Successful weight loss maintenance: Top 5 common factors

Long term weight loss

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By Rod Navajas

Most would agree that weight loss is a hard and daunting process. It’s very common for people to be very enthusiastic at the beginning. Unfortunately, a great proportion of people will give up before they reach their goal. But for those who succeed in a weight loss program, they are now faced with an even harder task: weight loss management. 

In fact, in a meta-analysis of more than 29 long-term weight loss studies (1), amongst those who managed to lose weight initially, more than 50% of the weight lost was regained after 2 years. By 5 years, more than 80% of the weight lost had been regained (Fig 1). Certainly, a very discouraging statistic for those interested in long-term weight loss. 

Fig 1: Percentage of weight lost regained in relation to the years after the initial weight loss. 

Luckily, as with most cases, we do have the outliers: those who are able to maintain the weight off well beyond the 5-year mark. Being able to identify certain common characteristics amongst those who successfully kept the weight off, can then become an important observational exercise in order to guide behaviors for those interested in long term success. 

Common factors of successful long-term weight-loss participants:

1. Increased physical activity

As you lose weight, the amount of energy you spend also gets reduced. In fact, it has been estimated that for every kilogram of body weight lost, there is a linear reduction in calorie expenditure of about 30kcal/day (2). It may not seem much, but at the same time, your appetite also increases. The combination of those 2 factors can be very detrimental for the weight loss maintenance process. 

Exercise can be a great ally to maintain energy expenditure high and stable. High levels of daily physical activity (1hour/day) has been reported amongst those who managed to keep their weight off beyond the 5-year period (3). 

2. Realistic Goal Setting

It’s very common for people engaging in a weight loss program to be unrealistic with their expectations towards weight loss. Setting goals that are unreachable, results in failure and disappointment. A personalized, adjustable goal that takes into consideration unique life circumstances and can be modified if necessary, tends to be associated with successful long-term weight loss programs (4).

3. Continuous Monitoring

This includes not only self-monitoring of calories and body weight for example, as well as ongoing monitoring by health-care practitioners, including nutritionists and personal trainers (4). 

This practice guides the process. If the results are good, continuation is encouraged. On the other hand, if results are not satisfactory, it gives the opportunity to reassess and modify the plan if necessary.

4. Flexible Eating

Long term restriction of certain foods, usually results in failure amongst dieters. Having a good understanding of nutrition, and the ability to introduce favorite foods without compromising the outcome of the plan, is essential if long-term success is desired (5). 

On this topic, quantity matters! Having a bite of your favorite dessert every now and then, is very different than going on a regular weekend binge. 

5. Consistent eating pattern across the week

Having set meal times and similar eating behavior throughout the week, has been associated with successful long-term weight-loss management (3). This creates a stable physiological environment where the body is not exposed to erratic eating behaviors. It also creates a baseline in which small adjustments can be easily introduced when necessary. 

Nonetheless, these factors are meaningless without a strong motivational factor that kicks off this process.

Finding your “why” is then the first step in any weight loss program! 

References:

  1. Anderson, J. W., Konz, E. C., Frederich, R. C., & Wood, C. L. (2001). Long-term weight-loss maintenance: a meta-analysis of US studies. The American journal of clinical nutrition74(5), 579-584.
  2. Hall, K. D., & Kahan, S. (2018). Maintenance of lost weight and long-term management of obesity. Medical Clinics102(1), 183-197.
  3. Wing, R. R., & Phelan, S. (2005). Long-term weight loss maintenance–. The American journal of clinical nutrition82(1), 222S-225S.
  4. Spreckley, M., Seidell, J., & Halberstadt, J. (2021). Perspectives into the experience of successful, substantial long-term weight-loss maintenance: a systematic review. International Journal of Qualitative Studies on Health and Well-being16(1), 1862481.
  5. Karhunen, L., Lyly, M., Lapveteläinen, A., Kolehmainen, M., Laaksonen, D. E., Lähteenmäki, L., & Poutanen, K. (2012). Psychobehavioural factors are more strongly associated with successful weight management than predetermined satiety effect or other characteristics of diet. Journal of Obesity2012.

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