A recent survey confirms what many wellness professionals have found to be a major stumbling block to successful programs: the individuals most in need of assistance are, in general, some of the most difficult to reach.

A persistent anti-diet sentiment among today's overweight Americans — those with a body mass index (BMI) of 25 and above — provides new evidence that these individuals are not making important changes in diet and physical activity levels, according to the Shape Up America! study, "X-FACTOR (Excessive Fat and Consumption Trends in Obesity Risk) Survey," conducted by Louis Harris and Associates.

One of the biggest stumbling blocks to achieving a healthier weight, the survey indicates, is the abandonment of dieting as a weight control strategy: 78 percent of the overweight and obese Americans polled are currently not on a diet to lose weight.

Further, only one in three (37 percent) Americans at the highest risk for health complications — with a BMI of 35 and over — are dieting to lose weight, the survey found. Approximately one-quarter (28 percent) of those in the high risk category (a BMI of 30 to 34) are on a diet, while less than one in five (18 percent) with a BMI of 25 to 29 said they are taking action to lose weight.

This anti-diet sentiment provides a renewed sense of urgency that educating Americans about weight control cannot wait, said Dr. C. Everett Koop, former U.S. Surgeon General and chairman of the Shape Up America! campaign.

"Until we give people the educational tools to fight obesity, they will remain frustrated and confused, and obesity rates will continue to skyrocket," Koop added.

Stumbling Blocks to Weight Loss

Such public confusion, especially about how to reduce calorie levels in the diet, is considered the biggest stumbling block, the survey found. Because this information is lacking, less than half of overweight Americans (42 percent) are trying to limit their intake of calories, even though this is an essential element in weight management, the X-FACTOR Survey revealed. This situation exists across the board among overweight individuals, regardless of their educational background.

These findings come in the wake of a study sponsored by Wyeth-Ayerst, which showed that 86 percent of Americans surveyed believed that being more than 20 pounds overweight can impact their health more than their appearance. The respondents cited high cholesterol (51 percent), followed by high blood pressure (47 percent) and diabetes (39 percent) as specific health conditions that can be affected by excess. Seventy percent of individuals in the Wyeth-Ayerst survey said they would seek medical professionals' help if they were obese.

Part of the growing problem of obesity may be related to Americans' changing eating habits. "Pigging out" has become a habit for most Americans, according to a survey conducted for Prevention magazine and "NBC Today — Weekend Edition." More than half of U.S. adults (54 percent, or at least 95 million Americans) clean their plates or nosh at parties (50 percent) even if they are full. Furthermore, nearly one in four Americans admitted they eat when they aren't hungry (38 percent), simply when they see food (39 percent), or when they are bored (38 percent).

This survey also uncovered gender differences in overeating, with more men than women eating out of habit: 61 percent of men clean their plate even when they are full, compared with 48 percent of women.

However, more women than men eat out of circumstance, the survey found. Forty-three percent of women eat when they are bored, compared with 31 percent of men; 44 percent of women eat when they aren't hungry, compared with 33 percent of men; and 32 percent of women eat when they are depressed, compared with 11 percent of men.

Dieting trends are fairly close to those found in the X-FACTOR Survey: approximately 26 percent said they went on a diet to lose weight in the past year. However, of those individuals, 22 percent said they are always on a diet, and 62 percent said they had tried one or two diets in the previous year.

Addresses: Shape Up America!, 6707 Democracy Boulevard, Suite 107, Bethesda, MD 20817; (301) 493-5368. Prevention Magazine, 33 E. Minor Street, Emmaus, PA 18098. Wyeth-Ayerst Laboratories, 145 King of Prussia Road, Radnor, PA 19087.