Maintaining weight loss can be a challenging task that becomes more difficult with age.
Post-menopausal women have it particularly tough as hormonal changes and the aging process slow energy expenditure.
Researchers have found that some behaviors that help a woman lose or control her weight earlier in life, may not be effective or sustainable for the long term. Researchers thus suggest that attention to these behaviors may improve long-term obesity treatment outcomes.
Long-term improvements in weight control are tied to learning to eat a healthy diet, such as enhanced consumption of fruit and nuts, rather than the total avoidance of substances such as fried foods.
Lead investigator Bethany Barone Gibbs, Ph.D., explains that a number of factors work against long-term weight loss.
“Not only does motivation decrease after you start losing weight, there are physiological changes, including a decreased resting metabolic rate. Appetite-related hormones increase. Researchers studying the brain are now finding that you have enhanced rewards and increased motivation to eat when you’ve lost weight.”
Thus biological changes in response to losing weight and as a function of the aging process, contribute to make it very difficult for older women to lose weight and maintain weight loss.
Traditional behavioral treatments for obesity, focused on caloric intake, have had poor long-term results.
In the study, investigators sought to determine if changes in eating behaviors and selected foods were associated with weight loss at six and 48 months in a group of overweight post-menopausal women.
Investigators followed 508 women randomized to either a Lifestyle Change group or a Health Education group.
The Lifestyle Change group met regularly with nutritionists, exercise physiologists, and psychologists throughout the study. Their goals were to reduce fats and caloric intake, increase consumption of fruit, vegetables, and whole grains, and participate in regular moderate exercise.
The Health Education Group was offered seminars by health professionals on general women’s health, but not specifically weight loss.
Investigators found that the eating behaviors associated with weight loss at six months were eating fewer desserts and fried foods, drinking fewer sugar-sweetened beverages, eating more fish, and eating at restaurants less.
After four years, they found that eating fewer desserts and drinking fewer sugar-sweetened beverages continued to be associated with weight loss or maintenance.
However, eating more fruits and vegetables and less meat and cheese emerged as additional important predictors for long-term weight loss.
Barone Gibbs explains that strategies such as eating fewer fried foods may not be sustainable for the long term.
“People are so motivated when they start a weight loss program. You can say, ‘I’m never going to eat another piece of pie,’ and you see the pounds coming off. Eating fruits and vegetables may not make as big a difference in your caloric intake. But that small change can build up and give you a better long-term result, because it’s not as hard to do as giving up French fries forever.”
The results suggest that decreased consumption of desserts and sugar-sweetened beverages are linked with short- and long-term weight loss or maintenance, but increased fruits and vegetables and decreased meat and cheeses are additional factors that may improve long-term weight loss or control.
“If the goal is to reduce the burden of obesity, the focus must be on long-term strategies because changes in eating behaviors only associated with short-term weight loss are likely to be ineffective and unsustainable,” said Barone Gibbs.
The research is published in the Journal of the Academy of Nutrition and Dietetics.