The Porcupine Health Unit is borrowing a successful formula from reality TV to curb obesity in Hearst and Kapuskasing.
The idea for a Biggest Loser-style contest came up during a Heart Health Coalition meeting, said Joëlle Zorzetto, a public health dietitian with the Health Unit. The six-month program was rolled out in Hearst in October 2008 with the co-operation of the Hearst Heart Health Coalition and the NordAski Diabetes Education Centre. It quickly recruited 48 adults interested in shedding some pounds.
"We planned a three-week media campaign, but it filled up after the first ad," said Zorzetto.
Participants stepped on the scale, submitted to the tape measure and had their blood tested at intervals throughout the program. They also attended regular workshops on nutrition and physical activity, received email blasts with advice and encouragement, and got together in teams to walk, swim, go to the gym and support each other.
Points were awarded for attending workshops, losing weight, keeping food diaries, engaging in physical activity and butting out. The team with the most points was awarded a cash prize of $600 at the conclusion of the program ($150 for each member), but there were also smaller incentives of under $5 for each participant and draws for $50 cash prizes at each workshop.
The Health Unit set its sights on a 10 per cent weight loss, but had to settle for a more modest 2.5 per cent result - from 100.1 kilograms to 97.5 kilograms, said Foyez Haque, public health epidemiologist with the Porcupine Health Unit.
"Even though the participants did not reach their targeted body weight, the study showed some findings which support community intervention as an effective tool to decrease body weight and achieve good health," said Haque.
Waist circumference decreased six per cent (from 118.5 centimetres to 111.3 centimetres), HDL levels increased 12 per cent and the total cholesterol to HDL ratio decreased 10 per cent.
"We were satisfied with the results," said Zorzetto. "We were looking for mild weight loss. We wanted to motivate the participants to come to sessions that would give them tools for further weight loss on their own. We weren't looking for another crash diet."
A second six-month program was launched in Kapuskasing in January and wraps up this month. It, too, filled up after one round of publicity, attracting 50 participants. This time, however, the Health Unit decided to go with teams of two, based on the feedback received from Hearst.
"They told us that teams of four required meetings to stay motivated and that was complicated, so we decided to go with teams of two," said Zorzetto. "That way, they could talk to each other instead of having a meeting."
In Kapuskasing the winning team will pocket $400 ($200 apiece).
The cash prizes injected a bit of fun into the program, but weren't the primary motivator, said Zorzetto. "Most of the participants said the big prize didn't motivate them to participate. Most just wanted to have a structure to keep them motivated. Only one guy said we should make it $10,000 or a car."
The cash outlay for the program may raise some eyebrows, but the cost of the program pales in comparison with the cost of obesity.
A paper on the Hearst weight loss program points out that obesity costs the U.S. health-care system $117 billion annually and accounts for 31 per cent of the total direct costs of 15 co-morbid diseases. In Canada, a study looking at only eight diseases came to the conclusion that obesity costs the health-care system $4.3 billion per year.
"In Northern Ontario, we know we're heavier than the rest of the province," said Zorzetto.
The region served by the Porcupine Health Unit had an obesity rate of 58.6 per cent in 2008, compared with a rate of 51.6 per cent for the province as a whole, according to the Canadian Community Health Survey.
The difference is generally attributed to Northern Ontario's longer winters and a lack of physical exercise.
The paper reporting on the program also points out that "occupation, educational attainment and household income are (also) associated with adult obesity. Among people who are employed with a good salary, have a higher educational background and a high household income, there tends to be decreased obesity in the whole family. In Northern Ontario, however, a comparatively lower number of people have a post-secondary education, and a lower household income."
The Health Unit had planned on a one-year follow-up in Hearst to evaluate the longer-term impact of the program, but the results were inconclusive because of poor attendance. More emphasis will be placed on a one-year follow-up in Kapuskasing to gauge the longer-term results of the program, said Zorzetto.
Obesity can contribute to a variety of health problems, including type 2 diabetes, hypertension, dyslipidemia, coronary artery disease, stroke, osteoarthritis and cancer.
The Porcupine Health Unit is also planning to introduce its weight loss program to Timmins in the fall.
