Weight Loss Maintenance - May 2022


California Polytechnic State University researchers investigated the experiences of people who successfully maintained weight loss over the long term. Researchers have determined that about 20 percent of Americans who lose weight can sustain the loss and experience better health and quality of life. The research team’s objective was to identify significant themes from a large sample who answered six open-ended questions about weight-loss triggers, current motivations, strategies, and experiences.

For example, one of the questions was, “What is one piece of advice that you would give to help someone succeed at long-term weight loss?” The research team chose to use open-ended questions because they can capture a variety of thoughts, feelings, values, behaviours, and beliefs related to the experience of long-term weight-loss maintenance. The researchers used data from 6,139 WW International, Inc. (formerly Weight Watchers) clients, 92 percent women, who had lost 50 pounds for at least three years. This study was the first to use machine learning (a form of artificial intelligence) and topic modelling to analyze the data. 

The results, published in The Journal of the Obesity Society, included: 

  • Motivators to lose weight and maintain weight loss - obesity-related memories, health concerns (diabetes and heart conditions, mobility, and fatigue mobility, concerns about fatigue), and appearance (a significant motivator as people feel shame and disgust when looking at photos or in the mirror). A motivator was the desire to “become normal.” Participants reported feeling embarrassed when clothes shopping and not being able to fit into clothes. 
  • Advice to people wanting weight loss success - maintain perseverance despite setbacks (restarting the next day anew or as soon as possible and seeing setbacks as temporary interruptions as opposed to failures) and keep track of food intake. Other studies support keeping track as a core component of standard behavioural obesity treatment and most evidence-based treatment approaches. The message is, “Don’t ever give up.”  
  • Rewards for weight management efforts - significant improvements in confidence, pain, mobility, body image and mental and physical health. Many reported that being able to fit into clothes was the most significant change from weight loss. For some, these positive improvements were motivators to continue. Negatives were the costs of buying new clothes, sagging skin, and unexpected criticism from others. 

The study authors comment that the findings may influence how health care professionals approach weight loss with their clients, e.g., emphasizing perseverance, keeping track of food intake, and highlighting changes in medical status. The study highlighted that society needs to address weight stigma. A major study limitation was that the participants were primarily white, female, married, educated and at least middle income, so results may not be generalized to other populations. 

Another source of information on successful weight loss maintenance comes from the US National Weight Control Registry. It represents the most extensive prospective study (a study that follows a group of similar individuals over time) of long-term successful weight loss maintenance. Rena Wing, PhD, from Brown Medical School, and James O. Hill, PhD, from the University of Colorado, established the registry in 1994. The criteria for being on the registry is to be 18 years of age and older and have maintained a minimum 30-pound weight loss for at least one year or more. The registry has over 10,000 participants. Some critical behaviours for successful weight loss maintenance that have emerged from the data include: 

  • Most report maintaining a low-calorie, low-fat diet and high activity levels
  • 78 percent eat breakfast every day
  • 75 percent weigh themselves at least once a week
  • 62 percent watch less than 10 hours of TV per week
  • 90 percent exercise, on average, about 1 hour per day
Sources: StudyFinds website, EurekAlert! website, Science Daily website, TODAY website

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