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The number of middle-aged New Zealand women using smoking and compulsive exercise as a way to control their weight is particularly concerning, University of Otago researchers say.
The researchers from the university's Department of Human Nutrition studied the weight control practices of 1601 women aged 40-50 who responded to a national postal survey in 2009.
The results, published in the New Zealand Medical Journal today, found more than 80% of middle-aged women were trying to lose or control their weight.
The most common method of trying to control weight, although fewer than half were doing it, was by cutting down on meal/snack size and fats and sugars, which the paper's authors, Sook Ling Leong, Clara Madden, Andrew Gray and Associate Prof Caroline Horwath, said was consistent with public health messages and ''encouraging''.
However, they also found smoking and exercising in a ''driven or compulsive'' way were used at least twice a week as weight-control strategies by 13% and 15% of respondents respectively.
That was cause for concern - particularly that a fear of gaining weight was reported as one of the major obstacles to stopping smoking and an unhealthy preoccupation with exercising was a recognised factor in developing eating disorders.
Also concerning was that 18.5% of underweight people were trying to lose weight.
The study is the first to describe weight-control practices in a nationwide sample of adult New Zealand women.
The paper noted a lower proportion of New Zealand women reported trying to lose weight than in overseas studies - a United States study found 50% of middle-aged women were trying to lose weight - but the proportion of women who reported smoking to control weight was twice that reported in Australian and US studies.
The results indicated 10%-14% of overweight or obese women were not trying to control their weight.
There was mounting evidence the long-term success of weight-loss efforts was modest, so a stronger focus on the promotion of weight-gain prevention and weight maintenance might be useful, the paper said.
The prevalence of other potentially health-damaging weight control practices such as fasting, using laxatives or diuretics, diet pills and vomiting was low, which was consistent with overseas studies.
In an introduction to the paper, Prof Jim Mann and Dr Kirsten Coppell, from the Edgar National Centre for Diabetes and Obesity Research at the University of Otago, said results around compulsive exercise, smoking, and underweight women trying to lose weight were ''rather alarming''.
The paper was a reminder of the complexities of managing the real and perceived problems of body fatness, and that an overarching strategy, including public health initiatives, was essential for the management of the global epidemic of obesity, they said.
Appropriate services for advising and supporting overweight people, especially those who already were pre-diabetes or had type 2 diabetes were ''woefully inadequate or absent'' in parts of the country and public health measures were needed to alter an environment which promotes unhealthy weight gain.
''Re-establishing a programme supporting healthy eating in schools may be a good place to start.''