ and ‘perhaps eating only half a tube of pringles is a good diet strategy’, but now I know that people just tell lies to make me feel good.  I know this because when I have actually lost a little, they look me in the eye and try to convince me that this time…it’s the truth - ‘no, honestly, I can’t believe it, it’s amazing, you’re practically wasting away’ - this means I’ve lost 2-3 pounds.  I know they mean well but really, if I’d actually lost a pound for every time I hear that I’ve supposedly lost weight, I’d be about the size of a pregnant flea.  Sycophants!

 So here’s the plan…

Tomorrow I’m starting a serious weight-loss and fitness-gain plan.  My goals are to run a 10K race at the end of August in 1h 10m (I did 1h 21m in Feb) and loose 5 kilos (around 11lb) in 5 weeks.  I enrolled on a bootcamp programme to kick my bum into shape and I’m planning meals instead of the usual tactic of ‘generally eating well’.  I’m going to really do it this time.

 People are going to pass out…  (smirk)