Small changes for the New Year to curb obesity

As the New Year sets in, consider a small adjustment—a rather easy lifestyle change—for your New Year’s resolution.

Change is hard, and quick and big changes are even tougher. Most people find it hard to stick to their resolutions, and eventually fall back on old habits. So while taking on big changes, not small ones, is a strategy likely to yield immediate gratification, noticeable benefits and inspire further positive change, perhaps in the long term small, slow and steady is a better strategy when it comes to food, as eating is such an ingrained habit.

Are small steps the way to go as a society too?

We all know something needs to be done about the growing waistline of most Americans. Intuitively, we’d all hope that something big could change, but in reality, it seems like the small change idea is gaining ground as the most practical approach to fighting the obesity epidemic.

Looking at obesity from the population point of view—as opposed to the personal one—paints a rather bleak picture. There are many factors acting together to create an environment that promotes obesity, and indeed obesity rates are still climbing up. Two-thirds of Americans are overweight or obese, and it’s predicted that if trends don’t reverse, the majority of the world population will become obese, with enormous health and economic consequences.

The small-changes approach—embraced by many groups—focuses on promoting a small, widespread lifestyle change, such as replacing one sugary drink a day with a non-caloric one, or walking an additional 20 minutes a day. These small changes won’t drive overall weight loss in a society, but will help eliminate further weight gain. Over time, such a measure could lead to reductions in obesity rates.

A recent report in The American Journal of Clinical Nutrition by James O. Hill, representing the 17-member task force consisting of members of the American Society for Nutrition, the Institute of Food Technologists and the International Food Information Council, considers whether a small-changes approach could be useful in addressing obesity.

There are some interesting points in this report that explain the rational for this plan. I’ll focus on just a few:

• The energy gap. This measure the daily discrepancy between energy intake and energy expenditure. For the American population, the energy gap is estimated at about 100 extra calories a day, which explains the gradual weight gain of the population.

Eliminating 100 calories a day from a population would prevent further weight gain.

On the other hand, the energy gap required to produce and maintain weight loss is very much higher, says Hill. The estimate is that the energy gap to maintain a 9-14 kg (20-30 pounds) weight loss in obese people would be 175-250 calories per day, and the energy gap to maintain a 18-27 kg (40-60 pounds) weight loss in obese people would be 325-480 calories per day. This explains why obese people find it so very hard not to regain the weight they lost.

• Small changes are easier to achieve and maintain. It’s very hard to sustain large behavioral changes, and small changes could be the start of a process that ultimately leads to larger changes.

• The small change approach has been shown to work successfully in reducing obesity in several studies that intervened by promoting a small reduction in energy intake (of around 100 calories) and a small increase in exercise (such as 2,000 steps over baseline). I reported about one such successful small step approach in a previous blog post.

Hill suggests that these studies demonstrate that small changes reduce further weight gain, and that attempts at large changes in the American diet have not been widely successful, unless they’ve been undertaken by the food industry. One example of this is the sharp decline in consumption of trans-fatty acids, which did not require behavioral change from consumers but rather change mostly from the food manufacturers.

Hill concludes:

“This task force believes that a small-changes framework aimed at helping people make conscious small changes in lifestyle behaviors in combination with efforts by the private sector to gradually ’ratchet down’ some of the environmental factors that have contributed to excessive energy intake and to the declining rates in physical activity could be successful in reducing obesity rates. This initiative could be supported by educational and social marketing campaigns driven by or influenced by the many government agencies addressing this problem.”

I think we shouldn’t give up on ambitious big changes, especially since some big changes can be driven by policy decisions (one example would be removing fast food from school cafeterias) and therefore not require self-discipline from individuals.

But I do think that taking on small and easy goals is a good idea. Given the difficulty of weight loss, and the discouraging overall results of endless weight loss regimens, it’s perhaps very sensible to focus efforts on overweight prevention, rather than weight loss.

For those of us who don’t carry unhealthy amounts of extra weight, resolving to a healthy lifestyle that prevents further weight gain is really all that’s needed.

If you’re a parent of young kids like me, you’re in a unique position to play an important role in helping them avoid extra weight in childhood and adolescence by teaching them the skills of how and what to eat. An overweight condition, once established, is very hard to overcome permanently.

A recent poll shows this year--just like many before it--the top New Year resolution was to lose weight with resolutions to exercise more, eat a healthier diet, and improve one's health at fourth, fifth and sixth places.

I would love to hear about small changes (or big ones) you’ve pledged to make this year, if any.

Happy New Year!
Ayala