Four Strategies Women Use To Manage Their Weight

Recent population surveys show that as many as two out of three women will report trying to lose weight in the past year.

Obviously, this answer does not really tell us much about what women are actually doing, as the types of diets and weight loss strategies seem virtually countless – some perhaps healthier than others.

Now a study by Stephanie Lanza and colleagues from Pennsylvania State University, published in the latest issue of OBESITY, suggests that women’s weight loss strategies can be divided into four common strategies and that simple questions can help predict these behaviours.

The study used a statistical method called latent class analysis (LCA) to identify subgroups of individuals who shared similar patterns of weight-control strategies amongst 197 non-Hispanic white women living in central Pennsylvania by analysing their response to 14 commonly used healthy and unhealthy weight-loss strategies.

Four groups were identified:

“No Weight Loss Strategies” (10%): individuals in this group are characterized by a low probability of reporting any weight-control strategy.

“Dietary Guidelines” (26.5%): individuals in this group have a high probability of reporting use of strategies consistent with healthy practices present in current guidelines, such as increased fruits and vegetables intake, increased exercise, decreased fat intake, eliminating certain foods, and reducing calories.

“Guidelines+Macronutrient” (39.4%): individuals in this group, in addition to the healthy practices of the guideline users, also have a high probability of reporting trying a low-carbohydrate diet.

“Guidelines+Macronutrient+Restrictive” (24.2%): individuals in this group report having tried nearly all weight-loss strategies, including both healthy and unhealthy strategies. This is the only subgroup of individuals who were likely to report skipping meals; use of appetite suppressants/liquid diets/diet pills; reducing alcohol consumption; and fasting.

Perhaps not surprisingly, women with weight concerns, the desire to be thinner, and dietary restraint were far more likely (in fact 10 to 30 fold more likely) to be in the “Guidelines+Macronutrient+Restrictive” class than in the “No Weight Loss Strategy” class.

The relationship between disinhibition and behaviour was more complex: disinhibition increased the odds of engaging in any weight-loss strategy when restraint was low; whereas, disinhibition increased the odds of engaging in unhealthy compared to healthy weight-loss strategies when restraint was high.

The authors interpret these findings to suggest that being both highly restrained and disinhibited may be a strong predictor of unhealthy, extreme weight-loss behavior that may ultimately be counterproductive.

As a clinician, I wonder if the identification of these behavioural classes will help better manage patients in these classes or even provide reasonable predictors of attrition and outcomes in clinical weight management programs. My guess is that individuals in the “Guidelines+Macronutrient+Restrictive” will pose a far greater clinical challenge than individuals in any of the other classes.

Clearly, in the same manner that obesity is not a homogeneous disorder, weight control behaviours come in different flavours – something that should perhaps never be forgotten in counseling.

AMS
New York, New York

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Lanza ST, Savage JS, & Birch LL (2010). Identification and prediction of latent classes of weight-loss strategies among women. Obesity (Silver Spring, Md.), 18 (4), 833-40 PMID: 19696754