Slip, Skip, Lapse, and Relapse

Every now and then, conventional wisdom turns out to be more than legend. A new study in the Obesity journal confirms a bit of wisdom about how a little slip in dietary plans can undermine long-term weight management goals. In an elegant analysis, Molly Tanenbaum, Kathryn Ross, and Rena Wing confirmed that people really do tend to skip the scales after after a temporary slip in their eating pattern.

For many people, keeping track of daily habits is essential to keeping on track for changing those habits. Fitness trackers, apps, and online support communities are enjoying explosive growth. Studies find durable links between tracking behaviors and sustaining changes in those behaviors. Daily self-weighing is pretty well associated with better outcomes in weight management.

But the problem comes with inevitable lapses. Tanenbaum wanted to confirm that a familiar pattern is real: a dietary slip up leads a person to avoid the scales. Then the slip can become a slide, with a lapse into old habits. And so that lapse becomes a relapse with weight regain.

Data from this study show that people are indeed much more likely (p=0.0004) to skip weighing on the day following a day when they eat at least 300 calories more than usual, based on self-reports. It’s not a disaster. It’s just a fact of natural human behavior. The authors note that their findings suggest important opportunities for better support:

Weight management interventions that collect daily self-monitoring data are well positioned to prevent non-adherence to self-weighing by responding and providing additional support to participants who report increased caloric intake on a given day.

Taken in perspective, these slips were not catastrophic. This self-reported data comes from an online weight management program. The outcomes, though self-reports, are reasonably good. People in the study signed up for a voluntary online weight management program at work in a large healthcare system. They were pretty good about tracking their calories (85% adherence) and their weight (87% adherence).

And better tracking linked to better outcomes.

The real challenge is to take these links (clues, really) and translate them into better support for better outcomes. For now, though, it’s a reminder not to turn a slip up into a relapse. Just keep moving ahead.

Click here for the study. Click here and here for more on self-monitoring.

Falling, photograph © Kevin Morris / flickr

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September 16, 2016