Obesity Treatment 209after-school activities, and the community was encouraged to take respon-
sibility for preventing obesity. This intervention has been evaluated by
comparing weight gain over a 3-year period in Colac and in the rest of the
region of Victoria and shows that children in Colac had significantly lower
increases in body weight, BMI, and waist circumference (Sanigorski et al.,
2008). Furthermore, these benefits were unrelated to socioeconomic status,
indicating that the intervention worked equally across all members of the
community. In another Australian intervention, children were randomly
allocated to one of four conditions designed to promote physical activity
and reduce screen viewing. An evaluation of this intervention showed that
it did increase enjoyment of physical activity and increase actual activity
levels, although this was greater for boys than girls (Salmon et al., 2008).
Prevention is therefore an important approach to managing the increas-
ing prevalence of obesity. It requires a commitment from funding bodies
and governments to consider obesity a serious problem, and involves both
population and individual changes. To date there is little evidence of the
effectiveness of preventive interventions.
Conclusion
Although some obese people manage their weight on their own, many come
into contact with health professionals, particularly their GP. Research
indicates, however, that many GPs do not believe that a patient’s weight
falls within their medical domain and are skeptical about the effectiveness
of available treatments. When patients are offered help, most help involves
dietary modification, with more recent multidimensional interventions
adding elements such as exercise, cognitive restructuring, relapse preven-
tion, and intensive long-term follow-ups. Some have also addressed the
fat–carbohydrate ratio, others have used very low-calorie diets, and some
have varied specific aspects of the diet. The results from these interventions
suggest that short-term weight losses are better than they were in the past.
Longer term weight maintenance, however, remains poor, with between 90
and 95 percent returning to their weights at baseline. This has raised the
question as to whether obesity should be treated at all. A cost–benefit analysis
of obesity treatment shows that dieting in the obese and overweight also
brings with it many of physical and psychological problems described by
restraint theory, such as lowered mood and self-esteem, overeating, and weight
variability. Successful treatment, however, can result in both psychological