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Writer's pictureWendy Wang, PhD Nutrition

Weight Loss Needs Support


This funny cartoon by Xiao Lin Man Hua captured the frustrations of people who are trying to achieve their hard-to-reach life goals: health and wealth. By translation, it says: "Why I am trying to lose weight every day but still not lean is a problem, while you are going to work every day but still have no savings is not a problem?"


As well-illustrated by the cartoon, losing weight can be quite hard as many of us have experienced. One friend wrote about her weight loss experience, which she allowed me to quote as follows: "I admire people who have succeeded in losing weight, how much self-control it takes! My own experience is like this: seeing the food in front of me, I want to eat it, but the calories are too high to eat, it doesn't matter if I think about it. I eat a little bit, it's too delicious, let's eat a little bit more. It's so delicious, don't care about it, eat! Lose weight tomorrow! So this fat will never be reduced. Every time I eat to be satisfied, my heart is full of regret and self-blame! Days and weight continue harmoniously in this entanglement!"


To be teased about can diminish a person's effort towards the weight loss goal. To have successful weight loss, it is a good idea to surround yourself with supportive people who can encourage you to stay on the weight loss course and help you to form new habits, for example, at the right moment to tell you not to eat that cake.


Many published papers demonstrated positive social support could help with weight loss outcomes. I just picked a few to show what kind of impact it can make.

Findings in a randomized trial that included 1407 participants showed that people in the in-clinic group visits, compared with those in the in-clinic individual visits, resulted in significantly greater mean weight loss at 24 months (–4.4 kg vs –2.6 kg, respectively), and the difference between people in the telephone-based group visits and in-clinic individual visits was not significantly different (–3.9 kg vs –2.6 kg) (1).


Being part of a social supportive group as seen in the group intervention groups in this study may be the reason why these participants lost more weight than those working on weight loss individually. The support from each other in the group may have encouraged group members to stick to the behavioral changes to reduce obesity.


A study was conducted on 75 obese people to determine whether habit-based interventions could be clinically beneficial in achieving long-term (12-month) weight loss maintenance. Subjects on the habit-based weight-loss interventions-forming new habits (-3.3 kg) and breaking old habits (-2.9 kg), lost significantly more weight (P = < .001) than those on the waitlist control (-0.4 kg) (2). This study showed that behavioral interventions such as changing old habits and forming new ones would result in more weight losses.


Obese participants (n=25) were recruited for a fully online 12-week weight loss program. Participants were randomly assigned to either an intervention group or a control group. All participants were given access to a secure platform for data tracking and video conferencing with the research team. The intervention group met with the medical doctor once per month and with a registered dietitian, weekly. Control participants met with the research team at baseline and 12 weeks. There was a significant difference between the intervention and control groups for bodyweight loss (7.3 ± 5.2 vs 1.2 ± 3.9 kg, respectively, p < 0.05) as well as for percent body weight loss (7.16 ± 4.4 vs 1.5 ± 4.1%, respectively, p < 0.05). Clinically significant weight loss was achieved in 9 out of 13 (69.2%) in the intervention group versus 1 out of 12 (8%) in the control group. This study showed that mobile phone-based health coaching may promote weight loss, and weekly video conferencing with education may be an applicable tool for inducing significant body weight loss in obese individuals (3).


Seventy-one overweight or obese people were allocated to one of three 12-week treatment programs. The Standard Support Group was provided support via website and two face-to-face group guidance sessions, at the beginning and the end of the program along with monthly general emails throughout the program. The Enhanced Support Group received four remote support sessions based on Supportive Accountability in addition to the Standard Support Group. The Control Group was provided the same program as Standard Support Group after the other two groups had completed the program.


Compared to the baseline, weight changes in the Enhanced Support Group, Standard Support Group and Control Group at the end of the 12-week program were -3.71 kg, -1.61 kg, and 0.59 kg, respectively. Enhanced Support Group participants reduced their weight significantly more than Standard Support Group and Control Group participants (P = 0.038, P < 0.001, respectively), and Standard Support Group participants reduced their weight significantly more than Control Group participants (P = 0.033). This study showed that more human support could boost weight reduction in Internet-based weight-loss intervention (4).


It takes self-discipline and effort to achieve either the health goal of weight loss or the wealth goal of having enough savings for financial independence. The few studies mentioned here showed that social support either from a medical doctor, dietitian, or a group can enhance weight loss. Since lifestyle changes for weight loss can be challenging, more human support not only can encourage you to change old habits and form new habits for the successful weight loss outcome but also friends and family can help to cheer you up through your tough and dark moments in achieving the weight loss goal. Almost like running a marathon, weight management can be a lifetime journey needing endurance. To achieve any goals in life, surround yourself with positive people is a good thing and even necessary.


References:

1. Befort, C. A., VanWormer, J. J., Desouza, C., et al. (2021). Effect of Behavioral Therapy With In-Clinic or Telephone Group Visits vs In-Clinic Individual Visits on Weight Loss Among Patients With Obesity in Rural Clinical Practice. JAMA, 325(4):363-372.

2. Cleo, G., Glasziou, P., Beller, E., Isenring, E., & Thomas, R. (2018). Habit-based interventions for weight loss maintenance in adults with overweight and obesity: a randomized controlled trial. International Journal of Obesity. doi:10.1038/s41366-018-0067-4

3. Alencar, M. K., Johnson, K., Mullur, R., Gray, V., Gutierrez, E., & Korosteleva, O. (2017). The efficacy of a telemedicine-based weight loss program with video conference health coaching support. Journal of Telemedicine and Telecare, 1357633X1774547.

4. Ozaki, I., Watai, I., Nishijima, M., & Saito, N. (2019). Randomized controlled trial of Web‐based weight‐loss intervention with human support for male workers under 40. Journal of Occupational Health, 61(1), 110-120.

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