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Habit-based interventions effective for maintaining weight loss

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May 15, 2018

Gina Cleo
Gina Cleo

Habit-based weight-loss interventions — either forming new habits or breaking old ones — may aid in achieving long-term weight-loss maintenance in adults with overweight or obesity, according to a study published in the International Journal of Obesity.

“Maintaining weight loss is often the hardest part of the weight-loss journey, yet it was successfully achieved by our participants on the habit-based programs, without the need for dieting or strenuous exercise,” Gina Cleo, PhD, research fellow at Bond University, Australia, and accredited practicing dietitian, told Endocrine Today. “Habit-based interventions have the potential to change how we think about weight management and, importantly, how we behave.”

Researchers recruited 75 adults aged 18 to 75 years with overweight or obesity (BMI ≥ 25 kg/m2; mean age, 51 years) to participate in a single-blind, three-arm, randomized controlled trial conducted at Bond University, Institute of Health and Sport in Gold Coast, Australia. Researchers randomly assigned participants to one of two habit-based weight-loss intervention groups (“Ten Top Tips” or “Do Something Different”) or to a waitlist control group, which included no intervention or weight-loss advice. Ten Top Tips was a self-guided intervention based on a leaflet and focused on forming new eating and activity behaviors. Do Something Different focused on breaking unhealthy behaviors and was implemented through online software. The trial was conducted for 12 weeks from July to October 2015 with all groups followed up after the intervention; the intervention groups were also followed up at 6 and 12 months.

At the post-intervention follow-up, researchers found that participants in the Ten Top Tips group and the Do Something Different Group lost more weight than those in the waitlist control group (–3.3 kg and –2.9 kg, respectively vs. –0.4 kg; P < .001). At the 12-month follow-up, Ten Top Tips participants lost an additional 2.4 kg, and Do Something Different participants lost an additional 1.7 kg; 65% of participants in both intervention groups had lost at least 5% of their baseline body weight. In addition, intervention group participants saw improvements in BMI, waist circumference, daily fruit and vegetable consumption, weekly exercise, and reported well-being, depression and anxiety from baseline.

“Habit-based weight-loss interventions could make a cost-effective contribution to the health improvements of individuals with overweight or obesity,” Cleo said. “They could also offer health practitioners a simple and time-efficient weight-loss intervention.” – by Melissa J. Webb

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Gina Cleo, PhD, can be reached at

Disclosures: The authors report no relevant financial disclosures.

itj+ Perspective

Donna H. Ryan

Is it better to break old habits or to form new habits to produce weight loss at 1 year? This study would suggest that either approach may be equally effective and that breaking old habits may not even need to target eating and activity behaviors. Community volunteers aged 18 to 75 years with overweight and obesity were randomly assigned to receive one of three following conditions: “Ten Top Tips” to adopt new behaviors around healthy eating and physical activity vs. counseling to “do something different” to change old habits vs. a wait-list control condition.

At 12 months, there was no significant difference in weight loss with either intervention. There were 65% of both intervention groups who lost 3% or more from baseline.

The “do something different” intervention targeted habits that had nothing to do with diet or physical activity. It consisted of daily online reminders tailored to individual participants’ regular habits to “drive a different way to work today,” to “choose a charity or local group to help” or to “write a short story on any subject.”

How could patients breaking old habits unrelated to diet and physical activity lose just as much weight as those forming new health habits? The authors propose that changing habits, per se, produces weight loss. However, both intervention groups were contacted weekly by the study investigators and both were encouraged to fill out a food diary. This study may actually be highlighting the power of self-monitoring of diet and accountability to a health counselor in weight loss success.

The take-away message from this study may be that the food diary is a powerful tool to increase awareness of food intake and will inevitably produce changes in food intake by itself. We need to use this simple tool more often. Furthermore, we need to see our patients more often, because accountability will increase weight loss.

Donna Ryan, MD

Professor Emerita, Interim Executive Director
Pennington Biomedical Research Center

Disclosure: Ryan reports no relevant financial disclosures.