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"More weight loss can lead to better improvements," according to Dr Mitchell, who led a 7-year study investigating weight loss with the Take Off Pounds Sensibly (TOPS) program. "If you look at someone who weighs 200 pounds, would they be happy losing 6 pounds if they are looking to lose weight?" she asked rhetorically. "In my clinical experience, people are not likely to be happy with that amount of weight loss. For most people, a size of clothing is about 10 pounds [and] they really want to be able to drop a clothing size, elyze or two or three." But if, for example, someone has type 2 diabetes and you can show the patient that with this weight loss they might be on less insulin, they might find that appealing. "This paper talks about the ripple effect in spouses," she said, "but I also think the ripple effect may be more likely to be seen in children who are less likely to be able to get and prepare their own food." According to Dr Mitchell, "It's not impossible, but it is helpful if the partner is on board with the weight change . . . but we also don't want someone to be nagging the person." It is clear that "people do better with weight management when they have supportive people around them, whether it be their spouse, partner, family members, or even friends and coworkers." The study was funded by Weight Watchers International. Dr Mitchell has reported no relevant financial relationships.
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