Flashback Friday: The Weight-Loss Program That Got Better with Time

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The CHIP program may be the most “well-published community-based lifestyle intervention…in the [medical] literature. And, one of the most effective, with “clinical changes…approaching [that] achieved in [live-in] residential lifestyle programs.”

Encouraging people to transition toward a more whole food, plant-based diet achieved blood pressure benefits that were “greater than those reported [with] the DASH [diet] and comparable with the results” in blood pressure-lowering drug trials. If we’re going to reverse the worldwide chronic disease epidemic, though, we’ve got to scale this thing up. So, to make the CHIP program “more accessible to a wider audience, each of [Hans Diehl’s] live presentations was videotaped.” Then, you could just have a volunteer facilitator get people in a room and watch the videos, and help foster discussion. When it comes to safe, simple, side effect-free solutions, like a healthier diet and lifestyle, you don’t need to wait for a doctor to show up and give a lecture. Yeah, but does it work?

Look at these numbers for those that came in—the worst of the worst—and finished all the videos: 20-point drop in blood pressures, 40-point drop in LDL, more than a 500-point drop in triglycerides. Of those that came in with diabetic-level fasting blood sugars, about one in three left with non-diabetic-level fasting blood sugars, and all they did was empower people with knowledge. Just encouraging people to move toward a whole food, plant-based diet led to these remarkable benefits.

How about the effectiveness of this “volunteer-delivered lifestyle modification program” on 5,000 people? Same kind of “significant reductions” in weight, blood pressure, cholesterol, triglycerides, and blood sugars. Most studies giving “dietary advice to free-living subjects” can be expected to reduce total cholesterol by only about 5%. But, hey, a sustained reduction of even 1% may result in “a 2-3% reduction in the incidence of…heart disease.” So, on a population scale, “even small” differences matter. But, put thousands of people through just one month of CHIP, and get an 11% drop on average—and up to a nearly 20% drop among those who need it most.

Yeah, but do they maintain their healthy habits? I mean, doctors can’t even get most people to keep “taking a [single] pill once a day.” How effective is a volunteer-led video series going to be at getting people to maintain a change of eating habits? Researchers looked at the CHIP data to find out. How were participants still doing 18 months later? Most were able to maintain their reductions of meat, dairy, and eggs, though some of the junk food started to slip back in. And, their fruit and veggie consumption dipped, though not back to baseline. But, here’s the huge shocker. Even though they were explicitly told to eat as much as they wanted—no calorie or carb counting, no portion control—just by being informed about the benefits of centering their diets more around whole plant foods, by the end of the six-week program, they were eating, on average, about 339 fewer calories a day without even trying. Instead of eating less food, they were just eating healthier food.

Okay. But, this was right at the end of the 6-week program, when they were all jazzed up. Where were they 18 months later? Anyone familiar with weight-loss studies knows how this works; you can excite anyone in the short-term to lose weight, using practically any kind of diet. But then, six months later, a year later, they tend to gain it all back, or even more. Yeah, they were eating about 300 calories less a day during the program, but 18 months later, were only eating about 400 calories less. Wait, what kind of diet can work even better the longer you do it? A whole food, plant-based diet. Many weight loss programs restrict calorie intake by “limiting portion sizes, which often results in hunger and dissatisfaction,…contributing to low compliance and weight regain.” But the “satiety-promoting,” all-you-care-to-eat, “plant-based, whole food dietary approach” may be the secret weapon toward sustainable weight loss.

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• Morton D, Rankin P, Kent L, Dysinger W. The Complete Health Improvement Program (CHIP): History, Evaluation, and Outcomes. American Journal of Lifestyle Medicine. 2016;10:64-73.
• Aldana SG, Greenlaw RL, Diehl HA, Merrill RM, Salberg A, Englert H. A video-based lifestyle intervention and changes in coronary risk. Health Educ Res. 2008;23(1):115-24.
• Merrill RM, Aldana SG, Greenlaw RL, Diehl HA, Salberg A, Englert H. Can newly acquired healthy behaviors persist? An analysis of health behavior decay. Prev Chronic Dis. 2008;5(1):A13.
• Rankin P, Morton DP, Diehl H, Gobble J, Morey P, Chang E. Effectiveness of a volunteer-delivered lifestyle modification program for reducing cardiovascular disease risk factors. Am J Cardiol. 2012;109(1):82-6.
• Tang JL, Armitage JM, Lancaster T, Silagy CA, Fowler GH, Neil HA. Systematic review of dietary intervention trials to lower blood total cholesterol in free-living subjects. BMJ. 1998;316(7139):1213 - 20.

Image credit: CDC/Dawn Arlotta via Free Stock Photos. Image has been modified.

Motion graphics by Avocado Video.