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Doctoral defence of Faranak Halali, MSc, 3 June 2022: Repeated weight loss attempts do not guarantee the best outcome

The doctoral dissertation in the field of Nutrition will be examined at the Faculty of Health Sciences at the Kuopio Campus. The public examination will be streamed online.

Individuals who had more previous attempts to lose weight had higher body mass index, according to the doctoral dissertation of Faranak Halali, MSc. Individuals who had attempted to lose weight reported a higher tendency to purposefully restrict food intake for weight control, and more uncontrolled eating with a tendency to overeat, than those with no prior weight management attempts. The dissertation studied weight management among Finnish adults with a special reference to weight loss history, defined as the number of weight loss attempts during one’s lifetime.

The researchers studied the relationships between lifetime history of weight loss and eating behavior tendencies, that is, cognitive eating restraint, uncontrolled eating, and emotional eating, as well as anthropometric features such as body mass index and waist circumference, and metabolic features, such as plasma insulin and cholesterol. In addition, the study explored motivations behind individual efforts to manage weight, barriers challenging these efforts, and common strategies to achieve weight goals.

The data were collected within two projects. In the Kuluma (Consumers on the weight management market) project, 2346 participants were contacted either at the entrance hall of two supermarkets or via a web-based survey. The StopDia (Stop Diabetes) study involved 2684 adults at high risk for developing type 2 diabetes, and its data consisted of measurements collected before and after a lifestyle intervention aimed at reducing risk factors of type 2 diabetes. In both projects the lifetime history of weight loss was assessed by the question ‘Have you tried to lose weight during your lifetime?’. The answers could be ‘no’, ‘no, but I have been trying to keep my weight stable’, ‘yes, 1-2 times’, ‘yes, ≥ 3 times’, and ‘yes, continuously’.

StopDia participants who reported several prior weight loss attempts also showed larger waist circumferences. In addition, those who had attempted to lose weight more often reported more emotional eating, defined as the tendency to overeat in response to negative emotions, compared to those with no previous weight loss attempts. Instead, those with no prior weight loss attempts displayed a noticeable decrease in their fasting plasma insulin concentrations following the one-year lifestyle intervention.

According to the study, the most important motivators of weight management were maintaining mobility, health, and well-being. Physical exercise and paying attention to the type of foods were the most frequently used strategies for weight management. Enjoying eating food and treats, and lack of self-discipline were reported as the most important barriers to weight management.

Participants could be categorized into three different clusters based on the motivators, barriers, and strategies of weight management: 42% were categorized as “Struggling”, 34% as “Independent” and 24% as “Determined”. The “Struggling” seemed to be the least and the “Determined” the most successful in weight management, as the “Struggling” reported the highest body mass index and the lowest level of weight satisfaction and they perceived the barriers to weight management the most strongly. On the other hand, the “Determined” reported the lowest body mass index, the highest weight satisfaction and they perceived the barriers the least to harm their weight management.

Repeated attempts to lose weight should be avoided

Global prevalence of obesity has been steadily increasing. “Nowadays, people are well aware of the health consequences of excess weight such as type 2 diabetes, cardiovascular disease, and cancers. Along with the thinness being idealized at the same time, attempting to lose weight has become a common practice in the society. Since most weight loss outcomes are short-term and not sustained over time, recurrent attempts to lose weight occur”, Faranak Halali says.

Obesity is a chronic disease, which needs to be treated with a tailored approach like any other chronic disease. Management of obesity requires lifelong adjustments in individuals’ daily routine, which demands identification of factors potential of affecting weight management. “Findings of this dissertation suggest that repeated attempts to lose weight should be avoided due to its potential negative associations with less favorable eating behaviors and anthropometric and metabolic profile, as well as benefitting less from the lifestyle modifications”.

However, it remains unclear whether the repeated attempts to lose weight is a cause or consequence of these outcomes. Therefore, health care professionals should discuss with the clients whether losing weight is health-wise necessary and their current resources and motivations to lose weight. “Next, an appropriate and concrete plan based on evidence-based strategies should be set, considering the potentially disadvantageous outcomes of repeated weight loss attempts”.

The dissertation additionally provides evidence that barriers to weight management should be considered in designing weight control programs. For enhancing the odds of long-term success, it also seems important that circumstances wherein unfavorable eating behaviors such as uncontrolled eating or emotional eating could occur are discussed and recognized. The finding concerning three clusters based on the motivators, barriers and strategies of weight management could be beneficial in designing individually tailored means and approaches for successful weight management.

The doctoral dissertation of Faranak Halali, MSc, entitled Weight management and its behavioral, psychological, and metabolic features among Finnish adults: with special reference to weight loss history will be examined at the Faculty of Health Sciences. The Opponent in the public examination will be Adjunct Professor, Ministerial Advisor Sirpa Sarlio of the University of Helsinki and the Ministry of Social Affairs and Health, and the Custos will be Adjunct Professor Anja Lapveteläinen of the University of Eastern Finland. The public examination will be held in English.

Doctoral defence online 

Dissertation online

Photo available for download

For further information, please contact: MSc Faranak Halali, faranak.halali (a) uef.fi