Abstract
SummaryIntroductionDietary self‐monitoring in behavioral weight loss programmes traditionally involves keeping track of all foods and beverages to achieve a calorie deficit. While effective, adherence declines over time. WW™ (formerly Weight Watchers), a widely available commercial weight management programme, sought to pilot an approach that permitted participants to consume over 200 foods without monitoring them.MethodsThe current study used a pre‐post evaluation design with anthropometric, psychosocial and physical health assessments at baseline, 3 and 6 months.ResultsParticipants (N = 152) were, on average, 48.4 (±12.3) years old, with body mass index (BMI) of 32.8 (±4.8) m/kg2 and 94% female. Mean weight loss was 6.97 + 5.55 kg or 7.9 ± 6.1% of initial body weight (ps < .0001) at 6 months. One third (32.6%) of the sample lost 10% or more of initial body weight. Significant improvements in hunger, cravings, happiness, sleep, quality of life, aerobic stamina, flexibility and blood pressure were observed. Attendance at group meetings, as well as decreases in hunger, and fast food cravings from baseline to 3 months were associated with achieving 10% weight loss at 6 months (p < .01).ConclusionsUsing an approach that does not require self‐monitoring of all foods and beverages produced significant weight losses and other physical and psychosocial improvements.
Highlights
While self-monitoring is effective and has long been identified as a key predictor of weight loss success, studies demonstrate that dietary self-monitoring decreases over time, subsequently leading to suboptimal outcomes.[2,3,5]
An approach that promotes the adoption of an energy-reduced diet while reducing the burden of self-monitoring is a well-reasoned and potentially sustainable approach for weight management but has not been well studied to date
Cravings for high fats, sweets, starches and fast food were significantly lower at 6 months (p < .001), and fruit and vegetable cravings were significantly higher at 6 months compared with baseline (p < .05)
Summary
Structured behavioral weight loss programmes are effective at producing clinically significant weight loss (5%–10%) over time[1] and result in reductions in co-morbid illnesses.[1,2] These interventions commonly prescribe an energy deficit in the form of a total daily calorie intake goal, combined with dietary self-monitoring, to ensure adherence to the prescription.[2,3] Self-monitoring, a key concept in self-regulation, is a series of measurements, observations and recordings that enhance awareness[4] and, when applied to diet, involves measuring and recording all foods and beverages consumed along with other metrics such as the time eaten, their calorie content, and atObes Sci Pract. 2020;6:353–364.wileyonlinelibrary.com/journal/osp[4 ] TATE ET AL.times, hunger or mood before eating. The effort involved in monitoring all foods, portions and calories or other metrics is substantial and relates directly to a decline in dietary programme adherence.[5] reducing calories without attention to nutrient composition may lead to hunger and dissatisfaction and may result in suboptimal weight change.[1] Certain protein-rich, low-fat foods can help improve satiety and combat food cravings.[6] dietary approaches with a greater allotment of low-energy-dense foods such as fruits and vegetables, which allow individuals to consume satisfying portions of food, have shown a positive effect on weight loss.[7] an approach that promotes the adoption of an energy-reduced diet while reducing the burden of self-monitoring is a well-reasoned and potentially sustainable approach for weight management but has not been well studied to date
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