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Volume 50 Number 2
Edited by Greg Townley
and Alicia Lucksted
Seeking interested individuals for Self-help Interest Group leadership position: Our second term as interest group co-chairs ends in Summer 2017, and we are hoping to identify individuals interested in taking over this leadership position. We will happily provide technical assistance to make the transition as smooth as possible. Please email Alicia (Aluckste@psych.umaryland.edu) and Greg (firstname.lastname@example.org) to discuss further!
Take Off Pounds Sensibly: A Self-Help and Mutual Support Organization
Written by Lauren E. Chacon and Jessica Corral,
The University of Texas at El Paso;
and Louis D. Brown,
The University of Texas Health Science Center at Houston
Obesity, a burgeoning disease, causes numerous comorbidities such as heart disease, diabetes, and increased risk for chronic diseases (Goldkamp, Anderson, Lifits‐Podorozhansky, & Gavard, 2015). While popular weight loss approaches, such as pills, diets, and exercise fads can be dangerous and detrimental to health, Take Off Pounds Sensibly offers a sensible and economical solution to the obesity epidemic.
Take Off Pounds Sensibly, a Wisconsin based non-profit organization also known as TOPS, is an internationally recognized weight loss support group (TOPS, 2016). Since 1948 this group has been devoted to serving individuals who seek to lose weight and maintain a healthy lifestyle. The weight loss support group is available to both males and females of all ages. Furthermore, TOPS strives to offer economical and practical solutions to obesity while fostering friendship and support throughout the TOPS community. TOPS instills in its members that, over time, small increments of weight loss augment and allow for weight reduction in a healthy manner.
There are two options to joining TOPS: you can become an online member or join a local TOPS chapter. In the United States the annual TOPS membership fee is $32 and in Canada it is $36, however, there is an additional monthly chapter fee, about $5, which differs among chapters (TOPS, 2016). The monthly chapter fee does not apply to online TOPS members who do not participate in a local chapter.
Before meetings begin, participants have a private weigh-in to track their progress. The chapters start meetings by reciting the TOPS pledge, “I am an intelligent person. I will control my emotions, not let my emotions control me. Every time I am tempted to use food to satisfy my frustrated desires, build up my injured ego or dull my senses, I will remember— I Will Take Off Pounds Sensibly.” (TOPS, 2016). After such procedures, TOPS members are encouraged to share whether they met their weight loss goal. While most participants openly discuss their progress, no one is forced to share. Praise and encouragement are a focus in each group. Every meeting includes motivational or informational presentations supporting weight loss and the upkeep of healthy lifestyles.
The times and location of the meetings depend upon the chapter. Most activities that occur during the meetings, such as health discussions and monthly games, are decided upon by the local chapter. Typically, games, prizes, and incentives are incorporated into meetings to motivate members to lose or maintain their weight. While TOPS inspires individuals to live healthy lives, it also promotes comradery among the members and an enjoyable atmosphere. Each group is unique, for instance, certain chapters offer different health resources, nutritious recipes, and exercises dependent on the location of the TOPS chapters and the demographics of the members. All TOPS chapters, however, maintain the same goal of supporting one another in the battle against obesity.
Promoting TOPS in El Paso County
El Paso, Texas, a city that sits on the Texas-Mexico border, is approximately 80% Hispanic and is one of the poorest counties in the United States (Community Health Assessment, 2013). Further, 24% of adults living in the El Paso County are obese and an additional 39% are overweight (Community Health Assessment, 2013).
One initiative in El Paso County aimed at reducing obesity is called Healthy Fit, a research program led by The University of Texas Health Science Center at Houston (UTHealth), School of Public Health in El Paso. The project uses community health workers to reach residents of El Paso, Texas and surrounding communities with health navigation services. Community health workers administer a health screening and then offer a variety of health resources to address issues identified in the screening. Individuals who are overweight receive a fotonovela that provides education and activities aimed at improving heart health. They also receive a list of free and low cost organized physical activity opportunities in the community. TOPS is a promising strategy to lower the prevalence of obesity in El Paso County because of the organization’s communal support and cost efficacy. Thus, Healthy Fit also provides referrals to TOPS groups.
In an effort to learn more about the groups, their meeting format, who attends, and how they are helpful, we visited each of the four TOPS chapters in El Paso County. From our observations, the El Paso TOPS chapters presented similar characteristics. All the chapters were openhearted, friendly, and always welcomed new members. Whether individual members lost or gained weight, the TOPS community was extremely supportive and encouraging of them. Activities, such as games and prizes, motivated members to maintain a healthy lifestyle; for example, “TOPS baseball” is a game that was played where members were split into two teams and the team who loses the most weight over the course of the month wins the game. Awards were also given to the “biggest loser” of the week, month, and quarter year. Other accolades were given according to member participation, weight loss, and the upkeep of healthy behaviors. The TOPS chapter locations were large, clean, private, and felt safe.
Although there are certainly advantages to participating in TOPS, the organization could improve upon the diversity of members, materials, accessibility of chapters, and meeting times. TOPS members in El Paso are predominantly women over 65 years of age. Groups are currently available only in English, thus excluding a large segment of the El Paso population that only speaks Spanish. In an effort to guide Healthy Fit participants towards the weight loss resources they are most likely to utilize, Healthy Fit staff only refer English speaking women over 50 to TOPS. To identify more participants that are a good fit for TOPS, Healthy Fit staff started recruiting participants from senior centers. After providing a TOPS referral, staff share participant contact information with TOPS members who volunteered to reach out to them to encourage their involvement in TOPS.
Disproportionate to the majority Hispanic population in El Paso, only a small percentage of the El Paso TOPS members are Hispanic. That TOPS material is only provided in English helps to explain this discrepancy. Conducting groups in Spanish may help to engage more of the Hispanic population in El Paso. We suspect the program can be appealing to the Hispanic population because of the cost efficacy and the sense of community, both of which are important parts of Latino culture. According to a TOPS representative, they are working on including Spanish and French materials for future members. To appeal to the younger population, TOPS is currently developing a mobile app.
Lastly, the number of TOPS chapters, their geological locations, and their meeting times may deter El Pasoans from joining TOPS. The El Paso County encompasses more than 1,000 square miles and inhabits approximately 800,000 residents (Community Health Assessment, 2013). Due to the expansiveness of the area, it could be difficult for residents to travel from one part of the county to the other. With only four chapters concentrated in the northeast and east regions of El Paso, it may be difficult for some participants to reach the groups. In the future, more chapters located throughout different regions of El Paso may better serve the community. Additionally, two of the four chapters meet during conventional work hours. These meeting times may conflict with work schedules and could account for the large number of TOPS members over the age of 65.
Overall, our observations of TOPS groups in El Paso suggest participants genuinely enjoy attending TOPS and benefit greatly. Some participants explained their weight loss struggles before TOPS, noting that they tried other weight loss programs but would not see results or found them to be too expensive. Given the risk of becoming patients in the hospital with diabetes or cardiovascular problems, we found it inspiring to see these groups of individuals trying to better themselves and believe TOPS is a unique weight loss solution. For more information regarding Take Off Pounds Sensibly, please visit: http://www.tops.org.
Goldkamp, J., Anderson, S., Lifits‐Podorozhansky, Y., & Gavard, J. A. (2015). Women’s Perceptions Regarding Obesity and Comorbidities and Provider Interaction. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 44(6), 784-792.
Mora, A., Schultz, L. (2013). Community Health Assessment and Improvement Plan – City of El Paso Department of Public Health. Retrieved from https://www.elpasotexas.gov/~/media/files/coep/public%20health/community%20health%20assessment%20final%20report.ashx?la=en
Take Off Pounds Sensibly (TOPS). (2016). How It Works. Retrieved from http://www.tops.org