Breaking News
March 20, 2018 - Sarepta Therapeutics Announces Plan to Submit a New Drug Application (NDA) for Accelerated Approval of Golodirsen (SRP-4053) in Patients with Duchenne Muscular Dystrophy (DMD) Amenable to Skipping Exon 53
March 20, 2018 - Post-Transplant Fatty Liver Disease on the Rise
March 20, 2018 - New mutation linked to ovarian cancer can be passed down through dad
March 20, 2018 - Scotland study aims to offer precise diagnoses for people with rare genetic diseases
March 20, 2018 - Stem cell treatment may help rejuvenate ovaries, avoid effects of premature menopause
March 20, 2018 - FDA Approves Hizentra (Immune Globulin Subcutaneous [Human] 20% Liquid) for the Treatment of Patients With Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
March 20, 2018 - Death Strikes Young in RA
March 20, 2018 - Quiescent cells also mutate
March 20, 2018 - Stem cell-derived ocular cells treat severe AMD
March 20, 2018 - Mediterranean diet appears to be good for postmenopausal women’s bones and muscles
March 20, 2018 - Scientists discover rare childhood liver cancer’s ability to metastasize to the brain
March 20, 2018 - Treating metastatic breast cancer with immunotherapy
March 20, 2018 - The 5:2 diet could have beneficial impact on important risk markers for cardiovascular disease
March 20, 2018 - Congress tackles the opioid epidemic. But how much will it help?
March 20, 2018 - Neanderthals Just Part of the Evolutionary Puzzle
March 20, 2018 - Higher Mortality With Surgery for Early NSCLC
March 20, 2018 - Researchers go skin deep to explore what causes wrinkles
March 20, 2018 - E-cigarette use linked to fat accumulation in the liver
March 20, 2018 - Fearful worms provide new clues about human anxiety
March 20, 2018 - Oral micronized progesterone may reduce hot flashes, night sweats in perimenopausal women
March 20, 2018 - Newer treatment for type 2 diabetes reduces liver fat in patients with NAFLD
March 20, 2018 - I.D. Break: PrEP Map; Faulty Flu Meds; Better Zika Test?
March 20, 2018 - Bronchial thermoplasty can improve severe asthmatic cough
March 19, 2018 - Speeding up wound healing using nanofiber dressings
March 19, 2018 - Summit Announces New Analysis Showing Ezutromid Significantly Reduced Muscle Inflammation in Phase 2 Clinical Trial in DMD
March 19, 2018 - Optimizing Sham Acupuncture: That’s Improbable!
March 19, 2018 - Women who have gestational diabetes in pregnancy are at higher risk of future health issues
March 19, 2018 - Viagra cuts colorectal cancer risk in animal model
March 19, 2018 - Vitamin B12 supplementation could postpone disease progression in Parkinson’s patients
March 19, 2018 - Study shows that omega-6 fatty acids could protect against premature death
March 19, 2018 - TherapeuticsMD Announces FDA Acceptance of New Drug Application (NDA) and Prescription Drug User Fee Act (PDUFA) Date for TX-001HR
March 19, 2018 - Minorities More Sensitive To Pain? Pain Medicine News Report
March 19, 2018 - Low blood sugar poses unaddressed threat to people with type 2 diabetes
March 19, 2018 - ACEA goes live with exhaustive, searchable library of NovoCyte publications
March 19, 2018 - Consumption of low-calorie sweeteners could promote metabolic syndrome, increase diabetes risk
March 19, 2018 - Wearable medical patch shows promise for early detection of hypoglycemia in type 1 diabetes
March 19, 2018 - High-energy breakfast leads to better diabetes control and weight loss
March 19, 2018 - D.C. Week: Community Health Centers Get Azar’s Love
March 19, 2018 - Younger siblings of SIDS victims have four-fold increased risk of sudden death
March 19, 2018 - Toothpaste alone does not prevent dental erosion or hypersensitivity
March 19, 2018 - Discovery aids understanding of amyotrophic lateral sclerosis
March 19, 2018 - Hormone imbalance may be reason for higher diabetes rates among men with insufficient sleep
March 19, 2018 - Docs worry there’s ‘nowhere to send’ new and expectant moms with depression
March 19, 2018 - Obesity linked to increased DNA damage in breast epithelium of BRCA mutation carriers
March 19, 2018 - Heart rate increases with higher alcohol consumption
March 19, 2018 - Template produced for clinically validated DIY stethoscope
March 19, 2018 - Experts highlight nocturia as most common cause of poor night’s sleep
March 19, 2018 - Fit Middle-Aged Women May Fend Off Dementia Later
March 19, 2018 - Fake Insta Doc; Humana’s Weird Pay Bump Tax Trick; Few NPDB Searches
March 19, 2018 - Guidelines for fluoride intake—are they appropriate?
March 19, 2018 - Race and pre-pregnancy BMI may be key predictors of maternal weight gain
March 19, 2018 - Telediabetes program improves blood sugar control for veterans
March 19, 2018 - Research suggests breastfeeding as protective factor against obesity in high-birthweight infants
March 19, 2018 - Morning Break: House Nixes ‘Right-to-Try’ Bill; Purdue’s PR Makeover; Air in the Brain
March 19, 2018 - Heart researchers develop a new, promising imaging technique for cardiac arrhythmias
March 19, 2018 - Mice study shows how BPA exposure during pregnancy can lead to altered brain development
March 19, 2018 - Breastfeeding mothers who overeat may increase risk of health problems in offspring
March 19, 2018 - New mobile application can detect atrial fibrillation that causes strokes
March 19, 2018 - Study finds low rates of preconception counseling among women of childbearing age with diabetes
March 19, 2018 - Vitl Life Science Solutions announces launch of new Lu-mini at analytica 2018
March 19, 2018 - ObsEva SA Reports Positive Topline Results from IMPLANT2 Phase 3 Clinical Trial of Nolasiban in IVF
March 19, 2018 - D.C. Week: States Plead for Federal $$ in Opioid Fight
March 19, 2018 - Polycystic ovary syndrome – Genetics Home Reference
March 19, 2018 - Reducing co-payments improves patient, physician adherence to guideline-recommended treatment post-MI
March 19, 2018 - Normalizing estrogen levels can benefit female athletes with irregular menstrual periods
March 19, 2018 - Fitness trackers and virtual coaches motivate patients to exercise post cardiac rehab
March 19, 2018 - Atrial fibrillation patients could reduce risk of dementia by taking stroke prevention drugs
March 19, 2018 - Low sperm count more prevalent with other health problems finds study
March 19, 2018 - Male birth control pill taken once a day shows success
March 19, 2018 - AcelRx Announces Receipt of Type A FDA Meeting Minutes and Plans to Resubmit the DSUVIA New Drug Application in Q2 2018
March 19, 2018 - Eye Docs Adopt EHRs Despite Reservations
March 19, 2018 - CRISPR enhances cancer immunotherapy
March 19, 2018 - Study finds first evidence of delayed aging among Americans
March 19, 2018 - Aussies unaware of sun protection rules to prevent skin cancer
March 19, 2018 - Essential oils linked to abnormal breast development in boys
March 19, 2018 - ‘Tummy Tuck’ Relieved Postpartum Back Pain/Incontinence
March 19, 2018 - New biomarkers for neuroblastoma, a type of cancer in children
March 19, 2018 - Hookah Smoking Carries a Poisoning Risk
March 19, 2018 - Do Mood and Anxiety Affect MS Disability?
March 19, 2018 - Mean depth of ultrasonographic penetration greater in autism
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