AHS wasn’t the only conference this past weekend. The Obesity Action Coalition held their Your Weight Matters national conference as well. What was very cool was that they live-streamed some of their sessions. I’ll be speaking to one of those sessions, Understanding and Managing Food Addiction, soon.
But today I’m writing about Weighing Success beyond the Scale: Identifying and Maintaining a Healthy Weight. In this session, research psychologist Gary Foster shared fascinating research (IMO) on expectations and weight loss. Here’s a bit from the abstract of one of the two studies he published several years ago and discussed in his presentation:
Expert panels and governmental guidelines now recommend that obese persons seek modest (i.e., “reasonable”) reductions in body weight rather than striving for “ideal” weights. Little is known, however, about patients’ views of what is a “reasonable” weight loss. This study assessed patients’ goals, expectations, and evaluations of various outcomes before, during, and after 48 weeks of treatment.
The participants (whose average weights averaged 215 and 240 lbs in the two studies) were asked to provide numbers for 4 different weights for the end of their nearly year-long program: their individual dream, happy, acceptable, and disappointed weights. Here’s the breakdown:
In the video presentation [16:00], Foster points out that the “best academic medical centers in the country” get to 8-10% weight loss (non-surgical) and that to get to 25% (what participants considered “acceptable”) is more typical of bariatric outcomes.
Percentages are important but don’t provide enough context. So let’s pretend we’re an average height woman weighing 240, use the numbers from the second study (rounded), and see what this means in terms of actual goal weights and weight loss:
|Category||% Reduction||Goal weight||Loss in lbs|
Makes sense to me! If you’re a woman at 240 looking at a year-long weight loss effort, wouldn’t you be disappointed if you didn’t make it out of the 200s? And does losing 74 lbs in a year (31%) seem so outrageous when the media splashes the 100+ lb, 50+ percent weight losses of folks on The Biggest Loser or Extreme Weight Loss?
So what happened in Foster’s study?
Not a single participant reached their “dream” weight … a weight that would have given our average height woman a “normal” BMI. One-third reached an “acceptable” or “happy” weight, but two-thirds did not … and nearly half of the participants didn’t get to the weight they would have been disappointed with!
Wow. Houston, we have a problem here! The weight lost in Foster’s two studies was on a par with other clinical trials, but looking at it through the perspective of participant expectations is striking.
Foster doesn’t really go there (to be expected from an OAC speaker?), but there are some strong HAES overtones to his concluding remarks. Foster points out the health benefits of even a small amount of weight loss (tho I am inclined to believe that’s less from the weight loss and more from the intervention that led to the weight loss). But at the end of the day, these participants are still overweight and obese and are still likely to be subject to stigma and well-meaning but potentially harmful public health interventions.