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What 11,000 women say works for weight loss?

By Matt O'Neill, MSc(Nut&Diet), APD

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Who better to ask about weight loss strategies than 11,000 women who've tried a range of diet, exercise and program-based methods? In this article I reveal the results of a large-scale survey and the startling implications for your shape-up program.

Despite the so-called obesity epidemic and intense consumer demand for fitness and nutrition programs, we really know very little about what women do to stay in shape and whether what they do works. In practice, is diet more effective than exercise? What about combinations of methods?

To search for answers, Dr Lauren Williams PhD and a team based at the University of Newcastle, Australia used the 1996 Australian Longitudinal Study of Women's Health and a follow-up two years later to examine what weight-loss practices women use, and their effectiveness.

They looked at the weight-loss methods, and how much weight had been gained or lost, among the 11,589 women aged between 47 and 52 at the second survey. This demographic is growing sector in the fitness industry, so the results offer us useful tips about programming.

Weight control practices

The study asked about nine weight control practices, which included;

  1. Commercial weight loss programs (e.g. Weight Watchers, Jenny Craig),
  2. Meal replacements or sliming products (e.g. Limits, Herbalife),
  3. Exercise,
  4. Cut down on size of meals or between meal snacks,
  5. Cut down on fats and/or sugars,
  6. Laxatives, diuretics or slimming pills,
  7. Fasting,
  8. Vegetarian diet, and
  9. Smoking.
Almost three quarters (74 per cent) of the women surveyed said they used at least one of these practices. And 83 per cent of these women used a combination of one or more of the practices.

Which methods worked?

In findings that could be seen as less than encouraging at first glance, the team found that although 74 per cent of the participants reported wanting to control their weight, there was little that proved totally effective.

With one exception, no single method or any combination of methods prevented weight gain. That exception - the only practice that led to any weight loss at all, and then only an average 0.03 kg - was a four-method combination: reducing fats and sugars, cutting back on portion size and snacks, exercise and a commercial weight-loss program. Only 7 per cent of weight-controlling women in the study used this approach.

Interestingly, the women who used commercial programs had a higher average BMI, which could mean women only see a need to sign up for a program when they are larger and need to lose weight.

The most commonly reported combination - cutting back on fats and sugars, reducing portion sizes and snacks, and exercise - which was practised by 32 per cent of the women, resulted in an average weight gain of 1.24 kg.

The researchers were surprised that even “doing nothing”, which 16 per cent of women did, was more effective than that, leading to a gain of 0.91 kg.

Vegetarian diets didn't work, unless practised in combination with exercise. Without the exercise, a vegetarian diet combined with other methods actually led to a weight gain of up to 1.5 times that of those eating a “regular” diet in combination with the same methods.

Only 8 per cent of all women surveyed used potentially health-damaging practices, including fasting, self-induced vomiting, smoking, and the use of laxatives, diuretics or appetite suppressants. But this group gained 1.5kg more over the two years compared to the women not using these practices.

Diet or exercise?

Women who used dietary practices only, by cutting portions, fats and sugars gained on average 1.32kg in two years compared to women who used exercise alone who gained 0.72kg. Women who combined diet and exercise practices gained 1.28kg.

The authors caution you can't claim physical activity is better than diet for weight control because many women who used exercise as their sole weight-control practice were within the normal weight range at the first survey, and reported that they did not want to lose weight.

So what to do? The researchers do point out that without the attempts to lose weight, weight gain may have increased. But they also caution that a strong emphasis on diet and weight control makes women think too much about food, which can be counterproductive for successful long-term weight control.

Take home messages

Based on the experiences of a large representative sample of 11,000 women in this study, just going on a diet or joining a gym by itself is unlikely to deliver fat loss results over the long-term. However, combining diet, activity and a commercial or structured program is likely to deliver results. It's the synergy between these slimming strategies that works best.

It may be that having a structured program, which could include weekly appointments, meetings, seminars, weight-ins or support is the glue that holds diet and exercise behaviour changes together. Without this level of motivation and accountability self-help efforts are more likely to come unstuck.

If you are looking for results yourself, your most rewarding decision will be to commit to a structured, supported program. If your business and career rewards are based on delivering results, start building a structured program, rather than just sharing diet and exercise advice.

Reference: Preventing weight gain: a population cohort study of the nature and effectiveness of mid-age women's weight control practices. Williams, L. et al., International Journal of Obesity (31), 978-986. 30 January 2007.



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