Most weight-loss programs focus almost exclusively on the body: Eat less, exercise more, and you'll drop pounds.
But a mounting body of scientific evidence suggests that what and how you think can also help you lose weight. And that possibility is drawing mainstream attention: Even the National Institutes of Health (NIH) in Bethesda, Md., are funding studies that examine how mental techniques can help yield thinner, healthier people.
The following is a roundup of recent research on which mind-body practices best support a weight-loss program.
We know that yoga is designed to bring inner calm, increase flexibility and even build strength. But for years, little scientific evidence existed to support yoga as a weight- maintenance activity.
In 2005, yogi Alan Kristal, D.P.H., M.P.H., and colleagues at the Fred Hutchinson Cancer Research Center in Seattle reviewed data on 15,550 men and women who had reported their physical activity and weight measurements for 10 years. The researchers found that participants who were overweight when the study began and had practiced yoga at least a half hour per week for 4 or more years lost 5 pounds during the 10-year period, while those who didn’t do yoga gained 13.5 pounds.
Although weight gain was measured at the beginning and end of the study, participants self-reported how often they practiced yoga. The study did not take into account participants' social or economic status and didn't show a clear cause and effect between yoga and weight loss — it showed only an association between people who did yoga and lost weight.
"Regular yoga practice can benefit individuals who wish to maintain or lose weight," the researchers concluded. They weren't sure exactly how yoga helped people drop the pounds, but many yoga devotees have theories.
"You need to separate it from the fact that it's a calorie-burning activity and view it more as a contribution to behavioral change and lifestyle change," says Elizabeth Larkam, a certified yoga instructor and mind-body spokeswoman for the San Diego-based American Council on Exercise (ACE).
"Think of it as meditation in motion. You feel more calm, more centered and therefore less likely to reach for a high-sugar snack to try to artificially balance your body's energy or your mood," she says.
The ancient martial art of tai chi combines mental concentration with slow, choreographed movements designed to focus the mind and breathing. Dozens of studies show that tai chi improves balance, stability and pain management in the elderly, but few researchers link tai chi with weight loss.
In the January-February 2004 issue of the Journal of Cardiovascular Nursing, an analysis of 7 studies on the aerobic benefits of tai chi found that it "may be an additional form of aerobic exercise," especially the popular, gentle Yang style of tai chi when it's practiced regularly for a year by previously sedentary adults.
However, Wojtek Chodzko Zajko, Ph.D., a tai chi expert and head of the Department of Kinesiology and Community Health at the University of Illinois at Urbana-Champaign, says that in general, tai chi is not an aerobic exercise for most people. Instead, its weight- loss benefit is part of "a broader wellness practice," he says.
"People who practice tai chi are less anxious, depressed and nervous and have better self-esteem," he says. "You could argue tai chi is a good component to a total holistic attitude toward health, and that people who practice tai chi are more likely to engage in healthy eating behavior that encourages weight loss."
Fitness instructor Scott Cole, creator of the Discover Tai Chi for Weight Loss DVD (Goldhil, 2002), believes tai chi's "sitting posture" — in which every movement is done with bent knees — burns energy and consequently helps people lose weight. "You're moving slowly and not relying on your momentum, so you're using your muscles at the deepest level," Cole says. "Your muscles are in quite a quivering state with a lot of muscle fibers firing, which increases muscle mass and gives you a metabolic boost
While many people believe meditation can result in weight loss, few valid studies back that theory up, says Ruth Quillian-Wolever, Ph.D., clinical director for the Duke Center for Integrative Medicine in Durham, N.C.
Quillian-Wolever and her colleague, Jean Kristeller, Ph.D., of Indiana State University, are seeking a more definite answer to the question. They are working on 2 National Institutes of Health–funded studies designed to determine if there is a clear link between meditation and weight loss. Together, the 2-year studies track about 230 people practicing vipassana, an ancient Indian form of meditation.
Vipassana teaches students to define and differentiate between their thoughts, feelings and sensations. Quillian-Wolever suspects vipassana might help people "register their body signals and learn what is physical hunger or what is emotional." Her theory is that if people could gain more insight into what drives their eating choices, they might have an easier time controlling nonphysical hunger impulses.
Quillian-Wolever says she has successfully used vipassana meditation for weight loss with individual clients. "Other forms of meditation don't change your thoughts or your relationship with the world," she says.
How often a person needs to meditate to achieve weight loss, Quillian-Wolever says, is "the magic question" she and Kristeller hope to answer. "My personal guess is 5 to 6 days a week, 20 to 30 minutes a day for 3 months, and then a couple times a week indefinitely after that" Quillian-Wolever says.
Hundreds of studies have been conducted on how cognitive therapy can improve everything from depression to shyness. But Judith Beck, Ph.D., daughter of the pioneer of cognitive therapy, Aaron Beck, M.D., knows of only one study linking cognitive therapy to weight loss.
That study, conducted in Sweden in 2005, tracked 105 obese people. Sixty-two of them participated in 3 hours of cognitive therapy a week for 10 weeks, while the rest served as controls. Eighteen months after the therapy ended, those in the cognitive therapy group had lost an average of 23 pounds, while the control group gained an average of 5 pounds.
Cognitive therapy for weight loss focuses on identifying negative thoughts — such as "I can't lose weight" — and responding to them realistically based on evidence. "If you change your thinking, you can change your behavior," says Beck, director of the Beck Institute for Cognitive Therapy and Research in suburban Philadelphia and clinical associate professor of psychology at the University of Pennsylvania.
The author of The Beck Diet Solution (Oxmoor House, 2007), she has seen similar results with more than 75 individuals she's coached over 20 years as well as with a group of 10 obese women who have met with her since July 2006. Prior to joining the group, the women had tried an average of 8 times each to lose weight and had failed. In the first 9 months of cognitive therapy with Beck, the women lost between 10 and 45 pounds each.
Whether individually or in a group, Beck's cognitive therapy for weight-loss plan involves meeting once a week for months or even years. Patients learn 34 to 40 different skills that help identify and change thinking that sabotages weight loss. Although Beck has anecdotal evidence that her program helps people lose weight, she hasn't conducted a controlled, clinical study.
"The idea is to identify your sabotaging thinking and give yourself helpful, realistic responses that allow you to follow a nutritious diet you can basically stay on your whole life," Beck says. "If you change your thinking, you can change your behavior and learn skills like how to recognize the difference between hunger and craving."
Reviewed by: Adam Perlman, M.D., M.P.H.
Date reviewed: April 2007
©2007 Revolution Health Group, LLC. All rights reserved
Date updated: April 23, 2007
By Vicky Uhland
Content provided by Revolution Health Group