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April 21, 2004

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Palo Alto Online

Publication Date: Wednesday, April 21, 2004

Our Town: Fighting fat Our Town: Fighting fat (April 21, 2004)

by Carol Blitzer

Americans are getting fatter every year and I was determined to stop being among them.

So a few years back I volunteered for the Stanford Healthy Weight Project, an 18-month study that divided people into three groups. Two were slotted into behavioral weight-loss programs and the third was a control group.

I was randomly selected into the control group. Although I wouldn't get the benefit of the classes, I did get to fill out questionnaires on eating habits and mood. The only promise the researchers made was that at the end they'd share what they learned.

At the end of the study, the principal investigator brought the participants together for a review of preliminary results. Since the study hasn't been published yet in a medical journal, she could not reveal specifics.

But she did talk about how their original expectations differed from their results. They expected that people in the first two groups would slowly drop 10 to 15 pounds in the first six months then maybe gain back a little. In fact, participants were all over the map in their loss, or gain. Most lost 8 to 10 pounds -- even the control group lost about that much.

But once the classes ended weight started to creep up. Many had a net loss at 18 months, but quite a few did not.

Some of what we learned reinforced very old news: It's a lot easier to lose weight than to keep it off. Future studies will try to isolate what factors contribute to people regaining that weight.

But the study leader was quick to emphasize that even a small weight loss, say five pounds, is enough to make a difference to one's overall health -- resulting in lower cholesterol and lower blood pressure.

That was enough to send me to Weight Watchers, and nearly two years later I'm a walking success story. But Weight Watchers doesn't work for everyone -- in fact no one food plan fits all.

The Stanford Prevention Research Center now is in the midst of a new study, comparing four diets. Volunteers will be randomly assigned to one of four plans: the unrestricted fat and protein, low-carbohydrate Atkins Diet; the Zone, with a balance of carbohydrates, fat and protein; the vegetarian Ornish diet, with high carbs and very low fat; and a more traditional plan based on the "food pyramid" most of us learned about in school, since revised.

What sets this study apart from many others is the number of women involved -- 300 -- and a required commitment to stick with the program all year even if they don't stick with their diet. Although they're asked to do their best, they don't actually have to adhere to the diet after the first eight weeks; they just have to remain in the study for the year.

"We think an important part is how hard is it to stay on a diet," said Christopher Gardner, principal investigator. He wants to know why people fall off the food wagon: Is it the cost? Taste? Difficulty when eating out?

Health professionals hear so many anecdotes about fad diets that "really work" -- for some. "People start it and it works, but we can't follow them long-term. They quit, the weight comes back," Gardner said. Many say the diet worked but they were weak. Their self-esteem is ruined, but "maybe the diet is limited" and to blame, he said.

This study is recruiting pre-menopausal women who are between 20 and 100 pounds overweight. It involves attending one-hour classes at Stanford once a week for eight weeks, and coming in to be weighed and measured four times during the year.

The study has been underway since last August, and the last group will begin next August -- applications will start being accepted in June. Anyone interested in participating may apply online at nutrition.stanford.edu -- look for "A TO Z: A Comparative Weight Loss Study," or call (650) 725-5018.

Gardner emphasized that it's extremely important to stay in the study, even if the diet isn't working: "We've had women who gained 20 pounds who came back to tell their stories. That's really important."

Assistant Editor Carol Blitzer can be e-mailed at [email protected]


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