TORONTO - There's an old saying that "talk is cheap," but that doesn't appear to be the case when it comes to keeping the pounds from slowly settling back around the waistline after someone loses a chunk of excess weight.
Researchers have found that even short but regular counselling sessions can be better than other strategies in helping people who lowered the number on their bathroom scale to stop it from heading skyward again.
In a 30-month study of more than 1,000 overweight or obese subjects, U.S. researchers found personal counselling worked better for keeping lost weight from returning than an Internet-based interactive program or a self-directed maintenance strategy.
By the study's end, those left to their own devices regained 3.3 pounds more on average than those who received 10 to 15 minutes of counselling per month, while the Internet group regained 2.7 pounds more on average, the researchers report in Wednesday's Journal of the American Medical Association.
Still, lead investigator Dr. Laura Svetkey admitted the difference in weight-loss maintenance was modest at best, and more research is needed to figure out what works best for individuals.
"We know how to help people lose weight in a healthy way, but we know very little about how to help them to keep the weight off," Svetkey, a professor of medicine at Duke University Medical Center in Durham, N.C., said in a phone interview Tuesday.
"So we're really at the beginning of developing the research on which to base recommendations," she said. "That's not very reassuring to folks who want help right now, so what I would say to them is look at the principles that went into the design of both the weight loss and weight-loss maintenance study."
The study began in 2003 and initially enrolled 1,685 overweight or obese subjects with high blood pressure and elevated cholesterol, who participated in a six-month intensive behavioural weight-loss program consisting of 20 weekly group sessions with a trained interventionist. Their average weight was 213 pounds.
Using a combination of a healthy, calorie-restricted diet and moderate exercise, as well as goal-setting and problem-solving, more than 60 per cent of participants lost weight - anywhere from nine to 66 pounds.
"We did that in the context of changing lifestyle," said Svetkey. "You never heard anybody on the study team say: 'Go on a diet.' Going on a diet is almost by definition a temporary thing. We wanted folks to make sustainable changes in their lifestyle that they could keep for the rest of their lives - or return to for the rest of their lives because we all slip sometimes."
The researchers then randomly assigned 1,032 subjects who had trimmed their weight to take part in one of three weight-loss maintenance strategies: managing on their own; using an interactive Internet program; or receiving monthly counselling, either by phone or in person.
At the end of 30 months, the personal-contact group had regained less weight than either the self-directed or the interactive-technology group. There was no difference in keeping weight off between the first two groups, although those using the website gained back fewer pounds on average up to the two-year mark, compared with the self-directed group.
Svetkey said she is intrigued by the fact that the Internet intervention worked for two years, but "then petered out in the last half-year of the study. That's of interest in part because it's an opportunity or strategy that can be disseminated very, very widely at minimal cost per person."
