Yet another weight-loss program is about the last thing many of us want to hear about. In the long term, many of the people who have tried diet programs have failed to keep the weight they lost from coming back. But the authors of a new study of a nonprofit behavior-based program now report that a high percentage of dieters using the plan have been able to keep weight off for many years. The findings of the study were presented this week at the annual meeting of the American Dietetic Association in Denver.

"The solution to weight problems is not to manipulate diet and exercise patterns but to go to the psychological roots that contribute to nongenetic obesity," says Laurel Mellin, MA, RD, an associate professor of family and community medicine and pediatrics at the University of California at San Francisco (UCSF) and the lead author of the study. "People can be taught skills in self-nurturing and setting effective limits at any time in life. And this program uses those two skills to help people achieve long-term weight loss."

Mellin and colleagues report that their study provides the first report of a nonsurgical obesity intervention that resulted in weight loss after treatment ended.

"In contrast to traditional methods of weight loss that trigger short-term weight loss followed by rapid weight regain, subjects in this study kept the weight off even after 6 years," says Mellin.

The weight-loss plan is called the Solution Method. In it, people are taught develop mental health skills of self-nurturing and setting effective limits. These skills are practiced repeatedly in therapy sessions. Each developmental skill involves a person inwardly asking two sets of questions, says Mellin. To develop self-nurturing, the subjects ask themselves, "How do I feel, what do I need, and do I need support?" To develop self-limiting skills, they ask, "Are my expectations reasonable, is my thinking positive and powerful, and what is the essential pain and earned reward?" By asking these questions before making an action, such as seeking out food, the subjects are able to determine better why they are seeking out that food and what the consequences of eating it will be.

"Our earlier research suggested that once the skills became integrated, a trend toward persistent emotional and behavioral balance followed," says Mellin. "Participants reported eating less not because they were complying with a diet but because they stopped wanting the extra food."

When these skills are mastered, Mellin adds, a person's drive to go to excess, whether it's with food, spending, drinking, or even work, is diminished.

"Most weight programs provide external sources of nurturing and limits that are inherently unstable," says Mellin. "But support groups break up. The doctor stops prescribing the weight-loss drugs. Or the dieter gets sick of a rigid diet and goes back to normal patterns and the weight is regained."

Mellin and her USCF colleagues, Mary Croughan-Minihane, PhD, and Larry Dickey, MD, analyzed data on 27 obese participants in the group program conducted at the university. Of those 27, 19 were available for 6 years of follow-up study. The researchers tracked the subjects' weight, blood pressure, exercise level, depression, and level of functioning. The group members participated in 18 weekly 2-hour group sessions to practice the developmental skills, completed journal homework assignments, and made telephone "connections" with other group members for skills practice.

On average, the participants lost 13 pounds without restrictive diets or weight-loss drugs, they found. The subjects continued the weight loss after the program ended. Overall, they maintained a weight loss of 17 pounds on average--23 pounds for those who were considered to have mastered the skills before the end of the treatment program.

In addition to weight loss, the subjects' scores on a test for depression decreased by 60% at just 12 weeks into the program and by 80% 6 years later. Their average levels of exercise increased from 110 minutes weekly at the beginning to 247 minutes at 12 weeks and 240 minutes at 6 years. Of the participants who smoked, drank, or used drugs, 67% at 1 year and 83% at 6 years significantly decreased or stopped their use.

"A lot of weight-loss programs out there direct people at the action phase of weight loss only," says Leslie J. Bonci, RD, a spokesperson for the American Dietetic Association, ADA, and director of the sports medicine nutrition program at the University of Pittsburgh in Pennsylvania. "These programs take an all-or-nothing approach that is not conducive to long-term weight management." Bonci says setting realistic goals and developing skills like these can be useful ways to approach weight loss.

Mellin cautions that the study included a small number of subjects and that much larger studies will need to be undertaken before any treatment generalizations about the plan can be made, but she says the study's results are more than encouraging.

"In addition to solving their weight problems, the true benefits have to do with the emotional balance they gained, and that affects all aspects of their lives--work, love, and play," she says.

(From CBSHealthWatch)