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"Prevention is key for fighting obesity, but until now, we didn't have any concrete evidence for guiding patients on how to prevent that weight gain," says Deborah Tate. "Now, for the first time, we do."

What’s the best way to avoid gaining weight? A new study finds two different strategies—daily small changes and periodic large changes—could work long-term.

The team tested the approach with hundreds of young adults. On average, this age group gains about 30 pounds between the ages of 18 and 35. The slow but pervasive weight gain can set the stage for obesity.

“Prevention is key for fighting obesity, but until now, we didn’t have any concrete evidence for guiding patients on how to prevent that weight gain,” says Deborah Tate, a professor of health behavior and nutrition at the University of North Carolina at Chapel Hill. “Now, for the first time, we do.”

The 2 strategies

Tate and colleagues tested the daily small changes approach (200 participants) and the periodic large changes approach (197 participants) to see which approach was best for preventing long-term weight gain.


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As the name implies, the large changes group made significant changes at the program’s outset such that they reduced their average calorie intake by 500 to 1,000 per day for eight weeks, and gradually increased their physical activity to 250 minutes per week and were encouraged to maintain that activity.

The small changes group reduced its average calorie intake by 100 per day and was encouraged to take 2,000 more steps using a pedometer each day throughout the course of the study.

The results were remarkable in both groups:

“During this three year period, adults in this age group, on average, would have been three to six pounds heavier, but they were two to five pounds lighter,” says Tate. “This sets them up for reduced obesity risk and fewer health problems.”

Also, both approaches cut the obesity risk by half, such that only seven percent of the small changes group and eight percent of the large changes group became obese as opposed to 16 percent in the control group.

“There was always this prevailing belief that if you make small changes to your diet—walk further, take the stairs, cut out a snack—you can prevent weight gain, but nobody had put it to the test,” says Tate.

The findings not only support this prevailing belief, but also introduce a new “large changes” approach—one that shows that weight loss due to a short burst of significant calorie reduction at the beginning of a program can help stave off typical weight gains.

Daily weigh-ins

At the outset of the study, researchers met with both groups groups 10 times over a four-month period to develop the skills and an approach to diet and exercise that would prevent weight gain during this high-risk period. One of the key elements of both approaches was daily weighing, to keep tabs on their weight, and to guide diet and activity changes over time.

“Could they do it? Could they remember? Could they make the adjustments?,” asks Tate. “We found that not only could they do everything that they were encouraged to do, but that it worked to prevent weight gain. That was the best part.”

Researchers rom Miriam Hospital and Wake Forest School of Medicine collaborate on the study, which is reported in JAMA Internal Medicine. The team has received funding to follow the study participants to see the effects at six years.

Source: UNC-Chapel Hill

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