Lifestyle Change Wins Over Weight Loss Programs

Samantha L. Thomas, MD, from Monash University, Notting Hill, Australia, and colleagues write, "Consumer involvement, perceptions and engagement are well recognized as cornerstones for developing effective interventions within communities and in improving the translated outcomes of intervention programs.... Yet, there has been very limited research seeking to understand the perspectives, attitudes and opinions of obese adults about current approaches to obesity."

The aim of this study was to explore the opinions and attitudes of obese individuals toward population and individual interventions for obesity.

The researchers conducted telephone interviews with a community sample of 142 obese adults aged 19 to 75 years who had a body mass index of at least 30 kg/m². The interviews lasted from 60 to 90 minutes. The participants were asked about their attitudes to 6 interventions:

• media-based social marketing campaigns;
• public health interventions and initiatives;
• regulation (e.g., banning junk food advertising aimed at children);
• obesity surgery;
• commercial diets (specifically Weight Watchers and Jenny Craig); and
• specialized fitness programs (e.g., women-only gyms such as Curves and public funding for personal trainers).

The researchers found that about two-thirds of participants thought that regulation was one of the most effective solutions for the obesity epidemic in Australia. Public health interventions and initiatives were favored by 60 participants (42%). One third of the participants thought that media campaigns were effective, especially ones based on positive messages and incentives, rather than scare tactics.

The researchers also report that most participants were somewhat skeptical about the long-term success of obesity surgery, voicing concerns about the commercial marketing of the surgery and also about the associated short- and long-term risks.

Only 26 participants (18%) thought that commercial dieting programs were effective interventions for weight loss, and only a small number thought that diets were effective for weight loss. Weight Watchers was deemed to be better than other commercial programs, with participants calling the program's approach "genuine," "sensible," and "[health-]promoting," according to the study authors.

The authors also found that participants distrusted the commercial marketing techniques of the diet industry and wanted the industry regulated. Some participants also described commercial diets as unsafe -- particularly those that provide pre-prepared meals. They used terms such as "greedy," "a scam," and "a rip-off" to describe the dieting industry. Despite these attitudes, many participants said they would still turn to commercial dieting to lose weight because they had very little other support available to them, the authors stated.

The reserchers noted limitations of their study, including the high education level of the participants and the preponderance of women participants over men.

Dr. Thomas and her colleagues conclude that their study provides a unique assessment of the perspectives, attitudes, and opinions of obese adults toward 6 different interventions currently used in Australia to address obesity. The results highlight the need for interventions that support and empower individuals to improve their lifestyle.

"At the individual level, personalized care planning and long term support systems must be developed to assist obese individuals," they write. "At the population level, anti-stigma campaigns and regulation should both be explored."

BMC Public Health. Published online July 15, 2010.