Healthy weight 4 life

Research program helps women drop pounds, change their lives

    Fad weight loss programs often focus on just one strategy—restricting carbohydrates, for example, or drinking a special shake, or working out on one special machine. In this one-size-fits-all approach, pounds lost initially may pile back on as rebellion or boredom sets in.

A research-based weight control program underway at the University of Arizona combines several strategies, tailoring choices in diet, exercise, counseling, and social support to help each participant (women aged 40 to 55) find her way to a healthy weight. Since “Healthy Weight 4 Life” began in fall, 2000, more than 150 women have lost an average of 10 pounds, and kept it off during an 18-week follow-up period. Some have lost as much as 50 pounds. The program is funded by the National Institute for Diabetes, Digestive and Kidney Diseases.

“This is not an innovative weight loss plan in terms of content, but it is innovative in the way we put it together,” says Scott Going, an associate professor in the Department of Nutritional Sciences. “There is a critical need for effective weight management programs that integrate all the factors that contribute to excess weight. Overweight and obesity affect more than 50 percent of the U.S. population, according to recent figures from the Centers for Disease Control.”

Going believes a university environment is the ideal place to develop multi-disciplinary, collaborative approaches to weight loss that combine research and community outreach. He is working with a multi-disciplinary team of researchers from the College of Agriculture and Life Sciences and the College of Medicine to develop and test a sound, scientifically-based weight loss program.

The two-phase program, administered through the Department of Nutritional Sciences and the Department of Physiology begins with a 16-week weight loss curriculum emphasizing increased physical activity, healthy eating, social support and the “mind-body” connection. “We promote slow weight loss: a pound a week,” Going says. “Key behaviors are diet and physical activity. Everything else we do supports that. Our goal over 16 weeks is to give participants the information they need, increase their awareness of behaviors contributing to excess weight, get them to try a lot of different activities, and figure out what works for them.”

Components in the first phase include:

• Physical activity–exercise and body composition
  Walking, plus other physical activities that will burn about 1500 to 2000 calories per week. Participants figure out how many minutes and calories each activity will take, and then choose the exercises that will work for them, given their occupation.
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  Coordinated by Scott Going, associate professor, nutritional sciences; Tim Lohman, professor, physiology; and Pedro Teixiera, Ph.D., exercise.

• Diet and nutrition
  Healthy eating, drinking enough water, cutting out the junk food, reducing both fat calories and portion sizes. The researchers assess each volunteer’s body composition, resting metabolic rate, and diet records, and suggest she eat 200-300 fewer calories per day than usual, emphasizing fruit and vegetable consumption, food pyramid guidelines, and consuming less than 30 percent of calories from fat, roughly 15 percent from protein, and the rest as carbohydrates.
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  Coordinated by Linda Houtkooper, professor, nutritional sciences; Fred Wolfe, department head, nutritional sciences
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• Counseling
  Mind/body discussions on women’s issues, body issues, eating behavior skills, and obesity. Counselors bring up barriers, emotional issues around food, and challenges in a safe setting where the participants can discuss their feelings, plus social and health ramifications regarding weight, including resistance to weight loss.
  
  
• Social Support
  Weekly discussion groups set their own agendas, and meet to exercise, share recipes, share problems or concerns. Social interaction helps develop healthy interpersonal relationships, and skills for dealing with psychological and emotional barriers to weight loss.
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  Both of the above are coordinated by Lauve Metcalfe, M.S., counseling; Jane Martin, R.N. and M.S., counseling; and J’Fleur Lohman, consultant and Ph.D., counseling.

Phase Two features 18 months of subsequent online support that offers encouragement for participants in maintaining their weight loss. The web-based format, managed by Jennifer Ricketts, an instructor in the Department of Nutritional Sciences, is more cost-effective than weekly face-to-face follow-up meetings. The program includes tools to monitor diet and physical activity, and a mind-body section with tips, articles, recipes, and links. The UA researchers are testing this method for its efficacy and usefulness in promoting and maintaining long-term weight loss. Half of the women are assigned to the Internet group; the other half, as a control group in the study, are asked to maintain their weight loss program on their own.

So far, more than 90 percent of the women enrolled in the online support phase have maintained their weight or have continued to lose more weight. Some of the women in the program bordered on class II obesity when they started. In the future, with additional funding, the team hopes to expand the program and test the Internet against other strategies for long-term support for weight loss.

Although “Healthy Weight 4 Life” was begun as a study, the researchers are pleased that so many people have changed their lives as a result of the program. “After a while these strategies become second nature to you; you want to do them,” Going says. “Many of the participants have gotten their boyfriends and husbands exercising, and they’re losing weight, too.”