Women Who Feel Good About Weight Loss More Likely to Keep It Off

Studies show that most patients who are obese would like to shed much more weight than is realistic using a non-surgical method. These patients typically want to lose up to 34 percent of body weight. Weight losses of 25 and 17 percent are viewed as only “acceptable” and “disappointing” respectively.


Researchers at the University of Pennsylvania School of Medicine sought to change these perceptions, and encourage individuals to find the smaller weight loss goal of 10 percent acceptable. They enrolled 17 women with a mean BMI of 34.7 in a 40-week modified cognitive behavioral treatment program.


The program was divided into four phases. In Phase I (weeks 1 to 4), patients did not change eating or physical activity behaviors. Instead, they focused on factors that influence unrealistic weight loss expectations, including cultural and personal meanings attached to weight status. Personal weight and dieting histories were used to make the point that large weight losses are often short-lived.


During Phase II (weeks 5 to 12), participants were instructed to eat 1,200 to 1,500 calories a day, begin a program of regular physical activity, self-monitor eating and exercise behavior, identify times and places that lead to overeating, and learn to eat highly desired foods in a controlled way.


Participants focused on improving body image and self-esteem during Phase III (weeks 13 to 20). The women learned to modify body image, develop tolerance for imperfect body areas, and change behaviors associated with negative body image such as avoiding social situations and mirrors.


In the fourth phase of the program (weeks 24 to 40), participants developed weight maintenance skills that included maintaining a program of enjoyable physical activity, reversing small weight gains as they occur, and living life now, rather than waiting to lose more weight.


After 40 weeks, participants lost an average of 5.7 percent of their body weights. This amount of weight loss would have been classified as “not successful in any way” at the study outset. However, the women reported significant improvements in satisfaction with their body weight, as well as their body image, self esteem, and quality of life.


One year after the program, participants gained back weight, but self-esteem remained improved. The women had maintained an average loss of 2.9 percent of their original weight. However, those who were less satisfied with their weight after the 40-week program regained three times as much weight as other women. The study authors suggest that satisfaction with body weight at the end of a treatment program protects against weight regain.


The full report “Promoting more modest weight losses: A pilot study” appears in the journal Obesity Research (2004;12:1271-1277).