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Self-regulation strategies reduce weight gain in young adults
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Young adults taught self-regulation strategies focused on large- or small-change interventions for weight maintenance were more successful at preventing weight gain than their peers, according to study findings published in JAMA Internal Medicine.
“We found both interventions to be effective in significantly reducing average weight gain over the 3 years of follow-up, but the large-changes approach was most effective,” Rena Wing, PhD, director of the Weight Control and Diabetes Research Center at Miriam Hospital in Providence, Rhode Island, said in a press release.
Wing and colleagues evaluated 599 adults aged 18 to 35 years with a BMI of 21 kg/m2 to 30 kg/m2 from two academic settings. Participants were randomly assigned to one of three conditions: “small changes” (10 group meetings over 4 months; reducing food intake and increasing activity by about 100 calories per day), “large changes” (10 group meetings over 4 months; losing 2.3 kg to 4.5 kg to buffer against expected weight gain) or control (one meeting to introduce concept of small- and large-change interventions). Researchers sought to determine changes in weight from baseline to a mean follow-up of 3 years; secondary outcomes included proportion gaining at least 0.45 kg from baseline, proportion developing obesity and weight change from baseline to 2 years.
“Until now, we didn’t have clear guidance on what the message and recommendations should be for preventing weight gain,” study researcher Deborah Tate, PhD, professor of health behavior and nutrition at the Gillings School of Global Public Health at the University of North Carolina, said in the release. “This study showed that frequent weighing and either initial weight loss or daily small changes to diet and activity are useful weight-gain prevention approaches.”
At baseline, self-weighing was reported by 11% to 13% of each group and increased to 75% in the large-changes group, 72% in the small-changes group and 30% in the control group at 4 months. Mean weight changes from baseline to the mean follow-up of 3 years was 0.26 kg in the control group, –0.56 kg in the small-changes group and –2.37 kg in the large-changes group (P < .001).
Weight gain of 0.45 kg or more was more common in the control group (40.8%) compared with the large-changes (23.6%) and small-changes groups (32.5%). The control group was more likely to develop obesity and have greater changes in weight gain from baseline to 2 years compared with the two intervention groups.
“Weight gain in young adults is likely related to the many changes occurring — school-to-work transitions and events such as pregnancy,” Wing said in the release. “This weight gain is a serious health risk, and approaches to prevent or reduce it are urgently needed. These new self-regulation approaches, which can easily and cost-effectively be shared to help prevent weight gain in young adults, could have a significant impact on our public health.” – by Amber Cox
Disclosure: Wing reports no relevant financial disclosures. Tate reports being a member of the Scientific Advisory Board for Weight Watcher’s International.
Perspective
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Donna Ryan, MD
The most appealing thing about this study is the demonstration of efficacy of a self-regulation strategy for weight management that is readily translatable to clinical practice. The volunteers in the study weighed themselves regularly and submitted this data to a study website, then received feedback. In practice, patients could record weights from home in their medical records and receive feedback from their health care team. This has enormous appeal for primary care where there is a dearth of strategies to efficiently help patients manage weight.
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