71.3% of patients succeeded, waist narrowing being an incentive for weight loss
Women are more likely to consult a nutrition specialist for aesthetic reasons, while men are usually bound by health reasons
Alicante. 11 January 2016
"A picture is worth a thousand words". According to the results obtained by UA researcher Isaac Elías Kuzmar Daza in his study "A new therapeutic approach to obesity treatment", the saying is also true for weight loss.
Physician Dr. Kuzmar Daza conducted a medical, nutrition-based programme for weight loss where image was one of the variables, measured by taking weekly photographs of the patients. Ninety per cent of patients completed the study, 71.3% of which succeeded in losing weight, while 28.7% did not. Also, 83.7% of patients had achieved a smaller waist by the end of the study. Kuzmar's conclusion in the face of his final results is that patients' response to diet improves when image is quantified as a variable.
Data were gathered in a nutrition clinic located in Barranquilla (Colombia). Kuzmar's doctoral theses was directed by Mª Mercedes Rizo Baeza (a lecturer at the University of Alicante's Faculty of Health Science) and Ernesto Cortés-Castell (a lecturer at Miguel Hernández University's Department of Pharmacology, Paediatrics and Organic Chemistry).
Patients' picture was taken on a weekly basis. According to Mercedes Rizo, it is very rewarding for them to actually see their waist get smaller and smaller. "We used personal image as a variable, and results showed that it was the factor that contributed the most to motivation and had the highest impact on patients' weight loss".
Waist narrowing was also one of the factors that had a positive impact on weight loss. Rizo states that 83.7 of patients had achieved a smaller waist by the end of the study, and that it was thanks to the pictures. In her own words, seeing a picture of yourself from the front and from the side and actually noticing the improvement is incredibly rewarding, and has a positive impact on both health and personal image.
On their first visit, the researcher would take the patients' picture, which allowed them to track their progress with the diet. There was also a hotline available to patients to call if they needed any help. In the weekly pictures, patients (mostly women) could see how their image improved, which gave them the motivation to keep losing weight and not quit the diet. According to Rizo Baeza, director of the study, what people want is a picture showing their progress, and not numbers.
In March 2015, Isaac Elías Kumar Daza successfully defended his thesis "Use of a new therapeutic approach to obesity treatment", directed by Mª Mercedes Rizo Baeza (a lecturer at the University of Alicante's Faculty of Health Science) and Ernesto Cortés-Castell (a lecturer at Miguel Hernández University's Department of Pharmacology, Paediatrics and Organic Chemistry).
Kuzmar's innovation was to prove how people who went to see a nutrition expert were more concerned about how they looked than about the possibility of having a condition entailing, for example, cardiovascular risks, high cholesterol levels, and so on.
The study analysed patients between 16 and 72 in the Caribbean city of Barranquilla (pop. +3,000,000). Total study sample was 271 patients (233 women and 38 men), divided in two groups.
For sixteen consecutive weeks, patients went to see the doctor once a week. The medical nutrition programme they followed included a computer-recorded medical record, and a customised, low-calorie diet where patients were allowed to choose which food they preferred among the options available. Traditional variables (BMI -body mass index- and waist/hip ratio) were used to track progress. Waist/hip ratio turned out to be a key variable, since as Rizo explains, BMI is no longer enough. Waist/hip ratio is a key variable these days, and points out which patients are at risk of becoming obese.
The patients' first picture was attached to their medical record, which included a thorough analysis of their eating and sports habits. Then, the patients started a sixteen-week diet programme based upon ICTs (information and communications technology).
One of the groups (50% of patients) had phone interviews with the physician, used ICTs, weighed themselves, kept a record of what they had eaten and how much exercise they had done, took and sent one picture every week. The other half of the patients, however, went to the physician's office for consult during eight random weeks during the treatment. The study showed how patients lost weight and achieved the same results regardless of the group they were in.
"We are social beings, and it is undeniable that diets have been clearly unsuccessful. The group of patients (50% of the total) that did everything remotely in this study are proof that there is no need for a weekly visit to the nutrition expert", says Mercedes Rizo.
The study also concludes that women seek nutrition advice because they want to look good, whereas men tend to do so for health reasons.
When selecting the study sample, Dr Kumar had to exclude a hundred patinents that had a normal weight. The study was originally made up of 371 patients, but only 271 were finally treated. Final results show that 10% of them did not complete the study, versus 90% who did. Also, 71.3% of participants succeeded in losing weight, while 28.7 did not. Finally, 83.7 of them achieved a smaller waist. About the weekly pictures, Mercedes Rizo claims that "seeing your waist get smaller week by week is really rewarding".
Isaac Elías Kuzmar Daza, doctor of the University of Alicante, was born in Colombia. He holds an MBA and is currently employed by the Finnish government. He has published several scientific articles in relation with this study: Kuzmar et al. (2014), Adherence to an overweight and obesity treatment: how to motivate a patient? PeerJ 2:e495; DOI 10.7717/peerj.495
Images courtesy of the research team.
PeerJ. 2014 Jul 29;2:e495. doi: 10.7717/peerj.495. eCollection 2014.
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