July 13, 2012 -- Keep a food journal. Don't skip meals, but do skip your afternoon lunch dates. Those recommendations come from research published Friday in the Journal of the Academy of Nutrition and Dietetics.
Researchers from the Fred Hutchinson Cancer Research Center evaluated the impact of self-monitoring and diet-related behavior and patterns among overweight and obese post-menopausal women. Among the 123 women who participated in the study, they found that those who completed food journals lost about six more pounds than those who did not note their food intake. Women who skipped meals lost eight fewer pounds than those who did not miss meals, and those who ate lunch out at least once a week lost five fewer pounds than those who ate out less frequently.
Dr. Anne McTiernan, lead author of the study and professor of epidemiology at Fred Hutchinson Cancer Research Center, said losing weight is really just about "accountability, knowing what you're eating and how much, and how that all adds up compared with your calorie goal for losing weight."
It's difficult to change a diet if dieters are not paying close attention to what they are eating, researchers said.
"The food journal helps you keep track, in real time, of what you are eating," said McTiernan. "Restaurant eating, on the other hand, makes it difficult to know what you are eating, and the serving sizes are often large enough for several people. So, it's difficult to keep an account of what you eat if you don't know what's going into the food."
The biggest obstacle in losing weight is setting unrealistic goals, McTiernan said.
"If you weigh 250 pounds, you won't get down to 125 overnight," she said. "That might take a couple of years, or you might need medical help. The good news is that you get major health benefits by just reducing by 5 to 10 percent of your starting weight."
Keith Ayoob, associate professor of pediatrics at Albert Einstein College of Medicine, said food journaling can be difficult because it forces dieters to "confront everything in real time."
"Taking this action can be extremely helpful though, so it's worth it, but it means letting go of some of the spontaneity about eating," he said.
Because of this, people make more informed choices.
"There's no 'I'll deal with it later' thing," said Ayoob. "When you write it down now, you have to think about it now, and that means you think about whether you really want it or need it."
"There's a tendency to eat more than you would if you were eating at your desk, perhaps because it can be seen as a treat," said Ayoob. "Unfortunately, people often fail to compensate for such treat occasions, so it results in weight gain."
Nevertheless, most experts said that the study offers confirmation, not necessarily new information, on the need for accountability while trying to lose weight.
Self-monitoring is a long-established mainstay of cognitive behavioral therapy, and the evidence has long been clear that it improves outcomes, said Dr. David Katz, director of the Yale Prevention Center.
"This study merely observed association between such behaviors and the outcomes, so does not prove cause and effect," Katz said. "Perhaps those people who kept the best journals are just the most meticulous people and adhere the best to any program.
"If so, it is character, rather than behavior, that is the real cause for the better outcome," said Katz.
For those interested in keeping a food journal, researchers gave the following tips to study participants:
o Be honest - record everything you eat
o Be accurate - measure portions, read labels
o Be complete - include details such as how the food was prepared, and the addition of any toppings or condiments
o Be consistent - always carry your food diary with you or use a diet-tracking application on your smart phone