Original Article

Comparison of Traditional and Nontraditional Weight Loss Methods: An Analysis of the National Health and Nutrition Examination Survey

Authors: Robert E. Post, MD, MS, Sharleen P. Johnson, MA, Robert U. Wright, MPH, Arch G. Mainous, PhD

Abstract

Objectives: To evaluate the real-world use of various weight loss techniques and to compare the effectiveness of nontraditional methods with diet and exercise in helping nongeriatric adults lose weight.

Methods: A cross-sectional analysis of the 2005–2010 National Health and Nutrition Examination Survey was performed. Adult, nonpregnant participants aged 20 to 65 years with a body mass index of ≥18.5 who tried to lose weight in the previous year were analyzed (weighted n = 53,570,979). Outcome measures included the proportion of patients who used nontraditional weight loss methods and a comparison of weight loss between those who used diet and exercise and those who used nontraditional methods.

Results: During the previous year, 56.9% (95% confidence interval 54.5–59.4) of participants used nontraditional methods (nonexclusive of diet and exercise) as their attempted weight loss methods. Overall, individuals gained a mean (standard error) of 4.9 (0.3) lb in the 12 months preceding the National Health and Nutrition Examination Survey questionnaire. Only 19.6% (95% confidence interval 18.0–21.2) of the sample lost weight within the previous 12 months. Those who used nontraditional methods gained more weight during the previous year than those who used diet and exercise only (for body mass index ≥18.5, 5.5 vs 3.5 lb; P < 0.01) in the overall sample, but there was no difference in the obese subgroup.

Conclusions: Physicians need to reaffirm that diet and exercise are better methods for weight loss, and they need to advise their patients to avoid other methods when attempting to lose weight because they do not enhance weight loss attempts.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Flegal KM, Carroll MD, Kit BK, et al. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 2012;307:491-497.
 
2. Seidell JC, Visscher TLS, Hoogeveen RT. Overweight and obesity in the mortality rate data: current evidence and research issues. Med Sci Sports Exerc 1999;31(suppl):S597-S601.
 
3. Allison DB, Fontaine KR, Manson JE, et al. Annual deaths attributable to obesity in the United States. JAMA 1999;282:1530-1538.
 
4. Fontaine KR, Redden DT, Wang C, et al. Years of life lost due to obesity. JAMA 2003;289:187-193.
 
5. Allison DB, Zannolli R, Narayan KM. The direct health care costs of obesity in the United States. Am J Public Health 1999;89:1194-1199.
 
6. Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003;289:76-79.
 
7. Hirani V, Zaninotto P, Primatesta P. Generalised and abdominal obesity and risk of diabetes, hypertension and hypertension-diabetes co-morbidity in England. Public Health Nutr 2008;11:521-527.
 
8. Burke GL, Bertoni AG, Shea S, et al. The impact of obesity on cardiovascular disease risk factors and subclinical vascular disease: the Multi-Ethnic Study of Atherosclerosis. Arch Intern Med 2008;168:928-935.
 
9. Samaranayake NR, Ong KL, Leung RY, et al. Management of obesity in the National Health and Nutrition Examination Survey (NHANES), 2007-2008. Ann Epidemiol 2012;22:349-353.
 
10. Burroughs VJ, Nonas C, Sweeney CT, et al. Self-reported weight loss practices among African American and Hispanic adults in the United States. J Natl Med Assoc 2010;102:469-475.
 
11. Post RE, Mainous AG 3rd, Gregorie SH, et al. The influence of physician acknowledgment of patients’ weight status on patient perceptions of overweight and obesity in the United States. Arch Intern Med 2011;171:316-321.
 
12. Booth AO, Nowson CA. Patient recall of receiving lifestyle advice for overweight and hypertension from their general practitioner. BMC Fam Pract 2010;11:8.
 
13. Dorsey R, Songer T. Lifestyle behaviors and physician advice for change among overweight and obese adults with prediabetes and diabetes in the United States, 2006. Prev Chronic Dis 2011;8:A132.
 
14. Ko JY, Brown DR, Galuska DA, et al. Weight loss advice U.S. obese adults receive from health care professionals. Prev Med 2008;47:587-592.
 
15. Heintze C, Metz U, Hahn D, et al. Counseling overweight in primary care: an analysis of patient-physician encounters. Patient Educ Couns 2010;80:71-75.
 
16. Blumenthal JA, Babyak MA, Hinderliter A, et al. Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch Intern Med 2010;170:126-135.
 
17. Yancy WS Jr, Westman EC, McDuffie JR, et al. A randomized trial of a low carbohydrate diet vs orlistat plus a low-fat diet for weight loss. Arch Intern Med 2010;170:136-145.
 
18. Levitsky DA, Pacanowski CR. Free will and the obesity epidemic. Public Health Nutr 2012;15:126-141.
 
19. Shiffman S, Sweeney CT, Pillitteri JL, et al. Weight management advice: what do doctors recommend to their patients? Prev Med 2009;49:482-486.
 
20. Chen GC, Ramanathan VS, Law D, et al. Acute liver injury induced by weight-loss herbal supplements. World J Hepatol 2010;2:410-415.
 
21. Egger G, Cameron-Smith D, Stanton R. The effectiveness of popular, non-prescription weight loss supplements. Med J Aust 1999;171:604-608.
 
22. Appel LJ, Clark JM, Yeh HC, et al. Comparative effectiveness of weight-loss interventions in clinical practice.N Engl J Med 2011;365:1959-1968.
 
23. Greenberg I, Stampfer MJ, Schwarzfuchs D, et al. Adherence and success in long-term weight loss diets: the dietary intervention randomized controlled trial (DIRECT). J Am Coll Nutr 2009;28:159-168.
 
24. Douketis JD, Macie C, Thabane L, et al. Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice. Int J Obes (Lond) 2005;29:1153-1167.
 
25. Shick SM, Wing RR, Klem ML, et al. Persons successful at long-term weight loss and maintenance continue to consume a low-energy, low-fat diet. J Am Diet Assoc 1998;98:408-413.
 
26. McGuire MT, Wing RR, Klem ML, et al. Behavioral strategies of individuals who have maintained long-term weight losses. Obes Res 1999;7:334-341.
 
27. Leser MS, Yanovski SZ, Yanovski JA. A low-fat intake and greater activity level are associated with lower weight regain 3 years after completing a very-low-calorie diet. J Am Diet Assoc 2002;102:1252-1256.
 
28. Phelan S, Wyatt H, Nassery S, et al. Three-year weight change in successful weight losers who lost weight on a low-carbohydrate diet. Obesity (Silver Spring) 2007;15:2470-2477.
 
29. Pagoto SL, Appelhans BM. A call for an end to the diet debates. JAMA 2013;310:687-688.
 
30. Kruger J, Blanck HM, Gillespie C. Dietary and physical activity behaviors among adults successful at weight loss maintenance. Int J Behav Nutr Phys Act 2006;3:17.
 
31. Christian JG, Bessesen DH, Byers TE, et al. Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight. Arch Intern Med 2008;168:141-146.