Evaluating Weight Loss Programs
MacLaren, MA, RD
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Want to lose those extra pounds once and for all? This battle is a common one for many of us, but often going on a diet results in short term weight loss and long term agony once those pounds steadily creep back on. Don't give up! Nutrition experts agree that overweight individuals can reap big health benefits by losing weight, and keeping it off.
According to registered dietitian Jennifer Speight, there are many healthy reasons to meet this goal, but it isn't always an easy one to achieve. "One out of three Americans is overweight", she says, "That's why we're seeing an increase in prostate cancer in men, breast cancer in women, and an increase in colon cancer. By the year 2000, 50% of us will be obese because of the lifestyles we lead. We press buttons to get whatever we want. We're not getting up to change the TV. We're eating a lot of fast food and not using fat free foods correctly."
While some people can lose weight easily on their own, many need the education and support that only a formal weight management program can provide. Since the number and variety of programs to choose from is extensive, it is often difficult to decide which program will best meet your needs. According to the National Academy of Sciences Institute of Medicine, there are several guidelines consumers can use to evaluate a potential weight loss program. These guidelines were designed to identify programs that not only meet an individual's needs, but help ensure success for the long term.
The Institute recommends that potential clients ask questions about qualifications of the program's staff, the success rate of the plan including long term success, total costs of the program, and the goals and approaches to weight loss.
Speight agrees and suggests that much of this investigative work can be done over the phone. She believes that this may be the most important step to losing the weight once and for all and shouldn't be taken lightly.
"You approach a program in weight loss just like you shop for anything else. Do a comparison of different programs. Invest your time just like you would invest your money somewhere because all programs are going to carry a fee. Just because it's a more expensive program doesn't mean it's a better program and vice versa."
The goals of the program should be looked at closely. Current emphasis is on a healthy, individualized weight goal rather than an "ideal" weight that has been taken from a standardized table. Ms. Speight feels strongly that weight goals need to be realistic, citing an example of a client coming in at 250 pounds and wanting to weigh what he did in high school in the shortest period of time possible.
She advises, "Emphasis should not be on a set amount of weight that you're going to lose, rather what is more of a goal for you as an individual. Lots of people want to weigh a certain weight, but that doesn't take into account how tall they are, their activity level and percent body fat."
In Speight's program, participants' body fat percentage is measured with a machine that calculates how many pounds of fat they are carrying. Using this information, she calculates an individualized weight goal taking into account the person's height, weight, activity level, and frame size. She advises that a good program should not just emphasize the number on the scale, but also consider the fat and muscle composition of each client.
For long term success, Speight believes a program should uncover the reasons a person overeats and devise strategies to deal with these problems. Some individuals are obsessive-compulsive about food while others may eat to alter their moods -- particularly if they are depressed.
Speight has her clients keep food diaries to uncover these hidden food cues. Clients record what they eat, who they eat with, and their mood at the time. After analyzing a diary, Speight develops an individualized program taking into account the personal habits of the client.
The rate of recommended weight loss is also an important factor to consider when evaluating a program. Weight loss greater than 1 to 2 pounds per week may indicate a reduction in muscle, not fat.
Evaluating the staff of a program is especially important. Speight cautions, "Anybody can put on a white lab coat and say anything. You need to look for a professional staff who knows how to counsel and knows the right information to give out."
Staff should regularly attend professional continuing education and be current in the latest techniques for weight control because the field frequently has new developments and clients can benefit from the latest technologies.
Staff should also be trained in recognizing related conditions, such as depression and eating disorders and either have someone on staff to assist with these problems or be able to refer the client to a professional that can. According to Speight, some clients can't lose weight until underlying psychological issues are resolved.
Follow up counseling can be just as important as in the weight loss phase of the program. "If they can help you lose weight, what can they do to help you keep it off?" asks Speight.
In her clinic, clients on maintenance come in for weekly weight checks to make sure they stay on track and get the continuing support to remain succesful. Speight also thinks a program should teach clients how to deal with real life situations like grocery shopping and eating out, and feels if the program is too regimented the long term success rate will be poor.
Additionally, consumers need to be wary of advertising for weight loss programs. Speight says, "Watch out for any kind of advertising that says they have a secret, ancient or foreign formula. Watch out for anything that burns fat while you sleep. Don't let people give you pills or herbs to lose weight because they don't work. A lot of these herbs contain diuretics that make you lose water, not fat."
She is also concerned about the impact of the new fat gene on people's motivation to lose weight. "There's no reason why anybody can't try. The only thing that concerns me is now people will think, 'Well, I was born to be fat, therefore I'm fat.' It's not an excuse to be fat. If you've got the gene it just means you're going to have to work even harder."
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