The hardest part about weight loss---keeping it off

There is nothing more discouraging to someone on a weight-loss plan than the oft-cited statistic that 95% of people who lose weight will regain it within a few years. The difficulty in sticking with a long-term weight-maintenance plan is one of the main reasons that weight-loss programs fail. In an effort to uncover clues to successful weight loss, researchers have been collecting information on people who have lost weight and successfully kept it off for many years. This project, known as the National Weight Control Registry (NWCR), records what these people did to achieve their goals.

Currently, the NWCR is tracking more than 5,000 people, who receive detailed questionnaires and annual follow-up surveys to examine their behavioral and psychological characteristics, as well as the strategies they use to keep weight off. Note, however, that these people are self-selected (that is, they chose to participate) and therefore represent only successful “losers,” not the entire population of people who have tried to lose weight. There is no evidence that the techniques and approaches these people use are the key to success, because many other people have used similar approaches without success. Nonetheless, their stories may prove helpful or inspirational for some people.

NWCR findings suggest that people who maintain weight loss over the long term are those who develop methods of incorporating healthy, low-calorie eating and regular physical activity into their daily lives. They are also highly motivated to continue doing so over the long term. Some are motivated by an experience that frightened them — for example, finding out that they were at high risk for a serious illness. Others reported feeling extremely unhappy with the way they looked and felt.

Their diet plans and physical activities differ widely, but one thing that these individuals have in common is that they chose strategies that they liked, that fulfilled some personal goal, and that they could stick with.

For example, in what is certainly one of the greatest success stories in the registry, one woman managed to overcome a strong genetic predisposition toward obesity and lose more than half her weight. She had had obesity since childhood, and at age 36 she reached her greatest weight, 325 pounds. The turning point came when an earthquake shut down the elevator in her apartment building, and she found herself unable to climb the stairs to her apartment. Over the next 2 years she lost 160 pounds by dieting and exercising. She ate smaller portions of food, cut back on fat, and started walking regularly. She added biking, weight training, and yoga to her regimen of physical activity. She has maintained her new weight at 165 pounds for 4 years.

Not everyone can rely on an earthquake for motivation, but it is possible to search for motivating factors in your own life. For some people, serious health problems may serve that function; for others, a romantic interest may be key. Likewise, no weight-loss or treatment plan will work for everyone. Ultimately, you have to find a way to eat healthfully and get regular physical activity that you enjoy. For some people, the answer may be a vegetarian diet, scheduled tennis matches, and biking. Others might prefer having at least some lean meat or fish, and taking long walks for exercise.

Research has shown that the more freedom people have in planning their weight-loss programs, the greater their prospects for success. A study in the British Medical Journal compared the outcomes of women following two maintenance-diet plans having lost weight through a medically supervised weight-loss plan. Over a yearlong period, one group of women selected meals and snacks from a menu of foods that added up to a set number of calories per day. The other group could eat whatever they wanted within certain general guidelines. The guidelines involved avoiding fried foods, cutting back or eliminating the use of butter or margarine on bread, eating lean meats, and eating more complex carbohydrates, such as brown rice or whole-wheat bread. After one year, the women on the calorie-restricted diet regained an average of 9 pounds, but those who ate what they wanted — within the healthy-eating guidelines — regained less than half that amount.

Research has identified several characteristics of people who have successfully kept pounds off. These are listed below. People who want to lose weight might consider following their example.

·         Many people in the NWCR ate on a schedule of three meals and two snacks a day and didn’t deviate from it.

·         Most also ate healthier foods in smaller amounts and exercised regularly — and kept on doing these things even after they reached their target weights.

·         They generally reduced their consumption of junk foods, such as cookies, donuts, and ice cream.

·         They typically did not lose weight quickly, but they lost it consistently. Some people lost weight over a period of several years.

Other research shows that among half of all people who lost weight over the long term, frequent contact with a health care practitioner led to more successful weight-loss maintenance. Such visits, even if they lasted only a few minutes and consisted of little more than being weighed by a nurse, helped keep people motivated to eat healthfully and stay active enough to maintain their weight loss.

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Being overweight isn’t just a matter of appearance. Carrying excess weight can raise your risk of several chronic diseases, including heart disease, stroke, and certain cancers. Start lowering that risk with Weigh Less, Live Longer: Strategies for successful weight loss, a special report from Harvard Medical School that helps you personalize an effective weight-loss plan. Equip yourself with all the tools you need to lose weight safely and, most importantly, keep it off.

 
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