Breaking News
December 13, 2018 - Chronic rhinitis associated with hospital readmissions for asthma and COPD patients
December 13, 2018 - Food poisoning discovery could save lives
December 13, 2018 - Cloned antibodies show potential to treat, diagnose life-threatening fungal infections
December 13, 2018 - Exercise may reduce colorectal cancer risk after weight loss
December 13, 2018 - Russian scientists create hardware-information system for brain disorders treatment
December 13, 2018 - Moderate alcohol consumption linked with lower risk of hospitalization
December 13, 2018 - Nurturing Healthy Neighborhoods | NIH News in Health
December 13, 2018 - Rise in meth and opioid use during pregnancy
December 13, 2018 - Researchers gain new insights into pediatric tumors
December 13, 2018 - FSU study finds racial disparity among adolescents receiving flu vaccine
December 13, 2018 - Drug cocktail induces cancer cell death by switching off energy supply
December 13, 2018 - Baculovirus virion completely eliminates liver-stage parasites in mouse model
December 13, 2018 - Researchers create noninvasive technology that detects when nerve cells fire
December 13, 2018 - Treating patients with hypertension induced albuminuria
December 13, 2018 - New substance could improve efficacy of established breast cancer treatments
December 13, 2018 - Scientists develop new stem cell line to study conversion of stem cells into muscle
December 13, 2018 - Re-programming the body’s energy pathway boosts kidney self-repair
December 13, 2018 - Research findings could help improve treatment of anxiety and post-traumatic stress disorders
December 13, 2018 - The Microbiome Movement announce Microbiotica as official industry partner
December 13, 2018 - New study reveals potential benefits of cEEG monitoring for infant ICU patients
December 13, 2018 - Whole-body imaging PET/MRI offers information to guide treatment options for prostate cancer
December 13, 2018 - International investigators fight against the negative campaign on benzodiazepines
December 13, 2018 - Targeting biochemical pathway may lead to new therapies for alleviating symptoms of anxiety disorders
December 13, 2018 - FDA Approves Tolsura (SUBA®-itraconazole capsules) for the Treatment of Certain Fungal Infections
December 13, 2018 - Are scientists studying the wrong kind of mice?
December 13, 2018 - Computer memory: A scientific team builds a virtual model of a key brain region
December 13, 2018 - Visual inspection alone is insufficient to diagnose skin cancer
December 13, 2018 - Paternal grandfather’s access to food associated with grandson’s mortality risk
December 13, 2018 - Our brain senses angry voices in a flash, study shows
December 13, 2018 - PM2.5 Exposure Linked to Asthma Rescue Medication Use
December 13, 2018 - Can’t exercise? A hot bath may help improve inflammation, metabolism, study suggests
December 13, 2018 - Can artificial intelligence help doctors with the human side of medicine?
December 13, 2018 - Virginia Tech and UC San Diego researchers team up to develop nonopioid drug for chronic pain
December 13, 2018 - NIH offers support for HIV care and prevention research in the southern United States
December 12, 2018 - Activating brain region could revive the urge to socialize among opioid addicts
December 12, 2018 - Relationship impairment appears to interfere with seeking mental health treatment in men
December 12, 2018 - Sleep, Don’t Cram, Before Finals for Better Grades
December 12, 2018 - Effective treatments for urticarial vasculitis
December 12, 2018 - Gun violence is a public health issue: One physician’s story
December 12, 2018 - The Science of Healthy Aging
December 12, 2018 - Yes to yoghurt and cheese: New improved Mediterranean diet
December 12, 2018 - Researchers uncover a number of previously unknown insecticide resistance mechanisms
December 12, 2018 - Regulating the immune system’s ‘regulator’
December 12, 2018 - In breaking bad news, the comfort of silence
December 12, 2018 - Study finds upward link between alcohol consumption and physical activity in college students
December 12, 2018 - FDA issues warning letter to Zhejiang Huahai Pharmaceutical involved in valsartan recall
December 12, 2018 - Weight history at ages 20 and 40 could help predict patients’ future risk of heart failure
December 12, 2018 - Presence of antiphospholipid antibodies tied to first-time MI
December 12, 2018 - DNA analysis finds that stethoscopes are teaming with bacteria
December 12, 2018 - New study could help inform research on preventing falls
December 12, 2018 - Women and men with heart attack symptoms receive different care from EMS
December 12, 2018 - Disrupted biological clock can contribute to onset of diseases, USC study shows
December 12, 2018 - New publications generate controversy over the value of reducing salt consumption in populations
December 12, 2018 - New data from TAILORx trial confirms lack of chemo benefit regardless of race or ethnicity
December 12, 2018 - Specific class of biomarkers can accurately indicate the severity of cancer
December 12, 2018 - Meds Taken Do Not Vary With ADL Impairment in Heart Failure
December 12, 2018 - Long-term study shows that HIV-2 is deadlier than previously thought
December 12, 2018 - People living near oil and gas wells show early signs of cardiovascular disease
December 12, 2018 - IONTAS founder and pioneer in phage display technology attends Nobel Prize Award Ceremony
December 12, 2018 - People who eat red meat have high levels of chemical associated with heart disease, study finds
December 12, 2018 - New method uses water molecules to unlock neurons’ secrets
December 12, 2018 - Genetics study offers hope for new acne treatment
December 12, 2018 - New computer model predicts prostate cancer progression
December 12, 2018 - Nobel Laureates lecture about immune checkpoint therapy for cancer treatment
December 12, 2018 - More Illnesses From Tainted Romaine Lettuce Reported
December 12, 2018 - Aspirin could reduce HIV infections in women
December 12, 2018 - The EORTC Brain Tumor Group and Protagen AG collaborate to study immuno-competence of long-term glioblastoma survivors
December 12, 2018 - Insights into magnetotactic bacteria could guide development of biological nanorobots
December 12, 2018 - Sacrificial immune cells alert body to infection
December 12, 2018 - Low-salt diet may be more beneficial for females than males
December 12, 2018 - Major soil organic matter compound battles chronic wasting disease
December 12, 2018 - Findings may open up new ways to treat dwarfism and other ER-stress-related conditions
December 12, 2018 - New computational model provides clearer picture of shape-changing cells’ structure and mechanics
December 12, 2018 - 10 Facts on Patient Safety
December 12, 2018 - Poorest dying nearly 10 years younger than the rich in ‘deeply worrying’ trend for UK
December 12, 2018 - Innovative care model for children with ASD reduces use of behavioral drugs in ED
December 12, 2018 - Spending time in and around Hong Kong’s waters linked to better health and wellbeing
December 12, 2018 - Simple measures to prevent weight gain over Christmas
December 12, 2018 - Research advances offer hope for patient-tailored AML treatment
December 12, 2018 - Researchers discover a ‘blind spot’ in atomic force microscopy
To improve self-control, call weight loss what it is: Difficult

To improve self-control, call weight loss what it is: Difficult

image_pdfDownload PDFimage_print
Credit: Drexel University

To reach your New Year’s fitness goals, a bit of reverse psychology might be in order. Telling people that weight loss is extremely challenging—rather than imparting a “You can do it!” mantra—motivated them to shed more weight, according to a new study by psychologists at Drexel University. However, the strategy did not compel participants to achieve the goal for which it was originally designed: to modify or replace many of the unhealthy foods in their homes.

The study’s findings, published this week in the American Journal of Clinical Nutrition, have conflicting implications, says Michael Lowe, PhD, a professor at Drexel’s College of Arts and Sciences.

“On one hand, giving overweight people a realistic sense of the dilemma that they are in and the powerful forces they are up against—including a genetic predisposition toward obesity and an increased susceptibility to many food cues in the environment—may actually promote cognitive restraint over their eating in the short-term,” Lowe said. “But, on the other hand, this message did not motivate participants to make numerous changes to the foods they surround themselves with.”

Lowe and a team of researchers originally set out to determine the effectiveness of three weight loss interventions: behavior therapy, behavior therapy plus meal replacements, or a condition focused on getting people to change foods in their home food environments. They enrolled 262 overweight and obese individuals and assigned them to one of the three methods, while tracking their weight over a three-year period.

Behavior therapy—the current “gold standard” in weight loss treatment—involves group support, regular weigh-ins, exercise, explicit goal setting and monitoring food intake, while meal replacement treatment replaces breakfast and lunch with calorie-controlled shakes or nutrition bars.

Behavior therapy is aimed at bolstering someone’s internal sense of self-regulation over food intake and exercise. But research has shown that increases in self-control are not sustainable, and lost weight is almost always regained. The powerful lure of foods high in fat, sugar and salt has been well-documented, and existing treatments do not do enough to ensure that foods kept in the home are permanently changed in ways that make self-control more feasible, according to Lowe.

“You can’t just give advice,” he said. “You have to work with people to eliminate and substitute very specific foods, and teach them to prepare food differently.”

That’s why his research team hypothesized that modifying the home food environment (or HFE) would be the most effective strategy for losing and maintaining weight loss. Participants in this group were given homework assignments to identify and make numerous changes to specific foods that were still satisfying but less calorically damaging.

“Asking people to make healthy decisions, when there are thousands of food choices available, is both emotionally challenging and also complicated,” Lowe said. “HFE treatment is really about mechanically trying to ensure that these changes are made, so the level of chronic temptation generated by foods in their homes is reduced.”

Most importantly, the research team repeatedly reminded the HFE group about the challenges associated with weight loss and maintenance. In doing this, the researchers aimed to acknowledge the participants’ vulnerability to overconsume favorite foods.

“We said, ‘It’s impressive and encouraging that you are taking this step to improve your weight and health, but we need to help you understand the daunting challenges you’re facing.’ The reason we did this was not to discourage them, but to give them a more realistic sense of how crucial it is for them to make lasting changes in their parts of the food environment that they could control,” Lowe said.

People struggling with their weight are likely to hold themselves responsible, even though a number of internal (heredity, for example) and external (fast food restaurants) forces are at play and beyond their control, Lowe said. The researchers suggested that by making multiple changes to their food environment, participants would be reducing the need to perpetually exercise self-control to maintain the weight they lost.

In addition to measuring the participants’ weights during six assessment sessions over three years, the researchers also assessed conditions such as binge eating, quality of life, cognitive restraint and food cravings by using questionnaires and statistical analysis.

At the end of the three-year study period, the researchers found that those in the HFE group lost more weight than those in the behavior therapy group. However, the differential in weight loss was modest, and all participants showed the familiar trend toward weight regain.

“We failed to get them to translate our warnings into the kind of actions we were trying to get them to take,” Lowe said.

The warnings did, however, have a positive—though unanticipated—effect. Cognitive restraint—defined by a participant’s ability to actively make healthy choices and measured with mediation analysis—showed the longest, most prolonged increase in the HFE participants, when compared to the other two treatment groups.

This suggests that the researchers’ rhetoric about the difficulties of sustaining weight loss may have actually caused the participants in the HFE group to “push back” against this message and increase their vigilance over their eating, Lowe said.

“That is, by questioning the usefulness of building self-control skills, the HFE treatment may have bolstered the very capacity it was meant to downplay—stronger self-control with regard to food,” the study authors write.

Though surprising, these results have potentially clinically-useful implications. By emphasizing the many factors that make lasting weight loss so difficult, it may help motivate individuals to mentally and behaviorally cope with these factors, according to Lowe.

“Rather than acting as cheerleaders giving facile encouragement, leaders of weight loss groups might serve their clients better by providing a more sobering description of the challenges participants face,” Lowe explained.

However, since the participants in the HFE condition did not make greater changes to their home food environment, future studies should examine how to better improve and monitor this weight loss intervention, such as sending dieticians or other practitioners directly to clients’ homes for periodic visits.

For Lowe, the study reinforces the challenging reality for those seeking to maintain weight loss—and makes a strong case for policies (such as Philadelphia’s beverage tax) that focus on preventing, rather than treating, the problem of obesity in the United States.

“Once these conditions develop and you are continuing to live in the same obesogenic environment, it is unrealistic to expect that many people will be able to sustain a large weight loss,” he said. “Society ultimately needs to prevent these unhealthy weight gains before they occur.”


Explore further:
Shedding consistent pounds each week linked to long-term weight loss

More information:
Michael R Lowe et al, Evaluation of meal replacements and a home food environment intervention for long-term weight loss: a randomized controlled trial, The American Journal of Clinical Nutrition (2018). DOI: 10.1093/ajcn/nqx005

Journal reference:
American Journal of Clinical Nutrition

Provided by:
Drexel University

Tagged with:

About author

Related Articles