In two recent studies reported in the journal of the Journal of the American Medical Association (JAMA doi:10.1001/jama.2010.1503/ doi:10.1001/jama.2010.1505) they showed that structured lifestyle programs can lead to significant weight loss in obese women. I know it sounds obvious but sometimes science needs to do that to show everyone that it really can be done.
In the first study of around 450 overweight or obese women the intervention included weekly counselling, increased activity, and reduced-energy intake with free prepackaged meals (Jenny Craig). At 2 years, weight loss was greater with the intervention than with usual care (7 kg vs. 2 kg). A good result but what was their nutritional status like?
In the second study, 130 severely obese adults (mostly women) took part in a one-year intensive lifestyle intervention consisting of diet and physical activity. One group (initial physical activity) was randomized to diet and physical activity for the entire 12 months; the other group (delayed physical activity) had the identical dietary intervention but with physical activity delayed for 6 months.
So one group started the exercise earlier. At 6 months, the early-exercisers had lost more weight, which is what you would expect but at 12 months, early- and delayed-exercisers had similar weight loss (12 kg and 10 kg, respectively). One of the findings the researchers reported was that these findings "directly counter the dogma that ... severely obese individuals do not respond to lifestyle intervention,".
So what is the key. Both programs had a strong structure and motivation built in and had pre prepared meals. The first study was sponsored by Jenny Craig (Nestle), but they had no role in the experimentation. The advantage of the pre prepared meals is that the people don’t have to think about their meals. Or is it an advantage. My preference is to get people to eat a big salad before a meal, just like the French do and what we do at home. It is also important to get people to think about nutrition beyond just calories and food beyond filling a big empty hungry feeling or some emotional need.