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Categorical strategies based on subject characteristics of dietary restraint and physical activity, for weight maintenance

International Journal of Obesity volume 29, pages 849–857 (2005)Cite this article

Abstract

OBJECTIVE:

The aim of this study was to investigate the effect of categorical strategies based on subject-specific characteristics of dietary restraint and physical activity, on weight maintenance (WM) in overweight and obese subjects, after a very low calorie diet (VLCD). Furthermore, find predictors of WM that can be important in the context of obesity treatment.

METHODS:

In all, 120 subjects (age: 49.0±9.8 y, BMI 31.0±3.8 kg/m2) followed a VLCD (2.1 MJ/day) for 6 weeks in a free-living situation, followed by a period of 1 y WM. Body weight (BW), body composition, leptin concentration, dietary restraint and physical activity were determined right before (t0) and after (t1) the VLCD, after 3 months (t2) and after 1 y (t3). During WM, subjects were divided into four categories of WM guidelines (dietary, activity, diet+activity, placebo), taking their capability measured during weight loss and their preference for particular guidelines into account.

RESULTS:

BW loss during VLCD was 7.0±3.1 kg. After 1 y follow-up, BW regain was 56.3±55.0%, without significant differences between the four groups. With respect to measured capability during weight loss, subjects with an increased dietary restraint (F1 of the Three Factor Eating Questionnaire) had less BW regain than subjects with an increased physical activity (Baecke questionnaire) (35.5±53.2 vs 68.5±46.4%, P<0.05). Moreover, activity guidelines promoted WM in dietary disciplined subjects compared to activity-related disciplined subjects (%regain: 25.2 vs 74.3%, P<0.05). Subjects receiving guidelines that were opposite to their preference showed a better WM than subjects receiving preferred guidelines. After 1 y WM, 21 subjects were successful (<10% BW regain) and 99 unsuccessful (≥10% BW regain). At baseline, these groups were significantly different in BMI (resp. 32.7±4.9 vs 30.7±3.5 kg/m2, P<0.05), waist circumference (106.5±14.0 vs 100.6±11.2 cm, P<0.05) and fat mass (FM) (35.2±10.6 vs 32.1±6.6%, P=0.06). Finally, successful subjects appeared to spare fat-free mass (FFM) to a greater extent than unsuccessful subjects.

CONCLUSION:

After weight loss, type of guidelines (dietary, activity, placebo) is not related to the magnitude of WM, whereas guidelines opposite to the subject's capability and preference are related. These only reach successful WM (>90%) in originally dietary disciplined subjects who are supported by characteristics such as a relatively high baseline BMI, waist circumference and FM, together with the ability to spare FFM.

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References

  1. Pasman WJ, Saris WH, Muls E, Vansant G, Westerterp-Plantenga MS . Effect of exercise training on long-term weight maintenance in weight-reduced men. Metabolism 1999; 48: 15–21.

    Article  CAS  PubMed  Google Scholar 

  2. Westerterp-Plantenga MS, Kempen KP, Saris WH . Determinants of weight maintenance in women after diet-induced weight reduction. Int J Obes Relat Metab Disord 1998; 22: 1–6.

    Article  CAS  PubMed  Google Scholar 

  3. WHO. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. World Health Organ Technical Report Series, Vol. 894. WHO: Geneva; 2000. pp i–xii, 1–253.

  4. Burton BT, Foster WR . Health implications of obesity: an NIH Consensus Development Conference. J Am Diet Assoc 1985; 85: 1117–1121.

    CAS  PubMed  Google Scholar 

  5. Ditschuneit HH, Flechtner-Mors M . Value of structured meals for weight management: risk factors and long-term weight maintenance. Obes Res 2001; 9 (Suppl 4): 284S–289S.

    Article  PubMed  Google Scholar 

  6. Pi-Sunyer FX, Becker DM, Bouchard C, Carleton RA, Colditz G, William HD, Foreyt JP, Garrison RJ, Grundy SM, Hansen BC, Higgins M, Hill JO, Howard BV, Kuczmarski RJ, Kumanyika S, Dee Legako R, Elain Prewitt T, Rocchini AP, Smith PL, Snetselaar LG, Sowers JR, Weintraub M, Williamson DF, Terence Wilson G . NHLBI obesity education initiative expert panel on the identification, evaluation, and treatment of overweight and obesity in adults. Obes Res 1998; 6: 51S–209S.

    Article  Google Scholar 

  7. Pasman WJ, Rossner S, Westerterp-Plantenga MS, Saris WH (eds). Body Weight Changes after Treatment of Obesity or Pregnancy. Edra: Milan, Italy; 1999.

    Google Scholar 

  8. Pasman WJ, Saris WH, Westerterp-Plantenga MS . Predictors of weight maintenance. Obes Res 1999; 7: 43–50.

    Article  CAS  PubMed  Google Scholar 

  9. Leermakers EA, Perri MG, Shigaki CL, Fuller PR . Effects of exercise-focused versus weight-focused maintenance programs on the management of obesity. Addict Behav 1999; 24: 219–227.

    Article  CAS  PubMed  Google Scholar 

  10. Anderson JW, Vichitbandra S, Qian W, Kryscio RJ . Long-term weight maintenance after an intensive weight-loss program. J Am Coll Nutr 1999; 18: 620–627.

    Article  CAS  PubMed  Google Scholar 

  11. Ewbank PP, Darga LL, Lucas CP . Physical activity as a predictor of weight maintenance in previously obese subjects. Obes Res 1995; 3: 257–263.

    Article  CAS  PubMed  Google Scholar 

  12. McGuire MT, Wing RR, Klem ML, Hill JO . Behavioral strategies of individuals who have maintained long-term weight losses. Obes Res 1999; 7: 334–341.

    Article  CAS  PubMed  Google Scholar 

  13. Perri MG, Sears Jr SF, Clark JE . Strategies for improving maintenance of weight loss. Toward a continuous care model of obesity management. Diabetes Care 1993; 16: 200–209.

    Article  CAS  PubMed  Google Scholar 

  14. McGuire MT, Wing RR, Klem ML, Lang W, Hill JO . What predicts weight regain in a group of successful weight losers? J Consult Clin Psychol 1999; 67: 177–185.

    Article  CAS  PubMed  Google Scholar 

  15. Leslie WS, Lean ME, Baillie HM, Hankey CR . Weight management: a comparison of existing dietary approaches in a work-site setting. Int J Obes Relat Metab Disord 2002; 26: 1469–1475.

    Article  CAS  PubMed  Google Scholar 

  16. Lejeune MP, Van Aggel-Leijssen DP, Van Baak MA, Westerterp-Plantenga MS . Effects of dietary restraint vs exercise during weight maintenance in obese men. Eur J Clin Nutr 2003; 57: 1338–1344.

    Article  CAS  PubMed  Google Scholar 

  17. Bellisle F, Dalix A . Cognitive restraint can be offset by distraction, leading to increased meal intake in women. Am J Clin Nutr 2001; 74: 197–200.

    Article  CAS  PubMed  Google Scholar 

  18. Karlsson J, Persson LO, Sjostrom L, Sullivan M . Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study. Int J Obes Relat Metab Disord 2000; 24: 1715–1725.

    Article  CAS  PubMed  Google Scholar 

  19. Lindroos AK, Lissner L, Mathiassen ME, Karlsson J, Sullivan M, Bengtsson C, Sjostrom L . Dietary intake in relation to restrained eating, disinhibition, and hunger in obese and nonobese Swedish women. Obes Res 1997; 5: 175–182.

    Article  CAS  PubMed  Google Scholar 

  20. Lawson OJ, Williamson DA, Champagne CM, DeLany JP, Brooks ER, Howat PM, Wozniak PJ, Bray GA, Ryan DH . The association of body weight, dietary intake, and energy expenditure with dietary restraint and disinhibition. Obes Res 1995; 3: 153–161.

    Article  CAS  PubMed  Google Scholar 

  21. Lowe MR, Kleifield EI . Cognitive restraint, weight suppression, and the regulation of eating. Appetite 1988; 10: 159–168.

    Article  CAS  PubMed  Google Scholar 

  22. Stunkard AJ, Messick S . The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 1985; 29: 71–83.

    Article  CAS  PubMed  Google Scholar 

  23. Westerterp KR, Nicolson NA, Boots JM, Mordant A, Westerterp MS . Obesity, restrained eating and the cumulative intake curve. Appetite 1988; 11: 119–128.

    Article  CAS  PubMed  Google Scholar 

  24. Baecke JA, Burema J, Frijters JE . A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr 1982; 36: 936–942.

    Article  CAS  PubMed  Google Scholar 

  25. Jacobs Jr DR, Ainsworth BE, Hartman TJ, Leon AS . A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc 1993; 25: 81–91.

    Article  PubMed  Google Scholar 

  26. Philippaerts RM, Westerterp KR, Lefevre J . Doubly labelled water validation of three physical activity questionnaires. Int J Sports Med 1999; 20: 284–289.

    Article  CAS  PubMed  Google Scholar 

  27. Westerterp-Plantenga MS, Pasman WJ, Yedema MJ, Wijckmans-Duijsens NE . Energy intake adaptation of food intake to extreme energy densities of food by obese and non-obese women. Eur J Clin Nutr 1996; 50: 401–407.

    CAS  PubMed  Google Scholar 

  28. Westerterp-Plantenga MS, Rolland V, Wilson SA, Westerterp KR . Satiety related to 24 h diet-induced thermogenesis during high protein/carbohydrate vs high fat diets measured in a respiration chamber. Eur J Clin Nutr 1999; 53: 495–502.

    Article  CAS  PubMed  Google Scholar 

  29. Westerterp-Plantenga MS, Goris AH, Meijer EP, Westerterp KR . Habitual meal frequency in relation to resting and activity-induced energy expenditure in human subjects: the role of fat-free mass. Br J Nutr 2003; 90: 643–649.

    Article  CAS  PubMed  Google Scholar 

  30. Westerterp-Plantenga MS, Kovacs EM, Melanson KJ . Habitual meal frequency and energy intake regulation in partially temporally isolated men. Int J Obes Relat Metab Disord 2002; 26: 102–110.

    Article  CAS  PubMed  Google Scholar 

  31. Foster GD, Wadden TA, Kendrick ZV, Letizia KA, Lander DP, Conill AM . The energy cost of walking before and after significant weight loss. Med Sci Sports Exerc 1995; 27: 888–894.

    CAS  PubMed  Google Scholar 

  32. Morris JN, Hardman AE . Walking to health. Sports Med 1997; 23: 306–332.

    Article  CAS  PubMed  Google Scholar 

  33. Blair SN, Kohl HW, Gordon NF, Paffenbarger Jr RS . How much physical activity is good for health? Annu Rev Public Health 1992; 13: 99–126.

    Article  CAS  PubMed  Google Scholar 

  34. Votruba SB, Horvitz MA, Schoeller DA . The role of exercise in the treatment of obesity. Nutrition 2000; 16: 179–188.

    Article  CAS  PubMed  Google Scholar 

  35. Westerterp KR . Pattern and intensity of physical activity. Nature 2001; 410: 539.

    Article  CAS  PubMed  Google Scholar 

  36. Westerterp KR . Obesity and physical activity. Int J Obes Relat Metab Disord 1999; 23 (Suppl 1): 59–64.

    Article  PubMed  Google Scholar 

  37. Westerterp-Plantenga MS, Verwegen CR, Ijedema MJ, Wijckmans NE, Saris WH . Acute effects of exercise or sauna on appetite in obese and nonobese men. Physiol Behav 1997; 62: 1345–1354.

    Article  CAS  PubMed  Google Scholar 

  38. Van Aggel-Leijssen DP, Saris WH, Hul GB, Van Baak MA . Long-term effects of low-intensity exercise training on fat metabolism in weight-reduced obese men. Metabolism 2002; 51: 1003–1010.

    Article  CAS  PubMed  Google Scholar 

  39. Fogelholm M, Kukkonen-Harjula K, Oja P . Eating control and physical activity as determinants of short-term weight maintenance after a very-low-calorie diet among obese women. Int J Obes Relat Metab Disord 1999; 23: 203–210.

    Article  CAS  PubMed  Google Scholar 

  40. van Marken Lichtenbelt WD, Westerterp KR, Wouters L . Deuterium dilution as a method for determining total body water: effect of test protocol and sampling time. Br J Nutr 1994; 72: 491–497.

    Article  CAS  PubMed  Google Scholar 

  41. Schoeller DA, van Santen E, Peterson DW, Dietz W, Jaspan J, Klein PD . Total body water measurement in humans with 18O and 2H labeled water. Am J Clin Nutr 1980; 33: 2686–2693.

    Article  CAS  PubMed  Google Scholar 

  42. Westerterp KR, Wouters L, van Marken Lichtenbelt WD . The Maastricht protocol for the measurement of body composition and energy expenditure with labeled water. Obes Res 1995; 3 (Suppl 1): 49–57.

    Article  PubMed  Google Scholar 

  43. Herman CP, Polivy J (eds). Restrained Eating. WB Saunders: Philadelphia; 1980.

    Google Scholar 

  44. Weinsier RL, Hunter GR, Desmond RA, Byrne NM, Zuckerman PA, Darnell BE . Free-living activity energy expenditure in women successful and unsuccessful at maintaining a normal body weight. Am J Clin Nutr 2002; 75: 499–504.

    Article  CAS  PubMed  Google Scholar 

  45. Harvey-Berino J, Pintauro S, Buzzell P, Gold EC . Effect of Internet support on the long-term maintenance of weight loss. Obes Res 2004; 12: 320–329.

    Article  PubMed  Google Scholar 

  46. Harvey-Berino J, Pintauro SJ, Gold EC . The feasibility of using Internet support for the maintenance of weight loss. Behav Modif 2002; 26: 103–116.

    Article  PubMed  Google Scholar 

  47. McGuire MT, Jeffery RW, French SA, Hannan PJ . The relationship between restraint and weight and weight-related behaviors among individuals in a community weight gain prevention trial. Int J Obes Relat Metab Disord 2001; 25: 574–580.

    Article  CAS  PubMed  Google Scholar 

  48. van Aggel-Leijssen DP, Saris WH, Wagenmakers AJ, Senden JM, van Baak MA . Effect of exercise training at different intensities on fat metabolism of obese men. J Appl Physiol 2002; 92: 1300–1309.

    Article  CAS  PubMed  Google Scholar 

  49. Renjilian DA, Perri MG, Nezu AM, McKelvey WF, Shermer RL, Anton SD . Individual versus group therapy for obesity: effects of matching participants to their treatment preferences. J Consult Clin Psychol 2001; 69: 717–721.

    Article  CAS  PubMed  Google Scholar 

  50. Anderson JW, Konz EC, Frederich RC, Wood CL . Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 2001; 74: 579–584.

    Article  CAS  PubMed  Google Scholar 

  51. Dulloo AG, Jacquet J . The control of partitioning between protein and fat during human starvation: its internal determinants and biological significance. Br J Nutr 1999; 82: 339–356.

    Article  CAS  PubMed  Google Scholar 

  52. Sartorio A, Agosti F, Resnik M, Lafortuna CL . Effects of a 3-week integrated body weight reduction program on leptin levels and body composition in severe obese subjects. J Endocrinol Invest 2003; 26: 250–256.

    Article  CAS  PubMed  Google Scholar 

  53. Nagy TR, Davies SL, Hunter GR, Darnell B, Weinsier RL . Serum leptin concentrations and weight gain in postobese, postmenopausal women. Obes Res 1998; 6: 257–261.

    Article  CAS  PubMed  Google Scholar 

  54. Neuhauser-Berthold M, Herbert BM, Luhrmann PM, Sultemeier AA, Blum WF, Frey J, Hebebrand J . Resting metabolic rate, body composition, and serum leptin concentrations in a free-living elderly population. Eur J Endocrinol 2000; 142: 486–492.

    Article  CAS  PubMed  Google Scholar 

  55. Sudi KM, Gallistl S, Borkenstein MH, Payerl D, Aigner R, Moller R, Tafeit E . Effects of weight loss on leptin, sex hormones, and measures of adiposity in obese children. Endocrine 2001; 14: 429–435.

    Article  CAS  PubMed  Google Scholar 

  56. Dykes J, Brunner EJ, Martikainen PT, Wardle J . Socioeconomic gradient in body size and obesity among women: the role of dietary restraint, disinhibition and hunger in the Whitehall II study. Int J Obes Relat Metab Disord 2004; 28: 262–268.

    Article  CAS  PubMed  Google Scholar 

  57. Hays NP, Bathalon GP, McCrory MA, Roubenoff R, Lipman R, Roberts SB . Eating behavior correlates of adult weight gain and obesity in healthy women aged 55–65 y. Am J Clin Nutr 2002; 75: 476–483.

    Article  CAS  PubMed  Google Scholar 

  58. Williamson DA, Lawson OJ, Brooks ER, Wozniak PJ, Ryan DH, Bray GA, Duchmann EG . Association of body mass with dietary restraint and disinhibition. Appetite 1995; 25: 31–41.

    Article  CAS  PubMed  Google Scholar 

  59. Steinle NI, Hsueh WC, Snitker S, Pollin TI, Sakul H, St Jean PL, Bell CJ, Mitchell BD, Shuldiner AR . Eating behavior in the Old Order Amish: heritability analysis and a genome-wide linkage analysis. Am J Clin Nutr 2002; 75: 1098–1106.

    Article  CAS  PubMed  Google Scholar 

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  1. Department of Human Biology, Maastricht University, Maastricht, The Netherlands

    N Vogels & M S Westerterp-Plantenga

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Vogels, N., Westerterp-Plantenga, M. Categorical strategies based on subject characteristics of dietary restraint and physical activity, for weight maintenance. Int J Obes 29, 849–857 (2005). https://doi.org/10.1038/sj.ijo.0802984

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