Ten top tips (10TT) weight control trial

This BLOG looks at the outcomes of an interesting study on weight control.

GP’s are often the first port of call for weight control advice. However they aren’t in a position to provide specialised therapy in this area. The researchers identified that although healthy ‘habits’ are the aim of many weight loss programmes, very few draw on the theory of habit formation.  So they designed a simple effective intervention that could be delivered without specialist skills and based on the fundamentals of building habits.

The essential feature of the psychological theory of habit formation is that habits are stimulated by environmental contextual cues. The intervention took the form of a leaflet called ‘Ten Top Tips’ (10TT) and it incorporated this idea. It listed target behaviours with advice on repetition and context. It also recommended self-monitoring during the habit acquisition phase.

A pilot study was carried out and then a small scale randomised control trial (RCT) with a volunteer population.  Subsequently a larger RCT was carried out with 537 primary care patients.

Pilot RCT weight loss results at 8 weeks and 32 weeks

Larger RCT weight loss results 537 participants after 3 months

* N.B. Usual care refers to the standard care provided by GP’s versus the 10TT leaflet.  In the pilot study the volunteer pilot RCT the control group didn’t receive any kind of care. The participants in the larger RCT were recruited from GP surgeries whereas the pilot study recruited volunteers.

The interesting thing to note is that in the pilot study weight loss continues after the intervention ended.  Maintenance of weight loss is often the biggest challenge for most people.

The 10 Top Tips (10TT)

I’ve reproduced the top 10 tips in full above as per the study.  My main comment is that I am not necessarily a fan of reduced fat products as they often use sugar or artificial flavourings to replace the fat content.  However monitoring your total fat intake is useful and especially any trans-fat intake as this will hamper weight loss efforts. I often refer clients to the BANT healthy plate https://bant.org.uk/bant-wellbeing-guidelines/.  My other comment on the ‘top ten’ is re sugar free squashes.  These will often use sweeteners which are neuro toxic and confuse the body.  It’s best to wean yourself off these kind of drinks entirely.

1. Keep to your meal routine by eating at roughly the same times each day whether this is two or five times a day.
2. Go reduced fat (I advise caution here as often reduced fat items are full of sugar or flavourings)
3. Walk off the weight – walk 10,000 steps which is equivalent to 60-90 minutes of moderate activity. Use a pedometer to count the steps.
4. Pack a healthy snack – if you snack choose a healthy option such as fresh fruit or yogurts instead of chocolate or crips.
5. Learn the labels – be careful about food claims (see point 2).  Check the fat and sugar content on food labels when shopping and preparing food.
6. Caution with your portions – Don’t heap food on your place (except vegetables). Think twice before having second helpings.
7. Up on your feet – break up your sitting time. Stand up for 10 minutes out of every hour.
8. Think about your drinks – Choose water or sugar-free squashes.  Unsweetened fruit juice contains natural sugar so limit to one glass a day (200 ml/1/3^rd pint). Alcohol is high in calories: limit to one unit a day for women and two for men.
9. Focus on your food – Slow down.  Don’t eat on the go or while watching TV.  Eat at a table if possible.
10. Don’t forget your 5 a day – Eat at least 5 portions of fruit and vegetables a day.

They calculated that these habits would generate a calorie deficit of between 800-900 calories daily.

References

Beeken, R.J. et al. (2012) Study protocol for the 10 Top Tips (10TT) Trial: Randomised controlled trial of habit-based advice for weight control in general practice; BMC Public Health; 12 pp. 667

Beeken, R. J. et al. (2017) A brief intervention for weight control based on
habit-formation theory delivered through primary care: results
from a randomised controlled trial; International Journal of Obesity 41 pp.246-254