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If you pay attention to the weight loss industry, youve been told over and over how easy it is to lose weightjust take this pill, follow that diet, or buy this piece of equipment, and everything will melt away in a flash. In fact, billions of dollars are spent each year on weight loss products and services and yet many people are still overweight.

Undoubtedly, losing weight is hard work but many peoplewho have lost weight may agree that keeping it off can be an even greater challenge.

An absence of self-control or a couple of such a large number of dietary indulgences is frequently referred to as purposes behind regaining weight.

A new study by the Harvard Gazette suggests that the type of calories you consume may influence how likely you are to keep that weight off for the long term.

Through his study, scientists wanted tosee if different levels of carbohydrates in the diet could prevent these metabolic changes from occurring, so that weight loss might stay off.

The emphasis on carbohydrates depended on the carbohydrate-insulin model of obesity, which holds that high insulin levels that come about because of eating a high glycemic load diet (i.e., highly processed carbohydrates like refined breads, crackers, cookies and sugars) cause energy from the food to be put away more effortlessly as fat, and may increase hunger and food cravings, lower energy consumption, and advance weight gain.

Scientists placed the study participantson a diet to lose about 12 percent of their starting weight to kickstart metabolic changes. The next phase randomly assigned the 164 participants who achieved this loss to one of three test groups:

The protein amount was the same in all groups, at 20 percent. Total calories were adjusted up or down in each participant to prevent any weight changes. All meals were provided to the participants during the weight-loss phase and throughout the 20-week test phase.

The types of foods in each diet group were designed to be as similar as possible, but varying in amounts: The high-carbohydrate group ate more whole grains, fruits, legumes, and low-fat dairy products, while the low-carbohydrate group ate more fat but eliminated all grains and some fruits and legumes.

After participants followed the diets for 20 weeks the researchers measured their total energy expenditure. They found that participants in all groups maintained their weight, and there was minimal difference in secondary measures, including physical activity and resting energy expenditure.

The outcomes suggest:

Consuming a low-carb diet leads to a decreased hormone level responsible forincreased appetite, ghrelin, and leptin. Thus, it leads toweight-loss maintenance. Leptinregulates energy balance and works to keep body weight stable. It typically counteracts ghrelin by sending signals to the brain to suppress appetite when the body has enough food.

David Ludwig, professor in the Department of Nutrition at the Harvard T.H. Chan School of Public Health said, This study raises the possibility that a focus on restricting carbohydrates, rather than calories, may work better for long-term weight control.

Walter Willett, professor of epidemiology and nutrition at the Harvard Chan School, who was not involved in the study, noted that, These findings from a carefully conducted investigation can help explain why low-fat/high-carbohydrate diets are not successful for most people and have failed to maintain weight loss in formal randomized trials that have lasted for one year or longer.

The study is published in the November issue of BMJ.

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TRAINING PHILOSOPHY

TEAM Bootcamp Training is not your usual training (which is why you get superior results). Our Training works equally well for those in search of Massive Weight Loss, as it does for Elite Military Forces and Professional Athletes Because its tailored to YOUR ability. This means youll be able to participate fully and get maximum personal results, alongside your fellow campers, who will range across all levels of physical ability.

WORK VS RECOVERYAnother reason TEAM Bootcamp Training is going to get better results for you is that we have struck the perfect balance between Work and Recovery. Unlike other boot camps that simply aim to run you into the ground until youve got nothing left (increasing the chance of injury and illness) we ensure youre always fit and able to give it your all, being able to work at a higher level, and get even more out of your training.

We include daily clinics, enforced rest, active recovery days and an all-out rest day for those staying with us longer than a week, to facilitate recovery.

Dont be fooled though The Work is designed to push you further than you ever thought your body could take you, which is a truly life-changing experience for many.

Its been described as being like flicking a mental switch, which proves to yourself that youre capable of so much more than you previously believed you were. This training not only forges a much fitter, healthier and happier body in the shortest time possible it also gives you an inner strength you can carry with you for the rest of your life.

THE TRAINING FACILITIESWeve invested a lot in making sure TEAM Bootcamp has the best possible facilities to train you to the best possible standard and delivery you the best possible result.

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Losing weight isnt easy, but keeping it off can seem even more daunting.

Thankfully, it turns out that the idea that most people who lose weight gain it all back (and sometimes more) might be amisconception,and theres research to back that up:An ongoingobservational studyfound that with sustained behavioral changes, the majority of people were able tokeep weight offfor 5+ years.

To help bolster your resolve, shed thesenine unhealthy habits and ways of thinkingto help make weight losspart of who you are,rather than a fleeting phase.

Feeling like you have to suffer forthe rest of your lifeto maintain your weight loss is understandably scary.

Thats why its crucial to have a realistic maintenance plan for eating and exercising that meshes with your life. Just as important, however, ishow you reactwhen you go off-plan.

Slipups will happen. Its helpful to not view them as a failure but as something you can learn from, says psychologist Holly Parker, Ph.D., author of When Reality Bites: How Denial Helps and What to Do When It Hurts.

Try to think of those ups and downs as a natural part of the process, she says, rather than getting hung up on the fact that the slipup happened. And use the information you gleaned to help guard against a similar lapse in the future.

Getting back on the horse right away can also make you feel more in control, Parker says. Feeling passive, on the other hand, can make you feel helpless and overwhelmed, which can be part of a vicious cycle that leads to poor diet decisions.

Many of us overeat or eat things that arent so healthy asa way to cope with difficult feelings, adds Aline P. Zoldbrod, Ph.D., a psychologist based in Lexington, Massachusetts, and a spokesperson for the American Psychological Association. So the best way to not get into feelings of hopelessness is to set small goals and to have a lot of compassion for yourself when you are struggling.

In addition,practicing mindfulnessormeditationcan help you become more self-aware, so you dont use food as a crutch when the going gets tough, she says.

(Pro tip: Need ideas on how to eat right and get fit? Download our free 100 Ways to Lose Weight guidehere!)

When social media starts exploding with testimonials about the latest magical diet food, it can be difficult to not get caught up in the hype and start thinking you cant possibly be healthy without it. But ifbeet smoothies, salmon jerky, or kalejust arent your jam, dont worry about it, nutritionists say.

Noonefood is the ultimate food, says Paige Bent, M.S., R.D., C.S.S.D.. Every food has a different macro- and micronutrient profile, and bodies need a variety of all of those things.

In other words, its the whole puzzle, not individual pieces, thats important. While one food doesnt have the power to ruin your diet, the health food of the moment wont make it healthy on its own either, says Tammy Lakatos Shames, R.D., a dietitian in New York City and co-author of The Nutrition Twins Veggie Cure, with sister Lyssie Lakatos, R.D.

Just like you wouldnt eat cake at every meal its OK every once in a while its the same with really good foods, says Shames. If your diet is poor overall, throwing in some kale or red quinoa once in a while wont make up for it.

In addition, no matter how impressive a foods nutrition profile is, it wont make much difference to your health if you resent eating it, Bent says.

Is kale healthier than romaine lettuce? Yeah, sure, she says. But if you hate kale, youre not going to eat it. Id rather you eat a salad with romaine that youll enjoy and keep eating rather than forcing yourself to eat kale once in a while.

You dont have to buy expensive exercise clothes to get a good workout, but theres evidence to suggest that clothes might actually play a role in keeping you motivated.

So, if youre wearing clothes that are uncomfortable (like baggy cotton shirts that get heavy with sweat or leggings that feel a little too low-cut), that might be what stands between you and a good workout.

According to a study published in the Journal of Experimental Psychology,when subjects wore lab coats, they performed better at tasks requiring attention, leading the authors to conclude thatclothes might have symbolic meaningand associations for some people.

And clothes might also have the ability to affect psychological processing. That might help explain why sometimes just putting on cute workout clothes can feel inspiring and energy-boosting, and why tying your sneakers can be the thing that finally spurs you to head out the door and go for a run.

Obviously, being comfortable makes working out more pleasant, Parker says. When I wear clothing that I feel uncomfortable in, my mental energy is distracted. So I imagine that wearing clothes that make you feel good can be motivating.

Life often gets in the way of good intentions: You go on vacation or to a wedding, and indulge a little too much. When that happens, its tempting to overcorrect with a quick-fix diet plan.

Any responsible dietitian will tell you to steer clear of unhealthy diets that severely restrict calorie intake or the variety of foods you can eat. From a pragmatic standpoint, you shouldnt do them because they wont help your reach your weight goals beyond the very short-term.

More importantly, your body may try to hold on to fat stores if you go below a certain calorie level in preparation for what it considers starvation.

Ultra-low calorie diets can backfire in terms of your metabolism function, Lakatos says. Although initially, there might be weight loss, part of what youre losing is muscle tissue, whichcan affectthe speed of your metabolism.

That means that when you start eating normal food again, it might be more of a struggle to keep weight off. Not only is it unsustainable, it leaves you back where you started, and that can be pretty depressing, she says.

This yo-yo dieting process is one of the biggest obstacles for people trying to keep weight off, says Bent, who has maintained a significant weight loss for several years herself.

Diets arent things you start and go off of and then go back to your old habits, she adds. A quick fix is not healthy, nor is it weight loss thats going to last.

What works is finding a balance that works for you, recommends Bent.Start slow and keep making small goalsfor yourself, such as adding an extra serving of vegetables to your diet each week so you adjust to eating more of them.

When you slowly incorporate changes into your life, eventually they wont seem as daunting, she says.

No matter what your weight is, exercise is an important part of a healthy lifestyle, and regular exercisetends to be a contributing factorin your ability to keep weight off over time.

The key is finding an activity (several) that you enjoy and will do regularly. While some people thrive on competition and enjoy group sports, others may preferat-home workoutsby themselves.

Its amazing how, when people develop a habit, it eventually can become a part of their identity, Parker says. For example, instead of thinking, Im running, you start thinking, Im a runner.

When they use that language, something has been folded into their identity, so theyre more likely to stick with it because it has become part of who they are, she says.

Sure, alcohol contains empty calories that dont do your body a lick of good, but if youre smart about it,you dont have to ditch alcoholto maintain weight loss.

Like a glass of juice or a scoop of ice cream, alcohol can fit into a healthy weight-maintenance plan, Bent says. Butitisa treat, she points out, and should be treated accordingly.

If you really know your limits and can have just a drink once or twice a week, we say its perfectly fine, Shames says.

Problems can arise, however, if people jump on and off the abstinence wagon without having a realistic plan to keep alcohol consumption in check.

When clients tell us theyre going to completely abstain for 2 weeks, well say, thats great, but if they felt deprived doing that, they might go wild after its over, Shames says.

They also advise setting a drink limit in advance: With a number set in your head, its easier to stick to, Shames says.

Pro tip:Drinking water or soda water between each alcoholic beverage helps slow you down and keeps you hydrated.

Sometimes we shift into party mode way too easily. A birthday party is a no-brainer danger zone, but if youre not careful, having friends over for dinner can trigger party mode, then regular Friday happy hours with coworkers.

How much you share about your indulgence plan for an occasion is up to you, but sometimesasking loved ones for helpand understanding about your goals can be helpful, Bent says.

If you tell people, this is something Im doing for myself, and I need your help, it makes you more accountable because they know youre working on these things, she explains.

There are also sneaky strategies to help you avoid nosy questions about what you might be eating or drinking: Having a little healthy food on the plate in front of you wont stand out like an empty plate would, Shames says. A red plastic cup filled with soda water helped Bent blend in unnoticed at college-era parties, she says.

Reminding yourself that you have a choice is another trick to maintain healthy behaviors, Parker says. A 2015 study found that when people at a mall were confronted with signs asking whether they wanted to take the stairs or the escalator,more people chose the stairsthan people who hadnt read the sign.

It might have a similar effect on eating behavior, Parker says, to remind yourself that you have the option to eat a cookie or eat an apple and its up to you.

A steady stream of negative talk about your body doesnt just make you feel bad it makes healthy choices more difficult.

Theres this idea that if people are hard on themselves, theyll be motivated to do better, but evidence shows that the opposite is true, Parker says, pointing out that research suggests that fat shaming may actuallycause people to eat more, not less.

Being cruel to yourself with negative self-talk can set you up for a vicious cycle, Zoldbrod says: You say terrible things to yourself, feel worse than you did before, use food to self-medicate your upset feelings, and then you feel disgusted by yourself, so you want to eat more to feel better. It just goes around and around.

When you catch yourself thinking bad things about your body or your weight,flip the body-shaming scriptby focusing on the bigger picture: Youre losing weight to be healthy and strong.

If you start beating yourself up for eating a cupcake or skipping a workout, think about healthy goals youre working on now.

Focusing on what you can achieve rather than what you can avoid has a more positive impact, Parker says.

Youre probably familiar with many of the reasons why stress is bad for your health, but heres another: cortisol.

This is the bodys stress hormone and it affects how your body stores fat,contributing to belly fat stores, and itcan also increaseappetite-stimulating hormones. So having you guessed it a plan to combat stress can help maintain your weight, Bent says.

When youre trying to lose weight, you might get stressed out that you cant have your favorite foods, she says. The trick is to map out your eating plan for the week and add healthier versions of your favorite not-so-healthful foods, or squeeze in a small treat here and there without being too restrictive.

Dont forget to keep moving, too: Exercise naturally boosts endorphin and serotonin levels, which helps lower stress, Shames says.

Try to remember that long-term weight loss isnt as much of a unicorn as previously thought. Experts agree that having a plan, setting small goals and challenges to keep yourself motivated, and not freaking out when life happens all go a long way in maintaining your weight. Ditch these bad habits, and youll be a step ahead in the weight-maintenance game!

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9 Things to Avoid for Long-Term Weight Loss | The ...

So, you don't just want to lose weight, you want to lose the extra weight forever. Ta-ta. Sayonara. Good riddance. While losing weight does take focus and dedication, it's important to remember that losing weight isn't really a start-and-end process. Sure, you have a weight-loss goal to reach, but once you get there, you don't just stop eating right and working out. No way! You keep it up because it's a healthy lifestyle that's livable and lovableand it makes you feel great.

Despite this, when you make the transition from losing weight to maintaining weight, you have a little more wiggle room in your diet and workout plan because you don't need to create a deficit of calories anymoreyou just need to take in as many as your body needs in order to not gain or lose. (For more on how many calories you need, be sure to update your weight and goals regularly on SparkPeople.)

So whether you're just starting out on your weight-loss journey or if you've reached your goal weight, follow these top strategies to keep the weight off for good.

Get Moving and Stay MovingBeing active is extremely important for keeping weight offnot to mention it has a slew of other great health benefits, including helping cholesterol ratios, reducing blood pressure, improving mood and well-being, and strengthening the heart. Be sure to get active doing something you love; whether it's dancing, walking, biking, or playing sportslife is too short to do something you don't like! Shoot for at least three days of cardiovascular exercise a week and two days of resistance training. Sessions should be at least 20 to 30 minutes each (which can even be broken up into smaller segments) with your heart rate up to 60 percent to 85 percent of its max. Not sure how to figure out your training heart rate? Check out this resource that shows you how.

JournalMultiple studies show that people who track or journal the foods they eat lose more weight and keep it off for the long haul. In fact, the National Weight Control Registry, which tracks more than 3,000 people who have lost an average of 50 pounds and kept it off successfully for five years, has found that logging foods is one way to stay on track well after they've lost the weight. In another study published in the American Journal of Preventive Medicine, those who used a food diary while dieting lost twice as much weight as those who didn't.

Eat the Foods You LoveIf you love cheesecake and chocolate but have a food plan that restricts you from eating them, chances are you're going to feel pretty darned deprived. And that's never a good thing (and typically backfires). To have a truly livable healthy lifestyle, you should include small treats (always eaten in moderation) in your diet. You can scour SparkRecipes for revamped and better-for-you versions of your not-so-healthy favorites!

Drink Enough H20Ask any successful weight-loss maintainer and I guarantee they do one thingdrink at least 8 glasses of water a day. Water helps support your metabolism, aids in removing fat from the body, can help cut cravings and is just darn good for you. So drink up!

Get SupportWhether it's a friend, family member or buddies on SparkPeople, having a support system is key. Another study that looked again at the National Weight Control Registry found that those who lost weight and continued going to bi-monthly support group meetings for a year maintained their weight. Those who didn't go to support meetings regained almost half of the weight they lost. Support doesn't have to come from a face-to-face interaction, so if you can't make it to a meeting there is hope for you too. Another study shows that online socialization and weight-loss support works, too!

Keep Challenging YourselfEven if you're already at your goal weight, never stop setting smart goals. Whether it's adding more weight to your strength training routine, walking or running a bit faster, fitting more fruits and veggies in your diet or simply saying "no" when Aunt Myrtle tries to guilt you into having that second piece of pie, keep setting weekly, monthly and yearly goals to keep you focused and challenged. And be sure to reward yourself (go see a movie, get a pedicure, enjoy a massage, buy new workout clothes, etc.) with good stuff when you reach your goals! Rewards can sometimes be the best motivator of all.

Switch Things UpMake a point every month to try something new. Whether it's a new exercise class, a change in your workout, a different recipe or a food you've never tried, changing things up regularly will keep things fun and engaging. After all, no one (not even those fitness nuts who love to work out) likes to eat the same meal or do the same workout day after day.

Remind YourselfI encourage many of my personal training clients to place a photo of themselves at their heaviest or unhealthiest somewhere that they can see it. You don't have to look at it every day, but once a week it's good to remember where you were and how far you've come. Keeping a photo of your past self in your wallet also comes in handy when you're tempted to skip a scheduled workout or tempted to make an unhealthy option while dining out.

Track Your WeightAbout three-quarters of all successful long-term weight-loss maintainers from the National Weight Control Registry report that they weigh themselves weekly to keep the extra pounds at bay. While sometimes the scale can be a beast of burden (especially when you're gaining muscle and losing fat), it's important that you continue to monitor and track your body to see if the weight is coming off and staying off. Whether it's the scale, measuring body fat, making sure you can fit in a certain pair of jeans or using a measuring tape, track your size regularly.

Embrace the LifestyleAfter a few weeks of eating right and working out, you shouldn't just look better. You should feel better, too! Losing weight is about improving your life, not restricting it. So be sure that you're focusing on the positive and embracing your healthy choices each day. After all, it is a choiceand you've chosen to be healthy and happy!

Are you a long-time loser or are you just beginning your weight-loss journey? How have you kept it off of or how do you plan to?

Sources:Maintaining Weight Loss, from Brigham and Women's Hospital

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10 Ways to Strategize for Long-Term Weight Loss

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Weight loss is not the main reason that most people consume this very popular herbal medicinal. The modern benefits of the plant have been widely documented for decades, including incredible pain relief, energy regulation, easing of symptoms of depression and anxiety. You almost never hear people talking about kratom for weight loss in the top five benefits, but this is probably more a function of just how many benefits there are.

Many users have reported that kratoms effects include the suppression of appetite. This, coupled with the natural, all-day energy that the leaves promote, can lead to the type of healthy, active lifestyle that goes hand in hand with weight loss. Over time, kratom users may find that they are doing less sedentary activities, and less snacking out of boredom.

More importantly, kratom use relaxes other deeper factors which may contribute to weight gain. These other factors leading to unhealthy diet, lifestyle, and weight problems include stress, depression, hopelessness, and lack of energy. Kratom famously goes to work right away inspiring feelings of euphoria and optimism. The bottom line is, happier people are healthier people. Energetic people are more active. In this way, regular use of kratom caps has an incredible therapeutic value, softening all of the ways in which we hold ourselves down. So, we can add healthy weight to the list of kratom benefits.

Read User Reviews on the Best Kratom Strains.

Of course, there are some detractors who consider kratoms long term effects of weight loss to be an unwanted side effect. This brings up an important question is it safe to use kratom with weight loss in mind? The answer is yes, but this should never be the sole intention for an herbal medicinal that has so many far-reaching benefits. Focusing too squarely on using kratom for weight loss could lead to an unhealthy pattern or perhaps too much kratom use for you to enjoy. Its best to think of the comprehensive benefits that kratom brings, with weight loss being just one happy symptom of widespread internal happiness and relaxation. Doesnt that sound like a low-stress weight loss strategy?

Furthermore, one is more likely to experience some side effects from kratom at doses which are too high for your body to happily handle. Side effects include stomach upset and brain fog. These are not serious, but are just uncomfortable enough that most people will stop taking kratom voluntarily in reaction to them, effectively preventing anyone from getting to a larger dose.

Weight loss is neither a major symptom nor goal for most kratom users. With responsible use, you may find your weight coming down slightly over a long period of time. If you find that you have lost your appetite completely in conjunction with regular kratom use, this is a good sign from your body to make an adjustment in your dosage or frequency of use. The idea is to use kratom to feel better, healthier, stronger, happier, and calmer. If you keep these intentions in mind and adjust your use accordingly, you cant lose.

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Does Kratom Cause Weight Loss?

Importance Effective long-term treatments are needed to address the obesity epidemic. Numerous wearable technologies specific to physical activity and diet are available, but it is unclear if these are effective at improving weight loss.

Objective To test the hypothesis that, compared with a standard behavioral weight loss intervention (standard intervention), a technology-enhanced weight loss intervention (enhanced intervention) would result in greater weight loss.

Design, Setting, Participants Randomized clinical trial conducted at the University of Pittsburgh and enrolling 471 adult participants between October 2010 and October 2012, with data collection completed by December 2014.

Interventions Participants were placed on a low-calorie diet, prescribed increases in physical activity, and had group counseling sessions. At 6 months, the interventions added telephone counseling sessions, text message prompts, and access to study materials on a website. At 6 months, participants randomized to the standard intervention group initiated self-monitoring of diet and physical activity using a website, and those randomized to the enhanced intervention group were provided with a wearable device and accompanying web interface to monitor diet and physical activity.

Main Outcomes and Measures The primary outcome of weight was measured over 24 months at 6-month intervals, and the primary hypothesis tested the change in weight between 2 groups at 24 months. Secondary outcomes included body composition, fitness, physical activity, and dietary intake.

Results Among the 471 participants randomized (body mass index [BMI], 25 to <40; age range, 18-35 years; 28.9% nonwhite, 77.2% women), 470 (233 in the standard intervention group, 237 in the enhanced intervention group) initiated the interventions as randomized, and 74.5% completed the study. For the enhanced intervention group, mean baseline weight was 96.3 kg (95% CI, 94.2-98.5) and 24-month weight 92.8 kg (95% CI, 90.6-95.0). For the standard intervention group, mean baseline weight was 95.2 kg (95% CI, 93.0-97.3) and 24-month weight was 89.3 kg (95% CI, 87.1-91.5). Weight change at 24 months differed significantly by intervention group (estimated mean weight loss, 3.5 kg [95% CI, 2.6-4.5} in the enhanced intervention group and 5.9 kg [95% CI, 5.0-6.8] in the standard intervention group; difference, 2.4 kg [95% CI, 1.0-3.7]; P=.002). Both groups had significant improvements in body composition, fitness, physical activity, and diet, with no significant difference between groups.

Conclusions and Relevance Among young adults with a BMI between 25 and less than 40, the addition of a wearable technology device to a standard behavioral intervention resulted in less weight loss over 24 months. Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioral weight loss approaches.

Trial Registration clinicaltrials.gov Identifier: NCT01131871

Overweight and obesity have high prevalence1 and are associated with numerous health conditions.2 Interventions emphasizing both diet and physical activity are effective for weight loss, resulting in 6-month weight loss of 8% to 10% of initial weight.3 However, challenges remain to sustaining weight loss long-term.3

There is wide availability of commercial technologies for physical activity and diet.4 These technologies include wearable devices to monitor physical activity, with many also including an interface to monitor diet. Short-term studies have shown these technologies to result in modest improvements in weight loss when added to a behavioral intervention.5,6 These technologies may provide a method to improve longer-term weight loss; however, there are limited data on the effectiveness of such technologies for modifying health behaviors long term.4

This randomized trial examined whether adding wearable technology to a behavioral intervention would improve weight loss across 24 months among young adults aged 18 to 35 years. Additional outcomes included body composition, fitness, physical activity, and dietary intake.

Question Is the addition of a wearable device to monitor and provide feedback on physical activity effective for improving weight loss within the context of a behavioral weight loss intervention?

Findings In this randomized trial that included 470 young adults, weight loss was significantly less (by 2.4 kg) in response to a behavioral intervention when a wearable device that monitored and provided feedback on physical activity was included within the intervention.

Meaning Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioral weight loss approaches.

IDEA (Innovative Approaches to Diet, Exercise and Activity) was a randomized clinical trial conducted at the University of Pittsburgh and was one of the studies within the EARLY (Early Adult Reduction of Weight Through Lifestyle Intervention)Trials consortium, with each study implementing a unique intervention in young adults.7 The IDEA study protocol is available in Supplement 1. Participants were randomized to 1 of 2 groups. Both groups received a behavioral weight loss intervention for 6 months; at 6 months, both interventions added telephone counseling sessions, text message prompts, and access to study materials on a website. However, after the initial 6 months, participants randomized to the standard behavioral weight loss intervention (standard intervention) group initiated self-monitoring of diet and physical activity behaviors, and those in the technology-enhanced weight loss intervention (enhanced intervention) group used the study website to access education materials only, and wearable technology was provided along with a web-based interface to monitor physical activity and diet. Randomization was stratified by sex and race (white or nonwhite) using a computer program that applied randomly selected block sizes of 2 and 4 with the sequence of randomization kept confidential to the other investigators. The primary outcome was weight change at 24 months.

Recruitment occurred across 10 recruitment periods that took place between October 2010 and October 2012 at the University of Pittsburgh using direct mail, mass media advertisements, or referral from clinical research registries. Eligibility was assessed based on self-reported medical history, and clearance from the participants physician was also obtained. Procedures were approved by the University of Pittsburgh institutional review board, and all participants provided informed consent.

Eligibility criteria included age between 18 to 35 years, body mass index (BMI) of 25.0 to less than 40.0 (calculated as weight in kilograms divided by height in meters squared), access to a cellular telephone that could receive text messages, and a computer with internet access. Exclusion criteria have been published.8

Both the standard intervention group and the enhanced intervention group received regular intervention contact. Group-based sessions were scheduled weekly for the initial 6 months and monthly between months 7 to 24. If a participant was unable to attend a scheduled group session, attempts were made to engage the participant in a makeup session. Theory-based strategies were used to promote adherence to weight loss behaviors.9-13 At each session, participants were given feedback on weight change and were provided materials to complement the topic of the session. Beginning with month 7, these materials were posted on the study website, along with a weekly behavioral tip.

During months 7 to 24, participants were also scheduled to receive a brief (10 minutes) individual telephone contact once per month and weekly text messages. The telephone contacts were conducted by intervention staff and followed a standard script. Text messages were provided once or twice per week and were used to prompt engagement in weight loss behaviors or to remind participants of upcoming intervention sessions. Participants were compensated $5 per month to offset the cost of receiving text messages.

Calorie intake in both intervention groups was prescribed based on baseline weight at 1200 kcal/d for individuals who weighed less than 90.7 kg, 1500 kcal/d for those who weighed 90.7 to less than 113.4 kg, and 1800 kcal/d for those who weighed 113.4 kg or more. If weight loss exceeded 6% during each 4-week period or if BMI was 22 or less, prescribed individual calorie intake was increased. Dietary fat was prescribed at 20% to 30% of total calorie intake, and sample meal plans were provided to facilitate adoption of the prescribed dietary recommendations. During months 1 to 6, participants were instructed to self-monitor dietary intake in a diary that was returned to the interventionists at the conclusion of each week, and the intervention staff provided feedback prior to returning diaries to the participants. During months 7 to 24, participants in the standard intervention group self-reported their daily intake using a website designed for this study, and this information was available to the staff during the intervention telephone contacts. Participants in the enhanced intervention group self-monitored their dietary patterns using the technology described below.

Nonsupervised moderate-to-vigorous physical activity (MVPA) in both intervention groups was initially prescribed at 100 minutes per week and increased at 4-week intervals until a prescription of 300 minutes per week was achieved. Participants were instructed to engage in structured forms of MVPA that were 10 minutes or longer in duration. During months 1 to 6, participants were instructed to self-monitor their MVPA in a diary returned to the interventionists at the conclusion of each week. The intervention staff provided feedback on these diaries. During months 7 to 24, participants in the standard intervention group self-reported their daily MVPA using a website designed for this study, and this information was available to the staff during the intervention telephone contacts. Participants in the enhanced intervention group self-monitored their MVPA using the technology described below.

Technology Used by the Enhanced Intervention Group

The enhanced intervention group was provided and encouraged to use a commercially available wearable technology that included a web-based interface (FIT Core; BodyMedia). This system included a multisensor device worn on the upper arm that provided feedback to the participant on energy expenditure and physical activity through a small display or through web-based software developed by the manufacturer. While the display provided information about total MVPA, the web-based software also provided feedback on MVPA performed in durations of 10 minutes or longer. The web-based software also allowed for self-monitoring of dietary intake. Intervention staff had access to this information during the scheduled telephone contacts.

Measures occurred at 0, 6, 12, 18, and 24 months. Participants received $100 for completing each of the 4 postbaseline assessments. Assessment staff were masked to prior data at each assessment to minimize potential bias.

Weight was assessed to the nearest 0.1 kg with the participant clothed in a hospital gown or lightweight clothing. Height was measured only at baseline to the nearest 0.1 cm with shoes removed.

Body composition was assessed using dual-energy x-ray absorptiometry from a total body scan. Prior to this scan, women had a urine pregnancy test; a positive result excluded the participant from further study participation.

Cardiorespiratory fitness was assessed with a submaximal graded exercise test performed on a motorized treadmill.8 Oxygen consumption was assessed using a metabolic cart.

Physical activity was assessed using a portable device worn for 1 week.14,15 Data were considered valid if the participant wore the device for 10 or more hours per day for 4 or more days during the observation period.16,17 Minute-by-minute data were used to identify minutes and metabolic equivalent (MET)minutes per week of sedentary behavior (awake time, <1.5 METs), light-intensity physical activity (1.5 to <3.0 METs), and MVPA (3.0 METs). Percent sedentary time was calculated as sedentary time identified by the activity monitor divided by the monitor wear time.

Diet over the past month was assessed using the web-based version of the Diet History Questionnaire18,19 and DietCalc software (version 1.5.0).

Percent weight loss was included as a post hoc outcome.

For safety, depressive symptoms were assessed using the 10-item Center for Epidemiology Studies questionnaire.20 Participants with a score of 13 or greater were referred to their primary care physician and provided a list of community resources to assist in obtaining treatment. Resting blood pressure was assessed following a 5-minute seated resting period using an automated system; participants with systolic blood pressure of 140 mm Hg or greater or diastolic blood pressure of 90 mm Hg or greater were referred to their primary care physician. Participants were queried regarding the occurrence of overnight hospitalizations and conditions to assess for adverse and serious adverse events.

Sex, education, income, employment status, smoking status, alcohol consumption, and depressive symptoms20 were assessed by self-report using questionnaires. Race and ethnicity, measures included in the early trials consortium, were assessed by self-report using questionnaires with fixed categories.

The mean weight loss from baseline to month 24 in the standard intervention group was projected to be approximately 3.4 kg at 24 months, with these estimates based on data from prior weight loss studies that included young adults.21-23 We specified 2.3-kg or more mean weight loss for the enhanced intervention compared with the standard intervention, so that the mean weight loss in the enhanced intervention group was expected to be 5.7 kg at the end of month 24. This would allow participants in the enhanced intervention group to maintain a clinically meaningful weight loss of at least 5%.3 Using a standard deviation of 6.8 kg for both groups, a 2-sided t test at 5% level of significance had 90% power to detect a mean difference of 2.3 kg (effect size, 0.33) between the enhanced intervention and standard intervention groups if 24-month data were available for at least 191 patients in each group. Based on an expected attrition rate of 20%, the recruitment goal was 238 participants per group.

Descriptive statistics were used to describe the participants in the 2 groups. Statistical significance of group differences in distributions was tested using Wilcoxon test for continuous variables and Pearson 2 test or exact tests for categorical variables, as appropriate.

It was expected that the likelihood of missingness could be predicted by the observed data, so missing data were assumed to be at random and a likelihood-based analysis was used. Thus, the primary hypothesis of participants in the enhanced intervention group achieving weight loss different from those in the standard intervention group was tested by fitting a linear mixed-effects model via maximum likelihood with weight over time as the outcome, including race, sex, time (assessment, treated as discrete, at baseline and at 6, 12, 18, and 24 months), intervention (enhanced intervention vs standard intervention), and interventiontime interaction as fixed effects and participants and recruitment periods as random effects. Weights measured during or after pregnancy were excluded from the analyses. Significance of the difference in distributions of weight was tested with a likelihood ratio test of the null hypothesis H0: =0, with as the coefficient of the intervention by 24-month visit interaction in the linear mixed-effects model.

For all of the models, if the interventiontime interaction was statistically significant (P<.05), the equality of mean changes in the 2 intervention groups at each intermediate time point was tested. The mean change at each time point, estimated using the least-square means, are presented by intervention along with the corresponding 95% confidence intervals. P values were adjusted by the Holm method for multiplicity when the differences were tested at multiple time points.24 No adjustments for multiple comparisons were made for the primary outcome. P values for all other secondary outcome analyses were adjusted for multiplicity using the Holm method.

Multiple imputation was used for sensitivity analysis. Specifically, 10 Monte Carlo Markov Chain imputations based on the observed variables (intervention group, sex, race, ethnicity, education, income, employment status, waist circumference, smoking status, alcohol consumption, depression, and weight) at previous assessments were used to impute the missing weights for the sensitivity analysis. The estimates from the imputed data sets were averaged to see if they were similar to the likelihood-based estimates from the primary analysis. A similar approach was used for the secondary outcomes.

Fisher exact test conducted separately for each time interval was used for comparing adverse events and other alerts. All tests were 2-sided, and P<.05 was used as the cutoff for statistical significance. All analyses were conducted using SAS version 9.3 (SAS Institute Inc).

This study randomized 471 participants (BMI, 25 to <40; age range, 18-35 years; 28.9% nonwhite; 77.2% women), with specific exclusion criteria by participant shown in the Figure. However, prior to the start of the intervention, 1 participant was discovered to be ineligible and was removed from the study. Thus, 470 participants received the intervention and are included in the analysis. Descriptive characteristics for the standard intervention and enhanced intervention groups are shown in Table 1. Weight data at 24 months was available for 74.5% of the sample (72.5% in the standard intervention group, 76.4% in the enhanced intervention group [Figure]). The 20 women in the standard intervention group and 9 in the enhanced intervention group who became pregnant after randomization discontinued participation in the study for safety. When these women are excluded, 79.3% of those in the standard intervention group and 79.4% in the enhanced intervention group had weight measured at 24 months.

There was significant change in weight over time (P<.001 for time), and the change differed significantly between the enhanced intervention and standard intervention groups (P=.003 for grouptime interaction), with less weight loss in the enhanced intervention group (Table 2). Estimated mean weights for the enhanced intervention group were 96.3 kg (95% CI, 94.2 to 98.5) at baseline and 92.8 kg (95% CI, 90.6 to 95.0) at 24 months, resulting in a mean weight loss of 3.5 kg (95% CI, 2.6 to 4.5). Corresponding values for the standard intervention group were 95.2 kg (95% CI, 93.0 to 97.3) at baseline and 89.3 kg (95% CI, 87.1 to 91.5) at 24 months, for a mean loss of 5.9 kg (95% CI, 5.0 to 6.8). At 24 months, weight loss was 2.4 kg (95% CI, 1.0 to 3.7) lower in the enhanced intervention group compared with the standard intervention group (P=.002). Results from the sensitivity analysis using multiple imputation were similar, with weight loss at 24 months of 3.3 kg (95% CI, 2.5 to 4.0) in the enhanced intervention group and 5.3 kg (95% CI, 4.5 to 6.2) in the standard intervention group.

In post hoc analysis, percent weight loss differed significantly between the standard intervention and enhanced intervention groups (P<.001) (Table 2). Although there was no significant difference between groups at 6 months (estimated means, 9.4% for standard intervention vs 8.4% for enhanced intervention; P=.15), percent weight loss was significantly greater in the standard intervention group compared with the enhanced intervention group at 12 months (estimated means, 8.9% vs 7.0%; P=.01), 18 months (estimated means, 7.9% vs 5.6%; P=.002), and 24 months (estimated means, 6.4% vs 3.6%; P<.001).

Participants in the standard intervention and enhanced intervention groups did not differ significantly for fat mass, lean mass, percent body fat, bone mineral content, bone mineral density, or cardiorespiratory fitness (P.05 for all), although there were significant changes across time among all participants (P<.01 for all for time). (Table 2).

Differences between intervention groups for physical activity and dietary intake were not significant (Table 3). Regardless of the intervention conditions, there was a significant change in percent sedentary time, sedentary time, and light-intensity physical activity across time (P<.001 for all). Although total MVPA (minutes per week or MET-minutes per week) did not change significantly over time, MVPA performed in bouts of 10 minutes or longer significantly changed across the intervention (P<.001 for minutes per week and MET-minutes per week). Approximately 95% of participants providing weight data also provided valid physical activity data across the assessment periods (eTable 1 in Supplement 2).

Total calorie intake and the percent of energy intake consumed as dietary fat, carbohydrates, and protein changed significantly over time (P<.001 for all).

Of the 237 participants randomized to enhanced intervention, 191 participants received the wearable device that was a component of the intervention starting after month 6 and wore the device for 1 day or longer (median days worn, 170.0 [25th-75th percentile: 68.0-347]). On days that the device was worn, the median wear time was 241.1 min/d (25th-75th percentile: 99.3-579.1). User experience with this technology is reported in eTable 2 in Supplement 2.

There were no significant differences between groups in the number of safety alerts, nonserious adverse events, and serious adverse events (Table 4).

In this study, the addition of wearable technology to a behavioral intervention was less effective for 24-month weight loss. This may be a result of the technology not being as effective for changing diet or physical activity behaviors compared with what was achieved with the standard intervention; however, the study found no significant difference in these measures between the standard intervention and enhanced intervention groups. Thus, the reason for this difference in weight loss between the standard intervention and enhanced intervention groups warrants further investigation.

The few studies that have shown promise for adding wearable technology at the onset of a weight loss intervention have been short in duration and have included relatively small samples of participants.5,6 However, in one 9-month intervention, combining a group-based weight loss intervention with wearable technology improved weight loss compared with the group-based treatment alone.25 Furthermore, the group-based treatment resulted in a mean weight loss of approximately 2 kg, whereas our standard intervention resulted in mean weight loss of approximately 8 kg at both 6 and 12 months. Thus, questions remain regarding the effectiveness of wearable technologies over and above a standard intervention and how to best use them to modify physical activity and diet behaviors in adults seeking weight loss.

Although this study showed weight loss across the 24-month intervention in young adults, similar to trials of middle-aged and older-aged adults,22,23,26,27 the benefits achieved at 6 months were not fully sustained long term. Thus, regardless of age, challenges remain to preventing or minimizing weight regain following initial weight loss in adults. These findings are important because of the lack of data to support the effectiveness of approaches for weight loss in young adults, who have a high prevalence of overweight and obesity.1 The interventions used in this study resulted in substantially greater weight loss than what was recently reported for young adults in response to a 24-month low-intensity, technology-based intervention.28 Given that there was not a no-treatment control condition in this study, the degree to which the observed change in weight is a direct result of the intervention vs other factors cannot be determined. However, the importance of examining effective weight loss strategies for young adults is supported by a recent report showing that this age demographic has a prevalence of obesity (32.3%) higher than the prevalence in youth 12 to 19 years of age (20.5%) but lower than that found in middle-aged adults (40.2%).29 This may suggest that young adulthood is an important transition period for weight gain and the development of obesity.29

There were limitations to this study. The study sample was restricted to young adults, so results cannot be generalized to other ages. The multisensor wearable device was worn on the upper arm, which may not reflect the effectiveness of more contemporary devices worn on the wrist. However, the accuracy of wrist-worn devices to monitor physical activity and energy expenditure compared with the arm-worn device has been questioned,30 which may also limit their effectiveness, and this may not be consequential. Moreover, the use of wearable technology was not initiated at the onset of the intervention, which may have influenced how the participants adopted and used the technology during their weight loss efforts. The device used was also commercially available, and therefore the investigators did not have control over any additional information that may have been provided through the website available for use with this device. Dietary intake was assessed using self-report, which may have affected the accuracy of this measure and therefore influenced the understanding of how the intervention influenced this aspect of energy balance. Additional investigation is also needed to examine for whom wearable devices and other technologies may be effective within the context of weight loss efforts and how these technologies influence other components of weight loss, namely, eating behavior and dietary intake.

Approximately 75% of the participants provided outcome data at the 24-month assessment. Of the 120 participants missing 24-month weight, approximately one-third (n=38) had missing weight due to either being excluded for pregnancy (n=29) or moving out of the area (n=9), which are unlikely to bias the results. Linear mixed models used all available data from participants with missing data (ie, from earlier time points) to gain efficiency. Although multiple imputation was used to account for missing data in a sensitivity analysis, the loss of outcome data most likely resulted in reduced precision for the parameter estimates. Moreover, it is possible that the results could be biased in the event that the data lost to follow-up were not missing at random. Assessment staff were also aware that individuals were engaged in a weight loss trial, which may have introduced additional bias.

Among young adults with a BMI between 25 and less than 40, the addition of a wearable technology device to a standard behavioral intervention resulted in less weight loss over 24 months. Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioral weight loss approaches.

Corresponding Author: John M. Jakicic, PhD, University of Pittsburgh, Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, 32 Oak Hill Ct, Pittsburgh, PA 15261 (jjakicic@pitt.edu).

Correction: This article was corrected online on September 22, 2016, to correct transposed data in the abstract.

Author Contributions: Dr Jakicic had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Jakicic, Davis, Marcus, Rickman, Wahed, Belle.

Acquisition, analysis, or interpretation of data: Jakicic, Davis, Rogers, King, Helsel, Rickman, Wahed, Belle.

Drafting of the manuscript: Jakicic, Marcus, Wahed.

Critical revision of the manuscript for important intellectual content: Davis, Rogers, King, Helsel, Rickman, Wahed, Belle.

Statistical analysis: King, Wahed, Belle.

Obtained funding: Jakicic, Wahed, Belle.

Administrative, technical, or material support: Jakicic, Davis, Marcus, Helsel, Rickman.

Study supervision: Jakicic, Davis, Rogers, Rickman, Belle.

Conflict of Interest Disclosures: Dr Jakicic reported receiving an honorarium for serving on the Scientific Advisory Board for Weight Watchers International; serving as principal investigator on a grant to examine the validity of activity monitors awarded to the University of Pittsburgh by Jawbone Inc; and serving as a co-investigator on grants awarded to the University of Pittsburgh by HumanScale, Weight Watchers International, and Ethicon/Covidien. Dr Rogers reported serving as principal investigator on a grant awarded to the University of Pittsburgh by Weight Watchers International. Dr Marcus reported receiving an honorarium for serving on the Scientific Advisory Board for Weight Watchers International. No other disclosures were reported.

Funding Support: This study was supported by grant U01 HL096770 from the National Institutes of Health and the National Heart, Lung, and Blood Institute (NHLBI).

Role of the Funders/Sponsors: The funders/sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. However, because this grant was funded as a cooperative agreement (U-award), the sponsor provided input on outcome measurements prior to implementation, and the program officers of the sponsor (NHLBI) were invited to participate in meetings of the data and safety monitoring board.

Additional Contributions: We recognize the contribution of the staff and graduate students at the Physical Activity and Weight Management Research Center and the Epidemiology Data Center at the University of Pittsburgh, who received salary support for their effort on this project.

Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice Hall; 1986.

Janz KF. Use of heart rate monitors to assess physical activity. In: Welk GJ, ed. Physical Activity Assessment for Health-Related Research. Champaign, IL: Human Kinetics; 2002.

Marlatt GA, Gordon JR. Relapse Prevention. New York, NY: Guilford Press; 1985.

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Monitoring and Feedback for Long-term Weight Loss - JAMA

If you don't want to waste time searching for the best weight loss plan, and especially if you are looking for long term results, look no further. Here are few things that will make deciding on the best plan for weight loss quick and easy. You'll want to make sure you investigate a few key things that the best weight loss plans in the country all seem to have in common.

We've come up with a set of essential rules for the best ways to lose weight when following a plan for weight loss. You will absolutely want to follow these if you want to lose weight and keep it off.

Guidelines to follow for the best weight loss plan:

1. Don't cut out a whole food group.

It is vitally important choose a balance of foods to make sure you don't miss out on any key essential nutrients. When you completely cut out a whole food group for example, grains, breads, potatoes, cereals, pastayou might miss out on the fortified vitamins and minerals that are found in these foods. It's better to reduce your portion size of these foods, rather than to completely cut them out for months on end to lose weight. Also, it's nearly impossible to cut out an entire food group for your whole lifetime, and this could set you up for future failure when it comes time to begin maintaining your weight.

2. No fewer than 1000 calories, per day, unless recommended and supervised by your doctor.

While keeping your diet at 900 calories per day may seem like the best way to lose weight in the moment, it's actually the worst. Why? Because you will without a doubt begin to lose lean muscle tissue. This is the last thing any of us want when we are attempting to achieve a healthy weight. Muscle protein is the largest contributor to metabolic rate, meaning it burns the most calories, even at rest. When you lose muscle, you'll see the scale drop, but this is not from losing fat! The fat tissue is still there, so it is extremely misleading when you inspect the scale. So steer clear of plans that decrease daily calories to under 1,000 kcals per day.

3. Focus on habits and lifestyle change.

The best weight loss plans all have one thing in common. They help you switch your entire lifestyle, not just your diet. Normally they will include lots of education, portion control, and will list ways to help you develop skills in food preparation. They should absolutely provide tips on how to order at restaurants, and what a healthy, balanced meal looks like. The best weight loss plans almost always help you with grocery shopping lists, or planning menus for a family. Most importantly, these plans will focus on changing how you live your life around food not just making temporary changes. If a program claims they have a fast way to lose weight, then you might want to think twice, because you may not develop the skills you need to keep the weight off once it's gone. And no one wants to have to lose weightagain.

4. Skip diets that skip protein, or recommend severely limiting protein intake.

If a diet is dropping your lean protein intake drastically, such as a vegan or vegetarian diet, you might want to skip it. You can easily add in all the healthy foods that a vegan diet containsand achieve all the same health benefitswithout dodging lean proteins. Contrary to popular belief, beans are NOT a complete source of protein. We're not sure where this rumor began circulating, but it's absolutely false and here's why: Beans contain a very, very small amount of lysine. Too small to count toward your daily amino acid needs. And so you MUST combine them with another food source, such as rice or bread, in order to get the complete amino acid profile your body requires. But the real problem is this: any of the amino acids found in plant foods will never be absorbed as well as amino acids from lean animal proteins. Plants contain fibers and indigestible complexes that bind amino acids and minerals, making them much more difficult to absorb. Lean proteins are easily broken down into separate amino acids, and are readily absorbed along with minerals like iron and zinc. So if a plan encourages a total vegan diet, you might want to reconsider the protein part, and embrace all of the healthy foods present in a vegan diet.

5. No fat and ultra-low carb diets are a no-go.

Most of us have moved on from the 80's and 90's no-fat dieting craze. However, there are still diets that recommend removing all the fat you can from your diet, which is truly crazy. You absolutely need certain essential fats. Without them, you might develop dry skin, texture changes in your hair, and deficiencies in certain vitamins, such as Vitamin A, D, E, and K. Additionally, your brain is composed mainly of fat, and healthy fat intake is crucial to maintaining healthy brain function. The essential fats you need are found in a variety of foods, such as flax seed, chia seeds, soybeans, pumpkin seeds, walnuts, salmon, and avocados. Any diet that does not include foods that contain essential fats is one you will not want to explore.

In summary, the best way to lose weight and keep it off is to follow a weight loss plan, such as bistroMD, that focuses on lifestyle changes, and helps you learn the skills you need to achieve a normal weight. Explore our menu and get started today!

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Best Weight Loss Plan for Long Term Results - bistroMD

With weight gain, slow and steady is the common pacewe often look back, wondering: How did I get to this weight? Long-term weight gain typically happens at a miniscule 1-2 pounds per year, which can snowball into something substantial as we age. Fad diets lure us with the promise of rapid weight loss, but researchers are looking at it from a different angle: Can changing what we eat stop long-term steady weight gain?

What the Science Says

Scientists from the Friedman School of Nutrition Science and Policy did a study using data collected from 120,784 healthy, non-obese, middle-age participants in three well-established cohorts: Nurses Health Study, Nurses Health Study II, Health Professionals Follow-up Study. Data was collected at every four-year period for 16 to 24 years.

Researchers were interested in how participants diet quality affected their trend in weight gain. Without altering anyones food intake, the researchers looked at what participants consumed, with a focus on protein and the glycemic load (GL)two measures of diet quality. Then, they examined how changes in participants weight corresponded to diet quality. Why?

High-protein foods (think meats, dairy, nuts, beans) are thought to help with weight loss because of their ability to promote satiety, spare lean muscle mass, and help offset the slow in metabolism. GL was used because it reveals both carbohydrate quality and quantity. The more popular glycemic index (GI) is used to assess how a food will increase your blood sugar, but this doesnt account for the amount of the food that you eat. GL accounts for both the foods GI and portion eaten. High GL foods (think refined carbs) are thought to make weight gain more likely because they make your blood sugar rise rapidlyleading to insulin release, which favors fat storage.

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Weighty Findings

Once the data was collected, the researchers could then summarize associations, also known as data trends, between certain types of food and weight gain or loss. Here are some of their weightier findings:

Keep in mind that the results of this study are associations meant to show relationships between diet quality and weight gain or loss. This does not confirm that particular diet types cause weight gain or loss. Nonetheless, these relationships are still important, given that were looking at a large group of participants over the course of decades.

Whats the Takeaway?

This study confirms that the quality of your diet matters for keeping your weight in check over a long period of time. A balanced diet rich in whole grains, fruits and vegetables will help you maintain a low glycemic load. Choosing lean protein sources like chicken, fish, nut butter and low-fat cheese will reduce the amount of fatparticularly saturated fatin your diet. Both glycemic load and protein type are indicators of your diet quality, and will affect your weight.

Its apparent that a calorie is not a calorie in this case, so do calories still count when it comes to weight loss? The answer is a resounding Yes! Even though the study focused on diet quality, this is just one factor out of many that affect our weight. To be successful at maintaining a healthy weight, both the number of calories consumed and the quality of those calories matters.

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Reset Your Resolution Ask the Dietitian: Why is Weight Loss So Hard? Ask the Dietitian: What is the Best Carb, Protein and Fat Breakdown for Weight Loss

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2 Science-Backed Strategies to Avoid Long-Term Weight Gain

Much has been made of the recently published results of the DIETFITS (Diet Intervention Examining the Factors Interacting with Treatment Success) study. Most of the headlines emphasized the fact that the two diets involved low-fat and low-carb ended up having the same results across almost all end points studied, from weight loss to lowering blood sugar and cholesterol.

Whats most interesting, however, is how these two diets are similar.

The authors wanted to compare low-fat vs. low-carb diets, but they also wanted to study genetic and physical makeups that purportedly (their word) could influence how effective each type of diet will be for people. Previous studies had suggested that a difference in a particular genetic sequence could mean that certain people will do better with a low-fat diet. Other studies had suggested that insulin sensitivity may mean that certain people will do better with a low-carb diet.

The study began with 609 relatively healthy overweight and obese people, and 481 completed the whole year. For the first month, everyone did what they usually did. Then, for the next eight weeks, the low-fat group reduced their total fat intake to 20 grams per day, and the low-carb group reduced their total carbohydrate intake to 20 grams per day. These are incredibly restricted amounts, considering that there are 26 grams of carbs in the yogurt drink Im enjoying as I write this, and 21 grams of fat in my half of the dark chocolate bar my husband and I split for dessert last night.

That kind of dietary restriction is impossible to maintain over the long term and, as this study showed, unnecessary. Participants were instructed to slowly add back fats or carbs until they reached a level they felt could be maintained for life. In addition, both groups were instructed to

People were not asked to count calories at all. Over the course of a year, both groups attended 22 classes reinforcing these very sound principles and all participants had access to health educators who guided them in behavioral modification strategies, such as emotional awareness, setting goals, developing self-efficacy (also known as willpower), and utilizing social support networks, all to avoid falling back into unhealthy eating patterns.

Participants in both groups also were encouraged to maintain current US government physical activity recommendations, which are 150 minutes of moderate intensity aerobic physical activity (2 hours and 30 minutes) each week.

Get all that? Basically, the differences between groups were minimal. Yes, the low-fat group dropped their daily fat intake and the low-carb group dropped their daily carb intake. But both groups ended up taking in 500 to 600 calories less per day than they had before, and both lost the same average amount of weight (12 pounds) over the course of a year. Those genetic and physical makeups didnt result in any differences either. The only measure that was different was that the LDL (low density lipoprotein) was significantly lower in the low-fat group, and the HDL (high density lipoprotein) was significantly higher in the low-carb group.

I love this study because it examined a realistic lifestyle change rather than just a fad diet. Both groups, after all, were labeled as healthy diets, and they were, because study investigators encouraged eating high-quality, nutritious whole foods, unlimited vegetables, and avoiding flours, sugars, bad fats, and processed foods. Everyone was encouraged to be physically active at a level most Americans are not. And this is a big one everyone had access to basic behavioral counseling aimed at reducing emotional eating.

This whole study could just as well be called a study of sustainable healthy lifestyle change. The results jibe very much with prior research about healthy lifestyle. The end message is the same one that we usually end with:

The best diet is the one we can maintain for life and is only one piece of a healthy lifestyle. People should aim to eat high-quality, nutritious whole foods, mostly plants (fruits and veggies), and avoid flours, sugars, trans fats, and processed foods (anything in a box). Everyone should try to be physically active, aiming for about two and a half hours of vigorous activity per week. For many people, a healthy lifestyle also means better stress management, and perhaps even therapy to address emotional issues that can lead to unhealthy eating patterns.

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Which diet is best for long-term weight loss? - Harvard ...

While the oft-touted advice to get to our goal weight is simply to cut back on calories, achieving long-term weight-loss goals is actually much more complex. What we dont realize is our goal weight can actually be hard to achieve and maintain, especially without an eye toward a lifestyle shift.

Research has proven time and again that restricting and dieting often dont work. In fact, traditional dieting methods often lead to long-term weight gain, rather than weight loss because it doesnt teach the necessary behaviors for developing sustainable healthy eating habits. Research also shows that restricting foods and calories alone often leads to increased cravings for them, resulting in potential bingeing, a cycle known as the restrict-binge cycle.

Eating mindfully and intuitively, on the other hand, focus on tuning into your body and trusting it to know what it needs. While intuitive eating doesnt focus on calories or weight, research shows it may stabilize and reduce weight. A 2015 study in the American Journal of Health Promotion found women who reported being intuitive eaters had significantly lower BMI scores than non-intuitive eaters.

Rather than focusing exclusively on counting calories or cutting out entire food groups, try these mindful ways to tune in to your body and hunger:

Ironically, it can be the rigidity established by cutting calories that causes us to crave certain foods even more, potentially making us crave foods we dont normally think about. The only way to learn how foods make you feel is not to feel restricted by them.

You may find that when you remove chocolate from the pedestal and give yourself permission to enjoy a piece of chocolate each afternoon, you may stop craving it altogether. You may determine it doesnt make you feel energized the rest of the afternoon or that allowing one piece removes the taboo and you can stop there. By paying attention, you may discover how foods affect you in different ways.

Picking an arbitrary number of calories to eat each day wont necessarily account for your bodys needs but listening to your hunger and fullness cues will. Because our bodies are fluid and adaptable, our calorie needs are constantly changing.

Recovering from an illness or injury, being under a significant amount of stress or recovering from an intense workout are just some examples of when your body may need more calories and specific macronutrients. Being able to trust your hunger cues, rather than ignoring or suppressing them is one way to become more trusting and intuitive.

READ MORE > ESSENTIAL GUIDE TO LOSING WEIGHT

A low-fat granola bar may taste better in the moment and have fewer calories than, say, an apple and an ounce of nuts. However, because of its higher sugar content, you may find yourself hungrier only to snack more afterward and ultimately consume more calories than if you ate the apple and nuts. This is your bodys way of seeking satisfaction. While our bodies dont monitor calories, they know what foods are satisfying and filling.

Theres a plethora of research indicating that there are different ranges of optimal Body Mass Index (BMI), including that we can be healthy outside of the normal BMI range. In addition, the correlation of mortality rates with BMI often fail to take into consideration such critical factors as family history, mental disorders and our social environment.

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