Before we talk about diet and successful weight loss and maintenance, we have once again received a book written by an author who has been to our site. Here are two reviews:
The second book is of interest to those who suffer from peripheral neuropathy, a condition that effects many people with diabetes. Numb Toes and Aching Soles, by John A Senneff, MedPress, San Antonio, Texas, 1999 is an excellent reference book for those who want to know what the condition is and what is available for treating it. It lists main stream and alternative therapies as well as nutrients and experimental drugs. With each medication and treatment, the author includes the comments of people who have had success or failure with that specific medication or treatment. The author does not have any product to sell or treatment to hawk, rather he has taken the time to research what is available and their pros and cons. There is also an impressive chapter on coping mechanisms and a chapter on Diabetes and HIV-Special Considerations. If you have questions about peripheral neuropathy, this is a good book to explain the condition and treatments and medications. You can reach MedPress at 1-888-Med-9898. The cost is $19.95 for the paper back version, with $4.00 added for shipping and handling. We thank Mr. Senneff for sending us a copy of his book. For further information you can visit the publisher as www.medpress.com
We had email asking about a running program for native Americans with diabetes. Here in Oklahoma the Cherokee Nation Healthy Nation has a program called Wings Running Club which can be reached at 1-800-850-0298. They have monthly races, running/fitness, holiday food drive, weekly practices, walking, and run/jog sessions. Their motto is Strong: mind, body, and heart.
Successful Weight Loss Maintenance
One of the earliest attempts to interview people successful at weight loss maintenance was published in 1982 by Dr. Stanley Schachter, a psychologist at Columbia University. He reviewed studies of successful rates in weight loss programs and believed these rates underestimated the number of Americans who had lost weight and kept it off. He argued that individuals who enrolled in such studies were 'hard core' patients who had been unable to lose weight on their own. He suggested that weight loss "success rates' in this select group were inaccurate estimates of most people's to lose weight and keep it off. Dr. Schachter believed that better, more effective estimates might be obtained by conducting a survey of the general population to determine how many successful losers existed within this broader group.
To prove the point, Dr. Schachter surveyed all members of his psychology department and the general population of Aragansett, New York. He found that a large proportion of people he interviewed (55-72%) claimed to be "cured fat" and he concluded that successful weight loss and maintenance did indeed occur more often than previously suspected.
Other researchers have gone on to study in greater detail the habits of successful people. In a study of men and women who had lost 20 % of their initial body weight, Drs. Colvin and Olson gathered information about the events that precede successful weight loss and maintenance. The men in this study were more likely than women to indicate that a specific event triggered their successful weight loss. When asked about the event, the men were more likely to describe medical triggers, such as heart attack and having been warned by doctors. Women were more likely to describe unpleasant emotional events, such as being excluded from a social group.
A current study of successful weight loss maintenance is being conducted by the University of Pittsburgh and the University of Colorado with the National Weight Control Registry. Participants were asked what, if any events led to successful weight loss. In this study men often described the trigger as medical in nature, while women described a trigger as an unpleasant emotional event.
Many people who have successfully maintained their weight loss can identify events that triggered their weight loss attempts. therefore, one might be tempted to conclude that achievement was critical to their success. However, before that conclusion can be drawn, such events must be shown to be common among people who are successful at weight loss and maintenance. Drs. Tinker and Tucker of Wayne State University attempted to identify events uniquely associated with successful weight loss maintenance by interviewing two groups of people. One group successfully lost weight and kept it off, and the other had been unsuccessful in maintaining weight loss. Researchers asked both groups if certain events (social activities, health problems) had occurred over a specific four-year period of time.
The researchers found that the successful maintainers were no more likely than the unsuccessful maintainers to have experienced health-related events during their successful weight loss attempt. People who were successful at maintaining their weight loss reported greater occurrences of 'negative social interactions" both before and during their weight loss. These findings are intriguing because they suggest that other non-weight related events may influence a person's weight loss.
The primary purpose of most successful weight maintenance studies is to examine the strategies currently used by these people to continue their weight loss maintenance. Some interesting similarities exist in weight loss strategies used by those who successfully maintained weight loss. Individuals who lose weight made changes in their dietary intake as part of their weight loss regime. These changes included decreasing fat intake and increasing fruit, vegetable, and fiber intake. They also used some well known behavioral strategies for controlling food intake. For example, in the National Weight Control Registry, 25 to 50 percent indicated they had limited portion sizes, counted calories or fat grams, and limited the percent of calories obtained from fat. Keeping such close track of food intake may be one reason that registry participants were so successful at weight loss.
In addition to changing eating habits, most people who were successful became more active while losing weight. In studies surveyed 75-90% of people reported that exercise was part of their weight loss program. Persons in both the Tinker and Tucker study and the National Weight Control Registry used exercise, at the 90% and 82 % levels respectively.
The National Weight Control Registry was established in 1994 to explore the habits of individuals highly successful at maintenance of weight loss in greater detail. This study has data from more than 2500 people who have lost an average of 66 pounds and kept off at least 30 pounds for 5.5 years. Participants in the registry answer an initial set of questions and complete annual assessments for 4 years. This data have allowed us to begin to answer several questions about successful weight loss maintenance. For example, on a daily basis, 35-40 % of calories consumed by the average American are from fat. Registry members, however, report only about 24 % of their calories are from fat While registry members work hard to limit fat intake, they are not shortchanging themselves on other nutrients: the diets meet or exceed Recommended Daily Allowances for essential vitamins and minerals. Overall, these successful maintainers are eating diets that include a large number of fruits and vegetables, low-fat and calcium-rich foods, and limited amounts of meat, fish, and poultry. These same people are very active. For example, the American College of Sports Medicine has recommended that people should try to expend at least 1000 calories per week through physical activity to lose weight. Nearly 75 % of registry members exceed this weekly goal. The American College also suggests that expending 2000 calories per week through physical activity is an "optimal activity level", a goal that is met or exceeded regularly by 50% of the registry members.
The successful maintainers spend more hours per week engaging in exercise than the general public and are more likely than most people to report that they are walking, engaging in aerobic exercise, and lifting weights for exercise. Interestingly, nearly half the registry members report cross-training activity, and only 9 % report engaging in no regular physical activity. People in the registry can be divided into three groups: self directed weight loss, structured weight loss program ( e.g. Weight Watchers, Overeaters Anonymous), and structured weight loss programs that include a liquid-formula diet ( e.g. Optifast). Of those registry members who gained weight during the one year follow up, a large percent reported significant decrease in activity.
To summarize, successful weight loss maintenance remains an elusive goal for many people. Nevertheless, research indicates that many people are successful with the adoption of a healthy low-fat diet and regular physical activity. Lessons can be learned from the new habits of these successful individuals, that is, they didn't just exercise to lose weight, exercise to maintain weight loss. Along with exercise, self-monitoring and a healthy diet are important parts of weight control. This means lower calorie intake and increased intake of fruit, vegetables and lower fat intake.
