Habit-change interventions for weight control aim to form positive eating and exercise habits or to disrupt unhealthy habits.
Ten Top Tips aims to set habitual behaviours associated with achieving and maintaining healthy weight. Evidence shows that the effectiveness of traditional weight loss approaches, which rely upon intention and motivation, typically wane over time. Education alone is insufficient and knowledge does not necessarily equate to behaviour. However, habit change interventions focus on simple messaging and repetition targeting healthy habits to become automatic and ‘over-ride’ intentions.
Trials of Ten Top Tips have shown short-term weight loss, which continues for 12 months following intervention. This simple strategy is as effective as, if not more effective than, traditional behavioural change strategies alone (which do not specifically address habit formation).
Ten Top Tips is a leaflet-based habit change intervention for weight control.
Weight control in people who are overweight (Body Mass Index (BMI) 25–30 kg/m2) or obese (BMI >30 kg/m2).
- Comorbid conditions requiring dietitian consultation and/or tailored exercise assessment and advice.
- Complex cases with severe obesity, who may be best referred onto specialist weight management services.
Ten Top Tips has a consumer handout available at: ten top tips weight loss tips based on scientific evidence.
There is also a logbook to help chart progress available at ten top tips logbook.
There are several intervention options for habit change to control weight. Ten Top Tips is the simplest, least invasive and most evidence-based option.
Ten Top Tips provides self-guided, leaflet-based interventions focusing on the recommendations of habit-formation theory. The program is intended to be self-guided at home. The goal is to promote automaticity of the Ten Tips which include:
- Keep to your meal routine: Try to eat at roughly the same time each day, whether this is two or five times a day.
- Go reduced fat: Choose reduced fat foods (e.g. dairy foods, spreads, salad dressings) where you can. Use high-fat foods (e.g. butter and oils) sparingly, if at all.
- Walk off the weight: Walk 10,000 steps (equivalent to 60–90 min moderate activity) each day (use a pedometer to help you count the steps). Take the stairs, walk escalators, and get off the bus one stop earlier – it all adds up.
- Pack a healthy snack: If you snack, choose a healthy option such as fresh fruit, plain yoghurts, or a handful of nuts instead of chocolate or crisps.
- Learn the labels: Check the fat and sugar content on food labels when shopping and preparing food.
- Caution with your portions: Do not heap food on your plate (except vegetables). Think twice before having second helpings.
- Up on your feet: Break up your sitting time. Stand up for 10 minutes out of every hour. Stand more anywhere, anytime – bus, train, and breaks or while on the phone.
- Think about your drinks: Choose water first. Unsweetened fruit juice contains natural sugar so limit to one small glass a day (200 ml). Alcohol is high in calories; limit to 2 drinks per day.
- Focus on your food: Slow down. Do not eat on the go or while watching TV. Eat at a table if possible.
- Do not forget your 5 a day: Eat at least 5 portions daily of various vegetables and fruit (400 g in total).
Implementation of the Ten Top Tips in research settings includes an induction meeting led by a practice nurse or dietitian and provision of a leaflet. Various implementation models have been trialled. In its simplest form, the leaflet outlines the ten tips and a daily self-monitoring form for the individual to complete at home.
Tips and challenges
- Considerations for individuals’ health literacy levels
- Ability and willingness to self-monitor progress
- Active encouragement to lose weight increases motivation and adoption of habit-based interventions
Habit-change interventions probably lead to weight loss at 3 months (Moderate certainty evidence) (2B).
Habit-change interventions may lead to weight loss maintenance (up to 12–24 months) compared with non-habit based weight loss programs (Low certainty evidence) (2C).