studies on which weight-loss advice works best across all who read it?

bennett@peacefire.org · medicine forum beginner Joined: 25 May 2006 Posts: 3

Note carefully the question. I am *not* asking the same question that
everybody else asks :)

Are there studies on what forms of weight-loss advice work best,
averaged across all the people who read it -- taking into account the
fact that some people who read it won't want to follow it if it's too
time-consuming?

I am not asking what weight-loss advice works best averaged across all
people who *follow* it. It's easy to get a high score on that metric
by giving "advice" like "Work out for an hour every day and don't eat
anything that tastes better than prison food."

What I mean is: Suppose you are given a random sample of 1,000 people
looking to lose weight. You can tell them anything you want, but you
can't make them do anything. Your score is determined by the total
amount of (healthy) weight loss achieved by the participants at the
end. Are there studies on what advice scores best under those
conditions?

(The advice can depend on the person, e.g. "If you are a man weighing
200 to 220 pounds, do this; if you are a woman weighing 150 to 200
pounds, do this." But the "success score" is still determined by
getting the average result from the random sample of 1,000 people.)

It seems like this would be THE question to focus on, for any person or
organization interested in doing something about the obesity epidemic.
Because whatever weight loss advice you come up with, the results will
be determined not by how it works for people who follow it, but by how
it works for everybody.

outsor@citynet.net · medicine forum Guru Joined: 11 Sep 2005 Posts: 569

The answer is the same, consume fewer calories. About 500 less per day is
a pound per week on average. Make yourself aware of how much is consumed
and do the math. Choose whatever mind games that work to do the above.

bennett@peacefire.org · medicine forum beginner Joined: 25 May 2006 Posts: 3

I'm sure that advice works great for people who follow it, but that's
answering the other question. What I'm asking is: What advice works
best averaged across all people who *hear* it?

Put another way: suppose you're participating in a game against twenty
other contestants. Each of you is assigned to help 1,000 randomly
chosen people who are interested in weight loss. As a contestant, you
write up your advice, and it's distributed to the 1,000 people you're
assigned to -- but that's all you get to do, you have no authority to
*make* them do anything. At the end of X months, the organizers hold a
weigh-in, and the contestant whose advice resulted in the greatest
average weight loss for their 1,000 people, gets a million dollars.

Would you really write: "Consume fewer calories. About 500 less per
day"?

outsor@citynet.net wrote:

outsor@citynet.net · medicine forum Guru Joined: 11 Sep 2005 Posts: 569

You seem to be referring to the "mind games" to which I referred in my
response. The one that comes to mind is to scare the hell out of them by
a frank listing of the facts, being over weight can lead to or contribute
to all manner of life disrupting disorders, not the least of which is
premature death, loss of limbs, heart disease, blindness, impotence in
men, kidney failure, strokes and others. But unless or until these become
realities most people will blow them off until it is too late, just as in
smoking and abuse of booze. The mind has the full ability to make excuses
and rationalizations and to cling to the exceptions,ie. "my grandpa lived
until 100 and smoked, until the reality of the danger of weight "smacks
them up 'side the head with a 2 x 4".

But your question is mostly irrelevant, only eating less and/or using more
calories works as the bottom line in everyone for weight loss unless some
disease is involved to cause it. When it works one might imagine a full
range of motivations that caused them to turn the corner to embrace this
basic biology of weight status.

bennett@peacefire.org · medicine forum beginner Joined: 25 May 2006 Posts: 3

Intuitively it seems like the "fear factor" approach *should* work.
However there have been studies showing that this doesn't have the
expected result. Malcolm Gladwell in "The Tipping Point" talks about
an experiment at Yale in the 60's where the experimenter distributed
booklets to students giving information about why they should get a
tetanus shot:
http://jludvik.net/weblog/2005_01.html
One version of the booklet depicted the disfigurements and other
possible consequences of not getting a tetanus shot, and it was
expected that more students who read this pamphlet would visit the
clinic -- but they didn't. The rate of students who got the shot was
only 3 percent in either case. But when the pamphlet included a map to
the clinic and a list of times when shots were available (even though
this information was easily available to all students who wanted the
shot), the rate of students getting the shot went up to 28 percent.
This suggests that if you want results, then scaring people is not as
important as making it easy for them to follow your advice.

But you could certainly try the "fear factor" approach; maybe it's
different for people when they're warned about a problem that they
already have, not a long-shot risk like tetanus. The final verdict
about what really works, comes from the numbers after you give people
the advice and see what happens. All I'm saying is that to anyone
concerned about the obesity epidemic, that's the game you should be
playing: finding what advice works best averaged across all people who
hear it.

It seems the problem is that even among people who are qualified to
figure out what would work, nobody really has any incentive to give
advice that scores well on this measurement. A doctor's first priority
is to make sure they give advice that it safe and won't get them sued;
whether you follow it is not up to them. A government researcher's
first priority is to keep their own job; in a perverse way, it may
actually be better for them if obesity is on the rise, since their
agency gets more money! And some people just get a kick out of giving
"advice" that puts down other people, implying that they eat too much
or exercise too little, and if you ask them if people are born with
different metabolism rates, they look at you like you're from Mars.

But if you create a contest like the one I described, then for the
first time ever you've given people an incentive to give advice that
helps people lose weight. It would be interesting to see what people
come up with.

You didn't ask, but I'm about average weight and happy with it, so it
doesn't much matter to me personally. It just seems like this is a
problem that lots of people talk about but nobody has tried this
approach.

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Mr-Natural-Health · medicine forum Guru Joined: 01 May 2005 Posts: 1807

bennett@peacefire.org wrote:

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