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Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: Lighten Up randomised controlled trial

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d6500 (Published 03 November 2011) Cite this as: BMJ 2011;343:d6500

Re: Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: Lighten Up randomised controlled trial

Dear Editor:

I read the report comparing various commercial and NHS-sponsored weight loss programs with interest. An accompanying editorial suggested that NHS staff trained to do obesity counseling were less effective than Weight Watchers staff because NHS staff were less experienced at such counseling than Weight Watchers staff. While that may be part of the explanation there is an additional explanation that bears consideration. With guidance from Barbara Rolls, first Weight Watchers and then Jenny Craig1 recently adopted treatment policies that encourage increased consumption of high-satiating foods, especially fruits, vegetables and whole grains, foods that tend to fill people up faster with fewer calories than conventional foods.2 Overweight women taught to eat more fruit and vegetables in addition to eating less fat have been shown in a randomized, controlled trial to lose more weight and nonetheless experience less hunger than women in a control condition featuring a traditional low-fat, energy-restrictive diet.3 The U.S. Department of Agriculture recently released MyPlate.gov, a replacement for MyPyramid.gov.4 MyPlate.gov explicitly encourages Americans who want to improve their weight control efforts to eat more of some foods, particularly water-bearing fruits, vegetables, and whole grain products because of their value in promoting satiation during a meal with fewer calories. Current UK clinical guidelines for counseling patients about strategies to lose excess weight make no mention of the behavioral benefits of encouraging such patients to eat high-satiation foods.5 When NHS staff are trained to include messages about the behavioral benefits of eating more high-satiating foods, they may achieve longer-lasting impact on their patients’ obesity risk.

Author:
William J. McCarthy, Ph.D.
Professor of Health Services
UCLA School of Public Health
A2-125 CHS, mc 690015
650 Charles Young Drive,
Los Angeles, CA 90095, USA
wmccarth@ucla.edu
References:

1. Rock CL, Flatt SW, Sherwood NE, Karanja N, Pakiz B, Thomson CA. Effect of a Free Prepared Meal and Incentivized Weight Loss Program on Weight Loss and Weight Loss Maintenance in Obese and Overweight Women A Randomized Controlled Trial. JAMA-J. Am. Med. Assoc. 2010;304(16):1803-11.
2. Rolls B. The Volumetrics Eating Plan. New York: Harper, 2005.
3. Ello-Martin JA, Roe LS, Ledikwe JH, Beach AM, Rolls BJ. Dietary energy density in the treatment of obesity: a year-long trial comparing 2 weight-loss diets. Am. J. Clin. Nutr. 2007;85(6):1465-77.
4. U.S. Department of Agriculture. MyPlate.gov, 2011. Accessed from: http://www.choosemyplate.gov/
5. National Institute for Health and Clinical Excellence. Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children 2006. Accessed from http://www.nice.org.uk/nicemedia/live/11000/38294/38294.pdf

Competing interests: No competing interests

04 December 2011
William J. McCarthy
Professor of Health Services
UCLA School of Public Health
A2-125 CHS, mc 690015, 650 Charles Young Drive, Los Angeles, CA 90095, USA