Preventing weight gain over the holiday season: it is possible
Effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period: randomised controlled trialLiterature - Mason F, Farley A, Pallan M et al. - BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4867 (Published 10 December 2018)
Introduction and methods
Long-term success in treating established obesity through lifestyle change turns out to be challenging, possibly due to the substantial, permanent changes in diet and physical activity that needed to achieve and maintain weight loss. An alternative strategy could be to focus on prevention of weight gain, but the evidence on the effectiveness of this approach is scarce.
Longitudinal weight tracking studies report that each year on average the population gains a small amount of weight (0.4-1 kg), with more rapid gain in particular periods such as the Christmas holiday season [2,3]. One review concluded that several studies have reported consistent weight increases of 0.4 kg to 0.9 kg over the holiday season . These weight gains are not fully lost in the following months, and these small gains may add up to a substantial increase in weight over several years that is sufficient to drive the obesity epidemic.
In the holiday season, several public holidays coincide in many countries, providing an opportunity for prolonged overconsumption and sedentary behavior. Effective interventions are needed to promote the restraint of eating and drinking during these high risk period. A systematic review of weight gain prevention interventions identified the potentially useful role of low intensity interventions that incorporate diet, physical activity and self-regulating strategies .
The Winter Weight Watch Study was a randomized controlled trial to evaluate the effectiveness of a brief behavioral intervention that encourages restraint of eating and drinking over the Christmas holiday period, to prevent weight gain. The intervention comprised of encouragement to regularly self-weigh, tips for weight management and information on the physical activity calorie equivalent (PACEq) of common festive foods and drinks.
Data collection took place pre-Christmas 2016 and 2017 (November and December), with follow-up in January and February (2017 and 2018), during one baseline and one follow-up visit. The goal of the intervention was to gain no more than 0.5 kg. The comparator group received a brief information leaflet about leading a healthy lifestyle, without dietary advice. 78% Of participants were women, mean BMI was 28.8 (SD: 6.6) kg/m²). Mean length of time in the study was 45.3 days.
- Follow-up weight was lower in the intervention group than in the comparator group. The mean difference in follow-up weight, adjusted for baseline weight and attendance at a commercial weight loss program was -0.49 kg (95%CI: -0.85 to -0.13, P-0.008).
- The mean difference in follow-up weight between groups was similar when further adjusting for baseline BMI and the time participants were in the study (-0.48 kg, 95%CI: -0.84 to -0.12, P=0.01).
- No significant difference was seen in the estimated reduction in percentage body fat between groups (-0.03%, 95%CI: -0.53% to 0.47%, P=0.91).
- No significantly higher odds of gaining no more than 0.5 kg weight was seen in the intervention group vs. the comparator group (1.23, 95%CI: 0.75-2.04, P=0.41).
- Cognitive restraint scores increased significantly for participants in the intervention group, as compared with the comparator group (mean difference in score in further adjusted model: 0.62, 95%CI: 0.06-1.19,P=0.03).
- No significant differences were seen between groups in emotional eating and uncontrolled eating scores.
These data show that a brief behavioral intervention that encourages adults to weigh themselves regularly, offering advice for weight management and information about the PACEq of popular festive food and drinks, can prevent weight gain over the Christmas period. Cognitive restraint was improved in the intervention group.