Winning at Long-term Weight Loss

One of the most discouraging facts of life for obese persons and those who try to help them reach a healthy body weight is the poor long-term results of most weight-loss programs. According to results of a recent study, however, managing to maintain weight loss for several years greatly improves the chances that it will stay off.

The National Weight Control Registry is conducting an ongoing longitudinal study of individuals 18 years of age or older who have lost at least 30 lb (13.6 kg) and have maintained the loss for at least 1 year. Maureen T. McGuire and colleagues studied 714 of the more than 1000 persons listed in the registry, using questionnaires and other measures to determine differences between those who successfully maintained weight loss and those who regained weight (J Consult Clin Psychol 1999;67:177).

The secret: maintaining healthy habits

At one-year follow-up, 248 individuals (35%) had gained more than 5 lb, 420 (59%) maintained their weight loss within 5 lb, and 46 (6%) had lost more than an additional 5 lb.

Several variables emerged that predicted who would gain weight over the year versus those who could successfully maintain weight loss. The variables included higher initial body weight, greater history of weight cycling, higher initial weight loss, shorter maintenance of weight loss, higher levels of both disinhibition and depressive symptoms, and reporting a desire to lose weight—rather than maintain or gain—when they initially entered the study.

Those who regained weight were unable to maintain healthy eating and exercise habits over the long term. Individuals who regained their weight reported marked decreases in physical activity (more than 800 kcal/week) and increases in the percentage of calories from fat with no other change in overall calorie intake. Those who gained weight also reported having increased hunger, dietary disinhibition, and binge eating.

The authors noted that generalizing about the results from this group must be done cautiously because the Registry group may be more highly motivated, better educated, and healthier than the general population. However, they did find that looking at an individual’s weight change history and psychological measures at baseline were helpful for guiding interventions to prevent weight regain.