Daily Weighing and Quick Action Keeps Pounds Off
successful dieters regain the weight they lost. But new research shows
that a daily weigh-in – and quick adjustments to diet and
exercise – can significantly help dieters maintain weight loss.
The clinical trial, conducted by researchers at The Miriam Hospital and
Brown Medical School, reports results of the first program designed
specifically for weight loss maintenance.
the scale every day, then cutting calories and boosting exercise if the
numbers run too high, can significantly help dieters maintain weight
loss, according to results of the first program designed specifically
for weight loss maintenance. Study results are published in theNew England Journal of Medicine.
obesity studies, which focus on how to lose weight, the "STOP Regain"
trial tested a method that taught participants how to keep those pounds
from coming back – regardless of the method they used to lose the
weight in the first place.
Led by Rena
Wing, professor of psychiatry and human behavior at Brown Medical
School and director of the Weight Control and Diabetes Research Center
at The Miriam Hospital, the study taught successful dieters a technique
called "self-regulation." With the goal of maintaining their weight
within five pounds, participants were taught to weigh themselves daily
and use the information from the scale to determine if they needed to
adjust their diet or exercise routine.
intervention worked: Significantly fewer participants regained five or
more pounds during the 18-month-long program. The program was most
successful when delivered in face-to-face meetings, although the
Internet also proved a viable way to help participants maintain their
"If you want
to keep lost pounds off, daily weighing is critical," Wing said. "But
stepping on the scale isn’t enough. You have to use that
information to change your behavior, whether that means eating
healthier or walking more. Paying attention to weight – and
taking quick action if it creeps up – seems to be the secret to
"We know that
losing weight and keeping weight off is very tough for many people,"
said Robert J. Kuczmarski, director of the Obesity Prevention and
Treatment Program at the National Institutes of Health. "However, the
results of STOP Regain show that there are definite actions that people
can take before their weight begins to creep upward. Weight control and
better health are not one-shot deals and this study will help people
In the study,
Wing and her team enrolled 314 participants who’d lost at least
10 percent of their body weight – averaging nearly 20 percent of
their body weight or 42 pounds – within the last two years. A
third of participants was assigned to a control group and received
quarterly newsletters about eating and exercise in the mail for the
duration of the study period.
two-thirds were assigned to groups that would test the weight
maintenance program. One third received the intervention over the
Internet, the final third in face-to-face group meetings. Whether
delivered over the computer, or in person, the education and support
program was virtually identical.
were taught strategies specific to prevent weight regain, many gleaned
from Wing’s National Weight Control Registry, a database of more
than 5,000 people who have successfully lost weight and kept it off for
at least one year. Strategies taught in the trial included eating
breakfast, getting an hour of physical activity each day and regular
weighing – participants were given a scale and urged to use it
daily. They also reported their weight weekly, either over the Internet
or by phone, depending on the study group.
were also introduced to a weight-monitoring system based on color
zones. If they were within three pounds of their starting weight after
the weekly check-in, they were in the "green zone" – and received
encouraging phone messages and green rewards, from mint gum to a dollar
bill. If they’d gained between three and four pounds, they landed
in the "yellow zone" and were instructed to tweak their eating habits
or exercise routine.
gained five pounds or more, they were in the "red zone" and encouraged
to restart active weight-loss efforts. They were urged to pull out a
red toolbox they received at the start of the program that included
items such as a meal replacement shake, a pedometer, a diet diary
– and their own weight success loss story. "Red zone" residents
also had the chance to get one-on-one counseling by phone, email or in
attended weekly meetings for the first month of the study period, then
monthly meetings either in groups or via a computer chat room. Internet
participants received a laptop computer, an Internet connection and
resounding: In the control group, 72 percent of participants gained
five or more pounds during the year and a half study period. But only
55 percent of Internet participants – and 46 percent of meeting
participants – gained back that much weight.
intervention worked, but the face-to-face format produced the best
outcomes," Wing said. "Both were successful because the message that
people got – pay attention to your weight, then take action to
maintain it – was effective. People were told to take personal
control of their health and were given the tools to do it. And they
kept off the weight."
note that daily weighing was strongly associated with prevention of
weight gain, but only in the Internet and face-to-face groups.
Intervention participants who weighed themselves daily had an 82
percent reduction in the odds of regaining five or more pounds.
However, daily weighing in the control group had little to no effect on
the amount of weight regained.
suggests that participants in the two intervention groups were able to
use the information from the scale to make constructive changes in
their eating and exercise behaviors," says Wing. "It’s further
evidence that getting on the scale each day is only part of the
Wing and her
team conclude that the concept of an intervention exclusively designed
for weight-loss maintenance is an important approach to the successful
treatment of obesity. Future studies should examine ways to refine the
Internet format, as well as test interventions designed to last longer
than 18 months.
Regain team also includes Deborah Tate, an assistant professor in the
School of Public Health at the University of North Carolina-Chapel
Hill, and Amy Gorin, Hollie Raynor and Joseph Fava of The Miriam
Hospital and Brown Medical School.
The results of the study, funded by the National Institute of Diabetes and Digestive and Kidney Diseases, was published in the New England Journal of Medicine.