Research published in the Journal of the Academy of Nutrition and Dieteticslooked at life-course theory to explain how obesity develops over time taking into account a person’s life events.
For a person to get the right intervention to lose weight it is important to determine if changes in weight were the result of a dramatic life change or were gradual changes in weight as the result of lifestyle habits and chronic dietary behaviors. The researchers identified four patterns of weight gain.
Those who reported being always heavy reached obesity in adolescence or their early 20s. For this group, early intervention and healthy habits might help to forestall further weight gain and possibly result in weight loss.
In the late peak group, most were of normal weight or just overweight through early to mid-adulthood, then began to gain rapidly. For this group, a life stressor appeared to be the trigger – marriage, children, divorce, death in the family – leading to drastic changes in weight caused by emotional eating. More than half the women who had children experienced weight gain after giving birth which was unrelated to post-pregnancy weight gain.
In the steady progression group weight gain occurred in increments, such as 15 pounds a year or a jump of 20 pounds after a stressing event. Though people often identify stress as a cause of weight gain, resolution of the stress rarely leads to weight loss. Instead, most people just stayed at the new higher weight and might diet not to gain further. What is interesting about stress eating is that it differs dramatically. Some may gain 10 to 20 pounds while others over 100 pounds. How individuals respond to stress is not well understood.
The weight cycling group was the most common weight gain pattern with weight histories characterized by large and numerous fluctuations in weight. Most were obese by age 30 and reported trying multiple diets, often over and over. They frequently targeted events – weddings, vacations, graduations – to prompt weight loss but regained after dieting and as they got older gains outpaced losses. We screen for many health conditions but few doctors regularly screen for obesity or track a patient’s weight over time to suggest intervention strategies. Just like nurse practitioners and medical assistants are part of the health care team, registered dietitians should be used to provide expertise in weight management. At this point in time, they are still sadly underutilized.
