National study shows new ways to stop weight gain cut young adults' obesity risk by half

By age group, young adults are gaining weight the fastest -- an average of one to two pounds a year -- and increasing their risk of becoming obese and developing weight-related health problems such as cancer. To prevent this weight gain, the study taught participants to weigh themselves every day and to use that information to maintain a current weight or implement behavior changes. Some participants were taught to make daily small changes in diet and exercise to prevent weight gain; others were encouraged to lose five to 10 pounds initially to act as a buffer against future weight gain.

The research findings were published online in advance of print in JAMA Internal Medicine. Lead author Rena Wing, Ph.D., director of the Weight Control & Diabetes Research Center at The Miriam Hospital, sought to examine novel interventions for weight gain prevention. The University of North Carolina at Chapel Hill served as a clinical site for the study, which was funded by the National Heart Lung and Blood Institute. Wake Forest Baptist Medical Center was the coordinating center for the trial.

While positive effects of weight gain prevention strategies are often observed initially, few studies have followed participants for as long as two to three years. A total of 599 participants, ages 18 to 35 years old, took part in this study from August, 2010 to February, 2012 in Rhode Island and North Carolina. Half had normal weights and half were overweight. Each was assigned randomly to one of three groups:

• Self-regulation with small changes in which participants made small, daily changes to their eating and exercise routine to prevent weight gain;
• Self-regulation with large changes focusing on an initial five to 10-pound weight loss to buffer any weight gain; or
• A control group that was given minimal treatment

The two self-regulation interventions were delivered through 10 in-person group sessions during the first four months, and then primarily online. All participants were weighed at the start of the trial, after four months and then annually. The study found that both the large and small changes approaches not only reduced weight gain over a three-year follow-up, but both, especially the large change strategy, led to some weight loss.

"We found both interventions to be effective in significantly reducing average weight gain over the three years of follow-up, but the large changes approach was most effective," said Wing, also a professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University.

Averaged over three years of follow-up, participants in the control group (who were not given help in adopting the self-regulation approaches) gained approximately a half a pound (0.26 kg). Those using the small changes approach lost 1.2 pounds (0.56 kg), and those in large changes lost 5.2 pounds (2.37 kg). Whereas almost 17 percent of participants in the control group became obese, this was reduced by approximately 50 percent by both the large and small change approaches [where only 8.6 percent and 7.9 percent of participants, respectively, became obese (BMI ? 30).]

"Until now, we didn't have clear guidance on what the message and recommendations should be for preventing weight gain," said Deborah Tate, Ph.D., professor of health behavior and nutrition at the Gillings School of Global Public Health at the University of North Carolina. "This study showed that frequent weighing and either initial weight loss or daily small changes to diet and activity are useful weight gain prevention approaches."

"Weight gain in young adults is likely related to the many changes occurring -- school-to-work transitions and events such as pregnancy," said Wing. "This weight gain is a serious health risk, and approaches to prevent or reduce it are urgently needed. These new self-regulation approaches, which can easily and cost effectively be shared to help prevent weight gain in young adults, could have a significant impact on our public health."