Improving long-term weight loss: Pushing the limits of treatment

Brownell, Kelly D.; Jeffery, Robert W.

doi:10.1016/s0005-7894(87)80004-7

Cited by 196 publications

(89 citation statements)

References 54 publications

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“…However, it seems that even losing weight with these approaches, most obese individuals do not maintain the loss for long periods. [3][4][5][6] Unfortunately, there are no accepted rules to guide interventions promoting behaviour and lifestyle changes for an effective and permanent weight loss.…”

Section: Introductionmentioning

confidence: 99%

Long-term weight loss after diet and exercise: a systematic review

2005

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OBJECTIVE:To assess the effectiveness of dietary interventions and exercise in long-term weight loss in overweight and obese people. DESIGN: A systematic review with meta-analysis. SUBJECTS: Overweight and obese adultsF18 years old or older with body mass index (calculated as weight divided by the square of height in meters)425. DATA SOURCE: Medline, Cochrane Library and Lilacs databases up to March 2003. Also, published reviews and all relevant studies and their reference lists were reviewed in search for other pertinent publications. No language restrictions were imposed. STUDY SELECTION: Randomised clinical trials comparing diet and exercise interventions vs diet alone. All trials included a follow-up of 1 y after intervention. DATA EXTRACTION: Two reviewers independently abstracted data and evaluated the studies' quality with criteria adapted from the Jadad Scale and the Delphi list. DATA SYNTHESIS: The estimate of the intervention's effect size was based on the differences between the comparison groups, and then the overall effect was calculated. A chi-squared test was used to assess statistical heterogeneity. RESULTS: A total of 33 trials evaluating diet, exercise or diet and exercise were found. Only 6 studies directly comparing diet and exercise vs diet alone were included (3 additional studies reporting repeated observations were excluded). The active intervention period ranged between 10 and 52 weeks across studies. Diet associated with exercise produced a 20% greater initial weight loss. (13 kg vs 9.9 kg; z ¼ 1.86Fp ¼ 0.063, 95%CI). The combined intervention also resulted in a 20% greater sustained weight loss after 1 y (6.7 kg vs 4.5 kg; z ¼ 1.89Fp ¼ 0.058, 95%CI) than diet alone. In both groups, almost half of the initial weight loss was regained after 1 y. CONCLUSION: Diet associated with exercise results in significant and clinically meaningful initial weight loss. This is partially sustained after 1 y.

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Section: Introductionmentioning

confidence: 99%

Long-term weight loss after diet and exercise: a systematic review

2005

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“…4,6,7 Health concerns are common reasons people offer for attempting to lose weight. 8 At any given time, approximately 40% of women in the United States are dieting, and dieting is even more frequent among overweight women. 8,9 Thus, intentional weight loss is one of the most common health-related practices.…”

Section: Introductionmentioning

confidence: 99%

“…8 At any given time, approximately 40% of women in the United States are dieting, and dieting is even more frequent among overweight women. 8,9 Thus, intentional weight loss is one of the most common health-related practices. 8,10 Despite the high prevalence of dieting, whether intentional weight loss can reduce cancer risk remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Intentional weight loss and incidence of obesity-related cancers: the Iowa Women's Health Study

2003

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OBJECTIVE:To examine the association of voluntary vs involuntary weight loss with incidence of cancer in older women. DESIGN: Prospective cohort study from 1993 to 2000, with cancer incidence identified through record linkage to a cancer registry. SUBJECTS: A total of 21 707 postmenopausal women initially free of cancer. MESUREMENTS: Women completed a questionnaire about intentional and unintentional weight loss episodes of Z20 pounds during adulthood. RESULTS: Compared with women who never had any Z20 pounds weight loss episode, women who ever experienced intentional weight loss Z20 pounds but no unintentional weight loss had incidence rates lower by 11% for any cancer (RR ¼ 0.89, 95% CI 0.79-1.00), by 19% for breast cancer (RR ¼ 0.81, 95% CI 0.66-1.00), by 9% for colon cancer (RR ¼ 0.91, 95% CI 0.66-1.24), by 4% for endometrial cancer (RR ¼ 0.96, 95% CI 0.61-1.52), and by 14% for all obesity-related cancer (RR ¼ 0.86, 95% CI 0.74-1.01) after adjusting for age, body mass index, waist-to-hip ratio, physical activity, education, marital status, smoking status, pack-years of cigarettes, current estrogen use, alcohol use, parity, and multivitamin use. Furthermore, although overweight women were at increased risk of several cancers, women who experienced intentional weight loss episodes of 20 or more pounds and were not currently overweight were observed to have an incidence of cancer similar to nonoverweight women who never lost weight. Unintentional weight loss episodes were not associated with decreased cancer risk. CONCLUSIONS: These findings suggest that intentional weight loss might reduce risk of obesity-related cancers.

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“…9 Such variability in body weight is a common phenomenon, 10 but the long-term health consequences of weight variability are not well understood. It is important to examine the health implications of weight variability.…”

Section: Introductionmentioning

confidence: 99%

Effects of ten year body weight variability on cardiovascular risk factors in Japanese middle-aged men and women

et al. 2001

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OBJECTIVE:The purpose of the present study was to determine the effects of weight variability on cardiovascular risk factors (CRF) based on a large sample of community-resident Japanese males and females. METHOD: A total of 3564 men and 1955 women, all Japanese, aged 30±69 y in the baseline year (1987), were followed-up for up to 10 y (end-point in 1996). Height, body weight, systolic and diastolic blood pressure, fasting serum total cholesterol, triglyceride and fasting plasma glucose were measured as an annual health check-up. At least six times in 10 y, body mass index (BMI) mean was calculated as an index of the BMI level of each subject (BMI mean). Direction and magnitude of the change in a subject's BMI was determined by a regression slope of BMI values over time (BMI slope). BMI¯uctuation was de®ned as the root mean square error (BMI RMSE) of a regression line. The slopes of the ®ve CRF were calculated using each regression equation over time. RESULTS: The BMI slope strongly correlated to each CRF slope independent of baseline age, baseline CRF value, smoking habit, BMI mean and BMI RMSE. BMI RMSE did not correlate to any CRF slopes. CONCLUSION: This study indicates that weight gain and weight loss have a much greater effect on CRF change than does weight¯uctuation in Japanese middle-aged men and women.

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Improving long-term weight loss: Pushing the limits of treatment

Cited by 196 publications

References 54 publications

Long-term weight loss after diet and exercise: a systematic review

Long-term weight loss after diet and exercise: a systematic review

Intentional weight loss and incidence of obesity-related cancers: the Iowa Women's Health Study

Effects of ten year body weight variability on cardiovascular risk factors in Japanese middle-aged men and women

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