WHJE - dieet

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Op zondag 15 april 2007 10:28 schreef cpcpb het volgende:
Hoi Sjeen,

Eigenlijk gaat het hier heel slecht!
Altijd moeilijk om te vertellen.. (in iedergeval een stuk moeilijker dan om een succesverhaal te vertellen) Ik heb het meeste er weer bijgegeten. Overeten, moe worden, niet meer bewegen door de vermoeidheid, tel daarbij schaamte, en onplezierig voelen, dat vervolgens weer wegeten...

Vandaag begin ik weer van voren af aan. Ik kom van 110,1 ben gegaan naar 71,8 en inmiddels zit ik op 99,0. Weer een hele weg te gaan, maar goed ik ga er weer voor.. Bewegen + whje, het heeft prima gewerkt, dus dat moet het nu weer gaan doen.

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Op zondag 15 april 2007 17:06 schreef Isabeau het volgende:

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Ik vind het super dat je het durft te melden, de meeste mensen schamen zich zo erg dat ze weg blijven en anderen het gevoel krijgen dat ze ècht iets verkeerd doen als ze wel weer aankomen. Die durven dat dan ook niet te melden etc. Helaas liegen de cijfers niet en komt 98% na een dieet binnen 3 jaar op het oude gewicht of meer terecht. Dus je hoort helaas 'gewoon' bij de meerderheid van de mensen. Nu nog van jezelf bekijken waar het verkeerd gaat en hoe je dat zou kunnen veranderen om wèl bij die 2% te kunnen horen. Heel veel succes en je hebt bewezen te kunnen afvallen, dus dat moet weer lukken. Alleen dat lagere gewicht zien te behouden, dat wordt dan de volgende belangrijke stap.

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Op zondag 15 april 2007 20:27 schreef Sjeen het volgende:
Misschien een hele stomme vraag Isa, maar die 98% is dat gebaseerd op alle afvallers of op alle mensen die een dieet gaan volgen en daarmee afvallen? Ik kan me namelijk niet voorstellen dat je als je door je eet- en leefpatroon blijvend aan te passen , afvalt... je alsnog binnen drie jaar weer terug op je oude gewicht zit...

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Preventing weight gain: a population cohort study of the nature and effectiveness of mid-age women's weight control practices.

Objective:To examine women's weight control practices and their effectiveness in preventing weight gain.Design:Retrospective cohort study of weight control practices and 2-year weight change among mid-age women participating in the Australian Longitudinal Study on Women's Health (ALSWH).

Subjects:11 589 Australian women (aged 47-52 years).

Measurements:The prevalence and types of self-reported weight control practices used were assessed by a nine-item instrument. Two-year weight change was self-reported and adjusted for baseline body mass index (BMI) and other potential confounders.

Results:Seventy-four per cent of the cohort (N=8556) reported actively trying to control their weight. Dietary modification was used more frequently than exercise. Two-thirds of the weight-controlling women used a combination of practices, the two most common being 'decreased food quantity, cut down on fats/sugars and exercise' (32%, baseline BMI 25.87(0.10)), and 'decreased food quantity and cut down on fats/sugars without exercise' (15.6%, baseline BMI 27.04(0.14)). Potentially health-damaging practices (smoking, laxatives, fasting) were relatively uncommon, at 7.9%. Only one combination of practices (decreased food quantity, cut down on fats/sugars, use of a commercial weight loss programme and exercise) prevented mean weight gain (-0.03 kg), whereas the mean (s.d.) weight of the cohort increased (+1.19(4.78)) over the 2-year period.

Conclusions:The majority of mid-age women attempting weight control used practices consistent with public health messages. Despite their efforts, the group was mostly unsuccessful in preventing weight gain. Public health authorities and health practitioners may need to make more quantitative recommendations and emphasize the importance of balancing physical activity with dietary intake to achieve successful weight control for women at this life stage

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Int J Obes Relat Metab Disord. 2002 Dec;26(12):1570-8. (hier kan ik niet bij, dus kan het hele artikel niet lezen)

Who does not gain weight? Prevalence and predictors of weight maintenance in young women.

OBJECTIVE: To investigate the prevalence and predictors of weight maintenance over time in a large sample of young Australian women.

DESIGN: This population study examined baseline and 4 y follow-up data from the cohort of young women participating in the Australian Longitudinal Study on Women's Health.

SUBJECTS: A total of 8726 young women aged 18-23 y at baseline.

MEASURES: Height, weight and body mass index (BMI); physical activity; time spent sitting; selected eating behaviours (eg dieting, disordered eating, takeaway food consumption); cigarette smoking, alcohol consumption; parity; and sociodemographic characteristics.

RESULTS: Only 44% of the women reported their BMI at follow-up to be within 5% of their baseline BMI (maintainers); 41% had gained weight and 15% had lost weight. Weight maintainers were more likely to be in managerial or professional occupations; to have never married; to be currently studying; and not to be mothers. Controlling for sociodemographic factors, weight maintainers were more likely to be in a healthy weight range at baseline, and to report that they spent less time sitting, and consumed less takeaway food, than women who gained weight.

CONCLUSIONS: Fewer than half the young women in this community sample maintained their weight over this 4 y period in their early twenties. Findings of widespread weight gain, particularly among those already overweight, suggest that early adulthood, which is a time of significant life changes for many women, may be an important time for implementing strategies to promote maintenance of healthy weight. Strategies which encourage decreased sitting time and less takeaway food consumption may be effective for encouraging weight maintenance at this life stage.

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Op zondag 15 april 2007 22:23 schreef Isabeau het volgende:

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Ik heb het betreffende artikel proberen op te sporen, maar ik kan het nu even niet vinden. Het staat ook in één van mijn handboeken, echter zonder bronvermelding

Soms kan je zo'n statistisch gegeven nog wel halen uit de literatuurlijst van een vergelijkbaar artikel, maar dit artikel staat niet in het tijdschrift Int J Obes (Lond). 2007 Jan 30, waar ik wel in kan lezen Dus wel een samenvatting, maar geen literatuurlijst. Hierbij geen getallen van succesvol zijn, wel hoe onsuccesvol 'we' zijn in het behouden van gewichtsverlies.
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Ook wel een interessant onderzoek wat ik zo snel tegenkwam:
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Dus de grootste kans om over 4 jaar niet te zijn aangekomen (gaat niet specifiek om afvallen) heb je als vrouw tussen de 18 en 23 als je:
- een management of professionele functie hebt *check
- nooit getrouwd geweest bent *check... tenzij ongetrouwd samenwonen gelijk staat
- als je nu studeert *uhhhh
- als je geen moeder bent *uhhhh
- als je nu al een gezond gewicht hebt *gezonder dan twee jaar geleden
- als je weinig stilzit *uhhhh
- als je weinig kant & klaar voedsel eet (vrije vertaling van 'takeaway food') *check

Ik zal uitkijken naar dat artikel waarin stond dat 98% niet succesvol is.

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Currently, few data are available on the prevalence of successful weight loss maintenance. One limit is the lack of a consistent criterion to define "success" and another is the difficulty of distinguishing intentional from unintentional weight loss. We therefore propose to define success in weight loss maintenance as achieving an intentional weight loss of at least 10% of initial body weight and maintaining this weight loss for at least one year. We could not find sufficient data, collected in a systematic fashion, to provide reliable information on predictors of weight loss for longer periods.

Overall there is a feeling of pessimism regarding long-term weight loss success (18). This pessimism started with a study by Stunkard & McLaren-Hume (42), who followed 100 obese individuals referred to a nutritional weight loss program and found that 2 years after treatment, only 2% maintained a weight loss of at least 20 lb. This finding was instrumental in creating the perception, perpetuated in the popular media, that hardly anyone succeeds in long-term maintenance of weight loss.

Recent studies of clinical programs are more positive. Every year for 4 years, Kramer et al (24) followed up on 114 men and 38 women who had participated in a behavioral weight loss program. Using a strict criterion of maintaining 100% of one's weight loss, they found that only 0.9% of men and 5.3% of women were consistently successful (i.e. maintaining this criterion all of the 4 years). However, looking only at year 4, cross-sectional data showed that 2.6% of men and 28.9% of women had maintained 100% of their weight loss. Several studies have used 5 kg or greater weight loss as a criterion of success. With this criterion, 13% (51) to 22% (41) of participants are successful 5 years after treatment.

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Much of the information about successful weight loss maintenance comes from the National Weight Control Registry (NWCR), founded in 1994 to study weight loss and weight maintenance strategies of successful weight loss maintainers. To be eligible for the NWCR, individuals must have maintained at least a 30-lb weight loss for at least 1 year. On recruitment, all subjects sign an informed consent form and then are sent several questionnaires to complete. These questionnaires seek information about weight loss and weight maintenance behaviors, as well as weight history, quality of life, and demographic information. All participants are asked to complete additional follow-up questionnaires on an annual basis.

There are currently over 3000 subjects in the NWCR. They average 45 years of age and are 80% women, 97% Caucasian, and 67% married. The average weight loss reported by NWCR participants is 30 kg, and the average duration of weight maintenance is 5.5 years. These subjects maintain a body weight that is, on average, 10 BMI units lower than their pre–weight loss BMI (from 35–25 kg/m2).

About half (46%) of NWCR subjects report having been overweight as children. Many report a strong family history of obesity, with 46% reporting one parent as overweight or obese and 27% reporting both parents as overweight or obese.

Almost all NWCR subjects (90%) have experienced previous unsuccessful attempts at weight loss. No obvious factor or factors distinguish this successful weight loss from previous failures other than registry participants noting a greater commitment, stricter dieting, and a greater role of exercise.

Clearly, a negative energy balance is needed to produce weight loss. A negative energy balance can be achieved by either decreasing intake or increasing expenditure. Research studies consistently show that successful weight loss maintainers change both their intake and their expenditure in order to lose weight and maintain their losses. In the NWCR, 89% of participants reported modifying both diet and exercise to achieve their successful weight loss (22). In subjects who reported modifying food intake to lose weight, the most commonly reported methods were restricting intake of certain types or classes of foods (88%), limiting quantity (44%), and counting calories (44%). However, there was marked variability in how they made these changes. About half of the registry participants (45%), but 63% of the men, reported losing on their own whereas the remainder of the registrants (55%), and 60% of the women, used a formal (e.g. commercial) weight loss program (22).

Although most health professionals recommend changes in both diet and physical activity for weight loss, many popular weight loss plans emphasize diet more than physical activity. It is worth noting that very few of these successful weight loss maintainers used diet alone to lose weight.