It Takes a Village to Prevent Obesity




Obesity is on the rise worldwide, and efforts to treat obesity show only limited effectiveness over the long term. Consequently, the public health focus is shifting from treatment to prevention of obesity. So far, very little research has been conducted in this area, but a new study in the British Medical Journal (BMJ) reports that to prevent weight gain, all people need is a little community support.

Many weight loss and lifestyle experts advise people wanting to lose weight to involve family and friends as a support system, but the BMJ study is among the first to quantify the role a support system places in preventing weight gain and making healthy lifestyle changes. The study evaluated 250 mothers of young children in a community in Australia. At baseline, the mean age of the mothers was 40 years and the mean body mass index was 28. (A body mass index between 25 and 30 is classified as “overweight.”) The women were assigned to an intervention group or control group, based on the schools that their children attended.

The intervention group attended four interactive group sessions that offered healthy living information, strategies for improving health behaviors, and group discussions. The intervention group also received supportive, personalized text messages every month. The control group attended one noninteractive lecture that presented population-based dietary and physical activity guidelines. After 12 months, changes in weight were compared between the two groups, as well as cholesterol and blood glucose levels, dietary habits, physical activity levels, and self-management behaviors. Overall, the women in the control group gained 0.83 kg (1.83 lbs) while the intervention group lost 0.20 kg (0.44 lbs). The intervention group also had improved cholesterol profiles, dietary habits, and activity levels. This group also expressed more confidence over weight control than the control group.

Preventing weight gain is an important step in reducing the burden of obesity-related chronic diseases. The World Health Organization promotes the early instruction of weight control to young adults, even those with an already-healthy body mass index. Women, particularly young mothers, are especially vulnerable to weight gain in early adulthood, owing to pregnancy and lifestyle changes related to marriage and family. (Estimates suggest that women gain approximately one pound per year in adulthood.) Maybe more significantly, these women influence the health behaviors and dietary habits of their families, which may, in turn, lead to more obese children and adults later in life. The main barrier to reaching young mothers and affecting change in their diet and activity levels is time. Mothers of young children are arguably among the busiest people in a community, and their own personal health and well-being often take a back seat to the needs of the rest of the family.

The response rate for the current BMJ study was only 12%, similar to other community-based intervention programs. But, the women who did participate achieved significant results, prompting the question of how to get busy mothers (or anyone) to participate in a program that focuses on their weight? The efforts required to effectively teach people about healthy diet and lifestyle choices are likely far less than the multitude of time and resources that are needed to treat obesity. From a public health and economic perspective, obesity prevention outweighs any treatment option.

The new study proves that a low-intensity community-based program aimed at supporting healthy lifestyles and preventing weight gain can be an effective tool in meeting the world’s growing health needs. The bottom line is that no one can do it alone. (If they could, there would not be an obesity epidemic.) Simple teaching tools, along with accountability and community support, can give women confidence to make healthy choices for themselves and their families.

References

Hardeman W, Griffin S, Johnston M, Kinmonth AL, & Wareham NJ (2000). Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods. International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 24 (2), 131-43 PMID: 10702762

Lemmens VE, Oenema A, Klepp KI, Henriksen HB, & Brug J (2008). A systematic review of the evidence regarding efficacy of obesity prevention interventions among adults. Obesity reviews : an official journal of the International Association for the Study of Obesity, 9 (5), 446-55 PMID: 18298429

Lombard C, Deeks A, Jolley D, Ball K, & Teede H (2010). A low intensity, community based lifestyle programme to prevent weight gain in women with young children: cluster randomised controlled trial. BMJ (Clinical research ed.), 341 PMID: 20627974

Lombard C, Deeks A, Jolley D, & Teede HJ (2009). Preventing weight gain: the baseline weight related behaviors and delivery of a randomized controlled intervention in community based women. BMC public health, 9 PMID: 19121220

Lombard CB, Deeks AA, Ball K, Jolley D, & Teede HJ (2009). Weight, physical activity and dietary behavior change in young mothers: short term results of the HeLP-her cluster randomized controlled trial. Nutrition journal, 8 PMID: 19409085

Lombard CB, Deeks AA, & Teede HJ (2009). A systematic review of interventions aimed at the prevention of weight gain in adults. Public health nutrition, 12 (11), 2236-46 PMID: 19650959

Østbye T, Krause KM, Lovelady CA, Morey MC, Bastian LA, Peterson BL, Swamy GK, Brouwer RJ, & McBride CM (2009). Active Mothers Postpartum: a randomized controlled weight-loss intervention trial. American journal of preventive medicine, 37 (3), 173-80 PMID: 19595557

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  • Your quote that fighting obesity takes family and friends is so true. My eldest daughter is 10 years old, and some of her friends are already obese, and they are her age.

    I am in my mid 40’s, and when I look at my elementary school pictures, maybe one kid in the class was fat, but today nearly half of her class overweight or obese. Kids today don’t play outside like we did, which is a complex issue of too much tv, foods with trans fats, and parents afraid to let the kids outside to play for fear of people who could harm them.

    So, this issue will take parents, friends and society to truly cure.

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Jennifer Gibson, PharmD

Jennifer Gibson, PharmD, is a practicing clinical pharmacist and medical writer/editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. She is the owner of Excalibur Scientific, LLC.
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