A simple community program has been shown to be effective in preventing excess weight gain commonly experienced by young mothers. The research, published online today in the British Medical Journal at bmj.com has found that weight gain can be prevented with a program based on simple health messages, small changes to behaviour, and delivered conveniently in a community setting.
Health problems related to obesity are major issues in developed countries. Australia is the fourth biggest nation, with 60% of adults either overweight or obese.The World Health Organization recommends weight management initiatives to include efforts to try to prevent adults from gaining weight, even if they are in an acceptable weight range. Young women in Australia are now gaining weight at a faster rate than women in any other age, increasing their risk for weight-related illnesses.
The study, by leading Australian women's health organisation, the Jean Hailes Foundation for Women's Health, investigated whether women who attended the HeLP-her Community Lifestyle Program gained more or less weight than women who attended a single thirty minute group lecture about the benefits of following population dietary and physical activity guidelines.
Two hundred and fifty women aged between 25 and 49 years of age took part in the research, led by Dr Catherine Lombard with Professor Helena Teede from the Jean Hailes Foundation for Women's Health in collaboration with Monash University in Melbourne. Women within the healthy weight range were included as well as overweight and obese women.
According to the authors, women are an important group to target in preventing weight gain because their lifestyle changes after they have children - and this can impact on the entire family.
"Their level of physical activity drops off and their diet changes," Dr Lombard said. "Women also tend to be in control of what food is in the house so they can influence what their partner and children eat and how much activity their children do."
Women in the intervention group attended just four interactive sessions at the local primary school where they discussed how to change their behaviour.
"We did not give the women a diet to follow or an exercise plan as we wanted the women to decide themselves what was important and possible to change at that time in their lives," said Dr Lombard. "Women don't want to feel pressured to reduce weight. In this program they decided what their needs were, and we supported them."
Dr Lombard, who is presenting additional study findings at an international obesity conference in Europe, said the intervention women were taught how to overcome barriers to healthy eating and physical activity and strategies to prevent relapses to help maintain their healthier lifestyles.
"We looked at what stops them from adopting healthy eating or engaging in more activity how could they overcome that," she said.
The women in the intervention group also received monthly SMS text messages encouraging them to stay active, eat well and follow a healthy lifestyle throughout the twelve months of the research project.
Women in the control group gained an average of 830 grams - just under a kilo - during the 12-month study and overall there was a 1kg difference between the groups. Participants in the control group who were less than 40 and within a healthy weight range gained the most weight (1.72kg). In contrast women under 40 in the intervention group lost around 0.27kg.
"While not a huge amount of weight the key issue is that this simple program stopped women putting on weight," said Jean Hailes Director of Research and Monash University Chair of Women's Health, Professor Helena Teede, also a lead researcher in the study.
In another decade or two these women could be 15-20kg heavier, putting themselves at greater risk of chronic disease. The aim of the research was to develop a simple program that prevented women gaining more weight and the HeLP-her Healthy Lifestyle Program did achieve that.
"We need to acknowledge the struggle this is for many women and their families on a daily basis. We know women are trying hard to lose weight, or to maintain a steady weight, but whatever they are currently doing isn't working. They need more support," said Prof Teede.
"Our research found that you can't just give women a few brochures about diet and exercise and expect them to do it themselves. Excitingly, our research suggests that it only takes small, simple changes, together with a bit of support, for ordinary women to successfully control their weight," she says.
Teaching women skills that increase their ability to recognise barriers to healthy lifestyles and then supporting them to change behaviour are important strategies to help prevent women gaining excess kilos.
In addition the connections women have with each other in their local community through schools, kindergartens and social groups are important in supporting these new healthy behaviours.
According to Dr Lombard the essential elements of the program could easily be translated into other community settings across Australia.
"Running such a program in a community setting such as a primary school worked well. Women did not need to attend a clinic - in this case they were already at school because they were dropping off or collecting their children, and they helped each other with ideas and strategies about how to avoid gaining weight," she said.
"We know women are interested in learning about preventing weight gain, we know it is important to their health and we know it works. Now we need to make sure women have access to programs locally that will help them and their families stay healthy."
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