30 April 2015 All Obese People are Not Alike

If you’re overweight or obese and trying to lose weight, you’re not alone. There are tens of millions of other people like you, struggling with the same problem. But are all obese people really the same? A new study says “No”. Just because you and lots of other people have a BMI of 31 doesn’t mean you all those other people will be successful with the same diet advice.

In other words, a one-size-fits-all approach to dieting won’t work because people are obese for different reasons. The researchers looked at over 4000 people with BMI over 30 and collected lots of data about physical characteristics, medical conditions and lifestyle factors. After doing a complex statistical analysis on all the data, 6 different obesity patterns emerged:

  1. Heavy drinking males
  2. Young healthy females
  3. Affluent healthy elderly people
  4. Physically sick elderly people
  5. Unhappy anxious middle aged people (mostly females)
  6. People generally in poor health

Do you see yourself in any of those groups?

The study authors believe that these categories will help target weight loss strategies that work best for people in each group. For example, they concluded that weight loss was not going to be a priority for all groups. Young healthy females and healthy elderly people are the most likely to have weight loss as a goal, while people in poor health are more likely to be concerned about their other health problems, not so much about going on a diet. And while an unhappy anxious middle-aged person may want to lose weight, he or she may get more benefit from counseling and increasing exercise, both of which can help with the emotional distress that can drive overeating. Effective weight loss advice for heavy drinking males would include information about calories in alcoholic beverages.

These conclusions make sense. If weight loss is the primary goal, motivated healthy young females or healthy elderly people might get the most help from calorie counting, advice on healthy food choices and help with sustainable exercise programs. If you’re in one of those two groups, tracking your food intake and exercise might be sufficiently motivating.

If you’re in the anxious middle-aged category, and you haven’t had success sticking to a diet due to emotional eating, perhaps dealing with the root cause of the eating through counseling would help you move forward.

The study results were more targeted at physicians, to help them decide which patients would benefit most from which type of diet intervention. For example, people in very poor health tended to be heavier and have more chronic health conditions. The message to physicians was that this group is already overwhelmed by medical problems. They don’t participate in healthy behaviors and are not likely to get any benefit from diet instructions. Heavy drinking males strangely had higher levels of exercise, but were less likely to be dieting to lose weight, so putting those men on a standard diet might not be helpful. A message that encourages exercise while cutting back on drinking might have more impact.

What can you do? Here’s my advice:

  • Young healthy females and healthy elderly people should work on portion control, healthy food choices and exercise. Calorie counting and food tracking can help, and if you’re in this group, you’re probably motivated to stick to a plan.
  • Unhappy anxious people who recognize a tendency to emotional overeating should consider psychological counseling to investigate triggers and develop coping strategies. If you’ve repeatedly failed at dieting because of emotional eating, diving into yet another restrictive diet plan isn’t likely to be successful.
  • Heavy drinking males are consuming excess calories from alcohol. Simply cutting way back may jump-start weight loss with no other diet changes. Weight loss may motivate you to push yourself more, eat healthier, control portions and exercise more.
  • People in poor health due to chronic conditions may feel obligated to attempt dieting, but if medical problems are your main concern, you need to work with your doctor to get those under control. Adding a restrictive weight loss diet to your life may be pointless. Rather than dieting, out of guilt or a feeling of obligation, just try making better food choices and physical activity, if possible.

Donna P. Feldman MS RDN

Nutrition journalist at Radio Nutrition

Co-host: Walk Talk Nutrition podcast.

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Disclaimer: The information provided here does not constitute medical advice. If you are seeking medical advice, please visit your healthcare provider or medical professional.

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Weight Loss/Behavior

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