The Role of Obesity in Cancer Survival and Recurrence: Workshop Summary by Margie Patlak

Author:Margie Patlak
Language: eng
Format: epub
Tags: ebook, book
Publisher: The National Academies Press
Published: 2012-12-21T00:00:00+00:00

Long-Term Adherence to Diet or Exercise Plans

A major challenge is having patients maintain a diet or exercise program for a long period of time, Dr. Demark-Wahnefried noted. Participation generally lasts for 12 to 24 months, and it can be challenging for volunteers to adhere to a diet or exercise plan for that long. But it is feasible, studies show, with the right degree of follow-up, Dr. Demark-Wahnefried stressed. “You need to keep up with the participants and follow them through the phone, the computer, etc.”

Dr. Wadden suggested several measures to improve adherence to weight loss interventions, including portion control, group treatment, and ongoing contact with health care providers or other professionals. He said diets that provide a fixed amount of food with known calorie content are critical because, for example, “If you consume a Slim Fast or Boost shake, you know you are getting 200 to 220 calories and when the can is empty, your lunch is over and it is time to stop eating.” Similar results can be achieved by using frozen food entrees, such as Lean Cuisine, he added. “You also can avoid problem foods in the short term by knowing precisely what you are going to eat, and by having convenient foods to eat. Many dietitians are upset by things like Slim Fast. But I always say, ‘What would you prefer—a breakfast of Slim Fast or a ham and egg and cheese sandwich and hot chocolate?’” Dr. Wadden cited a study that compared conventional reducing diets of 1,200 to 1,500 calories to those that were portion-controlled meal replacements and found that those on the meal replacements lost significantly more weight in the short and long terms (Heymsfield et al., 2003).

He also stressed the importance of people having ongoing contact with their health care provider once they have lost weight, so they do not gain it back. One study found that a group that had no provider contact after a 5-month period of weekly sessions regained about 40 percent of their weight 1 year later. Another group that continued to meet with their health care provider every other week for a year after the first 5-month period fared better in maintaining weight loss (Perri et al., 1988). He suggested teaching patients to maintain their weight loss by weighing themselves regularly, engaging in high levels of physical activity, and continuing to eat a low-calorie diet. “Physical activity is crucial,” he stressed. “The greater the physical activity the better, and strength training is a very beneficial part of this physical activity.” Dr. Wadden noted studies that found those individuals who exercised 200 or more minutes per week were more likely to maintain their weight loss than those who exercised less than 150 minutes per week (Jakicic et al., 1999). “The recommendation now is to engage in about 200 minutes of exercise per week and 275 minutes or more per week to maintain weight loss,” Dr. Wadden said.

High-intensity interventions, in which patients meet regularly with providers, generate better results (Wadden et al.

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