Complementing dieting with counseling

The authors of this study at the University of Pittsburgh School of Nursing in Pennsylvania tell us that the type of diet is important.

But there’s more to discuss here than just dieting.

First, the details.

  • 176 sedentary, overweight adults (BMI: 34kg/m2) were randomly assigned to their preferred diet, a standard weight-loss diet, or a lacto-ovo-vegetarian diet.
    • Lacto-ovo vegetarians eat no beef, pork, poultry, fish, shellfish, or animal flesh, but do consume cheese, butter, yogurt and eggs.
  • Participants also followed a university-based weight-control program of daily dietary and exercise goals plus 12 months of behavioral counseling followed by a 6-month maintenance phase.

And, the results.

  • 132 (75%) of participants completed the study.
  • After 18 months, volunteers on the standard weight-loss diet and lacto-ovo-vegetarian diets showed 8% weight reduction vs 4% for those who followed the diet of their choice — a significant difference.
  • There was no difference in weight loss between the standard weight-loss and lacto-ovo-vegetarian diet.
  • Over 18 month, all groups showed significant weight loss.

The bottom line?
A survey by Ms. Rhonda Anderson at Queensland University of Technology in Australia and a review by Ms. Irene Strychar from the University of Montreal in Canada help place these results in perspective.

Ms. Anderson’s findings suggest the reason behavioral counseling is useful. “Self efficacy is our belief that we can produce the result we want… A person’s level of self-efficacy,” says Ms. Anderson, “determines how hard they try and how long they stick at things in the face of difficulties. People with high self-efficacy are motivated and optimistic — when the going gets tough, they keep going.”

“We can improve our self-efficacy,” she concludes, “by developing skills, having role models and getting encouragement from others.”

That sounds good, but unfortunately, like dieting, the benefits of counseling are greatest over the short term. Ms. Strychar found that behavioral counseling combined with diet increased weight loss in the short term (1 year) but not in the long term (3–5 years).

It’s not unusual to achieve lower body weight of about 8%. But what to do to have a chance at long-term success remains an unresolved problem.

5/14/08 23:37 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.