Individuals are less likely to regain lost weight when
they get monthly tips straight from trained
counselors rather than from a weight-loss Web site,
according to results of a study by researchers
from Johns Hopkins and elsewhere.
"It's almost a given that you can achieve initial
weight loss with a variety of methods, but what
happens afterward doesn't get as much attention," said
Lawrence Appel, professor of medicine at the
Johns Hopkins School of Medicine. Few studies have
focused on how to prevent weight regain, which
carries frustration and health risks, he said.
In a study published March 12 in the Journal of the
American Medical Association, Appel and
other researchers from Johns Hopkins and seven other
institutions compared different interventions
aimed at preventing weight regain among 1,032 volunteers
who had recently lost, on average, about 19
pounds each.
The researchers tracked the volunteers, separated into
three groups, over two and a half
years. One group received regular, personal contact from
trained weight-loss counselors. Once a
month, counselors called these volunteers and chatted for
five to 15 minutes about calorie intake,
exercise habits and weight-loss strategies. Every four
months, these dieters had in-person meetings
with their counselors that lasted about an hour.
A second group was given access to a custom-built
weight-loss Web site loaded with information
and tools to track weight, record food diaries and monitor
physical activity levels. Bulletin boards on
the site allowed these volunteers to get online support
from other dieters, and automatic e-mails
encouraged the volunteers to log onto the site at least
weekly. If they missed more than two weeks,
they received automatic phone calls to steer them back on
track.
A third set of volunteers received some printed
information with diet and lifestyle
recommendations at the beginning of the study. This
"self-directed" group also met briefly with a
trained counselor once in the middle of the study but
worked to maintain weight loss largely on their
own.
Weights were recorded every six months, and by the end
of the study, most of the volunteers
had gained some weight back. However, the average amount
differed among the groups. Volunteers in
the group who received personal contact regained the least
amount of weight, averaging about nine
pounds each. Those in the Web site and self-directed groups
regained slightly more, about 12 pounds
apiece.
Although these differences were modest, Appel points
out that even small changes in weight
can have big effects on health. "Keeping just a few pounds
off can significantly affect your risk of
getting high blood pressure or diabetes," he said.
Appel speculates that being personally accountable to
a caring counselor could be an important
motivator for people to maintain healthy eating habits.
"Some dimensions of person-to-person contact
are hard to duplicate with technology," he said.
Even given these findings, doctors aren't likely to
recommend personal counselors for everyone
trying to keep weight off. "There aren't enough dietitians
and weight-loss counselors in the world to
maintain this kind of personal contact," Appel said. For
their next study, he and his colleagues plan to
test a combination of counseling and the Internet to
provide weight-loss support.
This study was supported by grants from the National
Heart, Lung and Blood Institute. Other
Johns Hopkins researchers who participated are Gerald J.
Jerome, Arlene Dalcin, Janelle Coughlin and
Jeanne Charleston.
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