Obesity is a global public health challenge that has substantial individual, societal, and economic impacts. It is predicted that, if the current trends continue, the majority (51%) of the global population will be living with either overweight or obesity by 2035, and 1 in 4 people will be classified as obese. High-income countries tend to have the highest rates of obesity. For example, in Australia, 66% of the adult population is classified as overweight or obese, with approximately 1 in 3 individuals classified as obese. In response to the impacts of obesity, the World Health Organization has set a global target to stop the increases in rates of overweight and obesity, and there have been calls to develop national strategies to address obesity. Among the range of approaches to address obesity, improving dietary intake and increasing physical activity are considered useful lifestyle strategies for losing weight. The economic impacts of overweight and obesity are expected to reach 3% of the global Gross Domestic Product by 2035. The costs to the Australian economy attributable to overweight and obesity were estimated to be Aus $11.8 billion (US $7.4 billion) in 2017 to 2018, and without significant action, these costs may rise to an estimated Aus $87.7 billion (US $54.9 billion) by 2032.
This article explores the weight loss journeys of Danielle Dalrymple and Laura Guzman, highlighting their personal struggles and triumphs. It also examines the effectiveness of a commercial, digital weight loss program, the CSIRO Total Wellbeing Diet Online, in achieving significant and lasting results.
Danielle Dalrymple's Transformation Through Beachbody
Danielle Dalrymple's story is a testament to the power of determination and self-prioritization. "Honestly for as long as I can remember, I never really was comfortable in my skin. I was never the athletic type, I avoided gym class in school, and I was never into working out or anything like that,” said Danielle Dalrymple. She said things started to get out of hand seven years ago when she opened her own business and did not have time for healthy eating. She was working full time and at the time had three children under the age of three. Dalrymple recounts how her weight gain escalated after pregnancy, feeling ashamed and unable to actively engage with her young children. “And then I had my son and I’m sure like a lot of other women, I gained a lot of weight in my pregnancy. I knew that I needed to lose it but I just kept telling myself ‘Oh well we’re gonna have more kids what’s the point’ and when my son was only a year and a half, I got pregnant with twins and gained even more weight,” said Dalrymple. Feeling ashamed of the way she looked and unable to run around with her young son, Dalrymple knew it was time for her to make a significant lifestyle change.
Initially, she postponed her weight loss goals to prioritize milk production while feeding twins and donating milk. “I didn’t want to be in pictures with my kids. I knew that I needed to make a change, I just didn’t know how to do it,” said Dalrymple. She said she tried diets when her twin daughters were newborns, but anything she did lowered her milk supply. “I was feeding twins and I was donating milk to the NICU as well. So I decided to put my weight loss goals on hold,” said Dalrymple. She said her milk production was really important for her and therefore she put everything on hold.
The turning point came after a family outing to the lake. In July 2020 the Dalrymple family went to the lake and Danielle was very self-conscious and really did not enjoy it but did it for her son. “When we got home, my husband was like ‘oh look, I got this really nice picture of you and Brady on the paddle board’ and I looked at the picture and I literally started crying,” said Dalrymple. She said sometimes it is hard for people to notice how out of control their weight has gotten until they see a picture. “That day I said ‘you know what, I’ve got a deep freeze full of milk, it’s time to put myself first’ and I need to do this, I need to do it for me and I need to do it for my family,” said Dalrymple.
Read also: Discover Kathleen's story of love and freedom
That night, she took the first step by signing up for Beachbody. She said her husband took the kids downstairs that night and she signed up for Beachbody. “I figured at home workouts would be perfect for me. Being a business owner, I work full time, at the time I had three kids under the age of three and I needed something that worked with my schedule,” said Dalrymple. She said at that point she had to modify the modified workouts as she was so out of shape, but she was determined to make the change for herself and her family.
Since beginning with Beachbody in July 2020, Danielle has dropped from 243 pounds to 151 pounds and has transformed her mental, physical and emotional health. She said working out was not always easy, but she took it one day at a time and she hopes that those who are starting their own journey do the same while aiming at small goals to avoid being overwhelmed. “A half hour workout just seemed like a lot, I would say I’m going to press play and I’m going to do it for two minutes and every single time I told myself that, I would finish the workout,” said Dalrymple. She said anyone can transform their lives if they set their minds to it. She said there is nothing special about her, she is a busy working mom of three.
Dalrymple emphasizes the importance of small, achievable goals to avoid feeling overwhelmed. For Danielle, the journey has been incredibly rewarding. “The most rewarding part of taking on this journey, honestly I think being able to have the energy to play with my kids,” said Dalrymple. She said she is now able to race with her son, she can play and go to the park and chase her children around. “I take them swimming all the time because I am okay putting on a bathing suit and being able to be a better mom,” said Dalrymple.
Laura Guzman's Triumph Through Carb Cycling
Anyone who loses weight, especially 100 pounds plus, is an inspiration. And when you combine that with becoming a natural bodybuilding champion, it’s sensational. Laura Guzman's weight loss journey led her to become a natural bodybuilding champion, losing an impressive 130 pounds. However, Guzman admits it wasn’t an easy path and that it took perseverance and patience. “When I started out at 285 lbs never would have guessed I would make it this far in my weight loss or compete in bodybuilding competitions.
Guzman shared how carb cycling helped her lose 130 pounds in a separate Instagram post. She also noted that carb cycling helped her control endometriosis. Carb cycling is a popular diet that has helped many people lose weight. In general, it’s having a mix of high-carb and low-carb days. If you have a higher carbohydrate day, you’ll eat more fats. However, your protein intake will typically be similar each day. Carb cycling is supposed to force your body to burn fat as fuel. The day people decide to eat high or low carbs will vary. That’s because carbs give your body energy and your muscles glycogen to fuel your workouts. There are several different approaches to take and include a variety of factors. There isn’t a necessarily cookie-cutter approach to carb cycling. It’s what works best for you and your goals. Laura Guzman was able to lose 130 pounds and become a natural bodybuilding champion by implementing carb cycling. Carb cycling has a mixture of higher and lower carbohydrate days to help your body burn fat.
Read also: Weight Loss Guide Andalusia, AL
The CSIRO Total Wellbeing Diet Online: A Digital Approach to Weight Loss
The Commonwealth Scientific and Industrial Research Organisation (CSIRO) and Digital Wellness have partnered to deliver a commercial, digital version of the CSIRO Total Wellbeing Diet. CSIRO is Australia’s national science agency and Digital Wellness is an Australian digital health solutions company. The CSIRO Total Wellbeing Diet is a weight loss program that has evolved from clinical trials to a popular series of books and now a digital platform. The CSIRO Total Wellbeing Diet Online program launched in 2014.
Program Overview
The CSIRO Total Wellbeing Diet Online is a commercial weight loss program managed by Digital Wellness and is available to individuals at a cost of Aus $199 (US $123) for the first 12 weeks and up to Aus $449 (US $278) for 12 months. The diet is a higher-protein, lower-glycemic index dietary pattern, with meal plans consisting of 3 meals and up to 2 snacks each day. The program contains a food group system where portions of food are presented as standard units for each food group. There are 7 food groups: fruit, vegetables, meat and alternatives, breads and cereals, dairy, healthy fats and oils, and indulgences. Meals are designed around a template of standard units, which ensures daily allowances of food groups are met and provides optimal nutrition and energy to promote weight loss. The weight loss program is promoted via media and digital channels, and the Australian public can join the program of their own volition. The user registration process collects information on year of birth, sex, physical activity levels, and weight loss goals to tailor eating plans.
The platform is a fully responsive web application with an interface that is optimized for viewing on a desktop and mobile devices. The program content provides general information and advice, and weekly tutorials. Self-monitoring and goal setting are key behavior change techniques used within the program. A weight loss goal is provided during the onboarding process. The food diary can be used to log meals and snacks, either by entering prepopulated recipes from the meal plan or by entering individual foods from a comprehensive food database. The food search function allows members to search a database to view information about their composition. The food tracker allows food units and total energy consumed over the day to be logged and reviewed, with graphical feedback provided comparing intake to daily food unit targets. A large database of recipes is available within the platform, and members can swap recipes in and out of the menu plan to suit their taste preferences, time, and cooking skills. Progress data are presented in a graph and table form. Members are encouraged to engage with the platform regularly, with recommendations provided to weigh in weekly, use the self-monitoring tools daily, and view program tutorials. The platform also has a forum for members to share their stories or discuss relevant issues with other members. Seasonal content is shared with members, and the program content is reviewed and updated periodically.
Study on Longer-Term Members
A study focused on longer-term weight loss and therefore used data from members who had joined the program between 2014 and 2022 and who had been members for at least a year. Participants of this secondary analysis included all adults who joined the CSIRO Total Wellbeing Diet Online and had data in the platform between October 2014 and June 2022 (n=155,075 people referred to as members). In the registration process, individuals who were aged <18 years or had a BMI that placed them in the underweight category (BMI <18.5 kg/m2) were automatically excluded. Participants excluded from this analysis were pseudo-members (ie, platform testers and affiliated staff), individuals whose membership was paid for by their employer because their motivations for weight loss might have been different from those who paid for their own membership, or people living outside of Australia because the context in which they were following the program might be different. This analysis focused on weight loss among longer-term members, defined as individuals who had completed at least 12 weeks of the program, had weight data recorded at baseline and approximately 12 weeks (61,514/152,895, 40.23%), and maintained a paid membership for about a year or longer. This left a sample of 24,035 longer-term members to examine the longer-term weight loss results of members on the CSIRO Total Wellbeing Diet Online program. To examine the patterns of weight loss over the first 12 months of membership, complete weigh-in data were required for the 4 time points of interest (12 weeks, 6 months, 9 months, and 12 months).
Key Findings
Longer-term members (24,035/61,514, 39.07%) had an average of 600 days of paid membership. The average starting weight was 92.6 kg, and the average BMI was 33.1 kg/m2 on commencement of the program. Most members were female (19,972/24,035, 83.09%) and aged between 31 and 50 years (9986/24,035, 41.5%) or 51 to 70 years (12,033/24,035, 50.06%). Nearly all the longer-term members were classified as overweight or obese (23,050/24,035, 95.9%), with 64.68% (15,546/24,035) classified as obese.
Read also: Beef jerky: A high-protein option for shedding pounds?
Weight loss and percentage of starting body weight loss were calculated at 3, 6, 9, and 12 months using 3 statistical approaches: (1) multiple imputations method, (2) all available data, and (3) complete data only. Using multiple imputations, the average estimated weight loss was 5.9 (SE 0.0245) kg at 12 weeks, 6.7 (SE 0.0348) kg at 6 months, 6.2 (SE 0.0400) kg at 9 months, and 5.5 (SE 0.0421) kg at 12 months. At 12 months, more than half the members (12,573/24,035, 52.3%) were at least 5% below their starting body weight and 1 in 4 (5865/24,035, 24.4%) were at least 10% below their starting body weight. In the subsample with complete data, the average weight loss at 12 months was 7.8 kg. The most common (961/6602, 14.56% members) weight loss pattern over the first 12 months was 6 months of weight loss, followed by 6 months of weight maintenance. This group had an average weight loss of 10.6 kg at 12 months (11.9% of their starting body weight). In a subgroup of participants who consistently lost weight over the 12-month period (284/6602, 4.3% of the sample), weight loss reached up to 22.3 kg (21.7% of their starting body weight). Weekly platform use was positively associated with total weight loss (r=0.287; P<.001).
Implications and Considerations
The results of members who joined the program in the first 5 years have been published previously. In a sample of >60,000 members who joined between 2014 and 2019, the average weight loss of all members was 2.8 kg (3.1% of their starting body weight), and for those who finished the 12-week program, the average weight loss was 4.9 kg (5.3% of their starting body weight). Reviews of commercial weight loss programs have been primarily based on randomized controlled trials and suggest that individuals who complete these programs can achieve significant weight loss in the short term. However, longer-term weight loss, and weight maintenance after weight loss, is challenging. Longitudinal and longer-term studies need to manage missing data. Randomized controlled trials often use statistical techniques, such as intention-to-treat analysis, to use data from all participants regardless of their adherence or completion of the program. However, a common limitation of real-world type studies that have evaluated the longitudinal effect of weight loss programs is that they often report results from a small proportion of the enrolled participants. Therefore, findings are more likely to represent the results of a highly motivated subsample and less likely to represent the expected weight loss for an average participant or be applicable to the broader population. In fact, reported dropout rates for weight loss programs range from 10% to 80% at 12 months, often due to reasons associated with lack of, or less than, desirable weight loss. Data from participants included in follow-up analyses would suggest that longer-term weight loss success is a real challenge. Studies of weight loss maintainers report some common behavioral strategies associated with longer-term success. Frequent self-monitoring of body weight and food intake, high levels of physical activity, and following a low-fat diet were shared behaviors among successful longer-term weight loss maintainers in the National Weight Control Registry.
Weigh-in data were needed to calculate weight loss. The amount of missing weigh-in data increased over time. At 12 weeks, 25% of weigh-in values were missing; at 6 months, 29% were missing; at 9 months, 50% were missing; and at 1 year, 61% were missing. To explore the effect of missing weigh-in data on weight loss estimates, analyses were conducted on the raw data (missing data ignored) before applying the multiple imputations method. The monotone multiple imputation model was used, which included weight loss at each time point, age group, sex, state, starting weight, starting BMI, and Socio-Economic Indexes for Areas quintiles. A total of 20 imputation datasets were created. The model assumed missing data were missing not completely at random. Weight loss was also calculated using the available weigh-in data in the system. The amount of weigh-in data ranged from 75.02% (18,032/24,035) at 3 months to 39.16% (9413/24,035) at 12 months. Weight loss was also calculated using only members with complete weight data at all time points (6602/24,035, 27.47%). Weight loss patterns in four 3-month blocks over 12 months were examined and recorded as a sequence. Weight loss during each 3-month period was categorized as weight loss (L), weight gain (G), or weight maintenance (M). Consistent with previous research, a change in weight within 1.4 kg of previous weight was considered weight maintenance, and anything greater was considered weight loss or weight gain. For example, if a member lost weight from baseline to week 12 and also lost weight in months 3 to 6, 6 to 9, and 9 to 12, then the weight loss pattern was labelled as L|L|L|L to indicate 4 consecutive periods of weight loss. Alternatively, if a period of weight loss was followed by a period of maintenance and then 6 months of gradual weight gain, the pattern was labelled as L|M|G|G.