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Maintaining Weight Loss

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Old 06-08-2007, 09:21 AM   #1
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Default Maintaining Weight Loss

A new study from the CDC suggests that keeping weight off lost weight is nowhere near as dismal as the 1 in 20 figures that have been tossed around for years. Here is the link:

http://www.webmd.com/diet/news/10101...nds-off-common

I haven't gone to the original literature and looked up the paper yet, but this is interesting enough that I'm planning to. The article summarizes key findings as:
  • 60% of people who have lost 10% of their body weight kept most of it off for at least a year.
  • The more weight you lost, the more likely you are to regain it.
  • Mexican-Americans were more likely to regain than "non-Hispanic whites or blacks"

The article concludes with a summary of findings from the National Weight Control Registry, which was not a part of the CDC study.

A couple things I saw--this was based on more than 1300 people so it is a good-sized study, but it isn't clear to me from the article if they actually weighed these people or if this is all self-reported. Also, keeping "most" of the lost weight off was defined as 5% or less regain, which effectively means that people could regain half of their lost weight--my feeling is that this would disappoint most dieters, although from a medical point of view this is still fabulous. Finally, this followed people for one year, and I'd be interested in a followup in a few years to see if those trends continue over time.

Any thoughts?

BTW: if anyone wants some real life examples of people who are maintaining weight loss over long times, come to the Maintainer's section of the boards. Maintenance works best when it starts at the first pound lost, and not the last.

Anne
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Old 06-08-2007, 10:15 AM   #2
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Anne, thanks for the link. I find this topic very interesting because I'm less than a month away from my Goal anniversary date. So far, so good. A few slip ups along the way that made me re-evaluate my goals and refocus on my reasons for keeping the wt. off. It is definitely not easy, but it's also not impossible. The maintainers board here is fantastic and has been a big part of my successful maintenance, that is for sure.
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Old 06-08-2007, 11:34 AM   #3
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These are some of the things discussed in the Rethinking Thin book. I'm about half way done--its interesting but a bit depressing as well.

All I can say is this: it's work to lose and it will be work to maintain. I won't be able to slack off in order to keep the weight off (as evidenced by my recent gain).
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Old 06-08-2007, 12:20 PM   #4
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I read the article as saying that people who kept off most of their weight regained less than 5% of the weight they lost. Anne, you seem to be saying that it means they gained less than 5% of their total body weight. That's a big difference! I wonder which interpretation is right? The article isn't very clear:

"The researchers found that nearly 60% of the participants maintained their weight loss, gaining 5% or less of their weight back, while 33% reported more than a 5% weight gain."
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Old 07-07-2007, 04:13 PM   #5
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Ok, I pulled the paper from the original literature and took a look. All weights and height for BMI calculation are self-reported, and the paper does acknowledge that this is a potential weakness of the study, with reference to studies that show women under-report weight, and men over-report height. Participants were asked their height, their maximum weight, their weight one year ago, and their weight today.

The 10% weight loss is based on highest weight and the 5% weight regain is based on weight one year ago. Once again, this is quite clear in the original paper, but not necessarily in the WebMD article that quotes it (referenced above). People who lost 10% of their maximum weight were included in the study, and the cutoff between weight regain and weight maintenance was defined as a gain of 5% of last year's weight.

The sample is relatively large (1310), and at least makes an attempt to be representative of the population of the US at large (or at least the "civilian, non-institutionalized" population), as opposed to self-reported weight maintenance success stories (like our beloved National Weight Control Registry) or graduates of one particular weight loss program or another.

Factors associated with weight regain the authors found include:
  • Mexican American ethnicity
  • greater percentage of maximum weight lost
  • fewer years since reaching maximum weight
  • attempting to control weight
  • greater daily screen time (non-work computer + TV)
  • not meeting physical activity recommendations
The authors also make no claims of causality with these associations, and in fact point out that it is possible that the attempt at weight control is a result of the regain, and not the cause, as there was absolutely no attempt to figure out which came first. They also note that their data was not sufficient to analyze the nutritional side of weight regain.

One point I found interesting is that there was no difference in regain patterns in those who met the "improved health" exercise guidelines of 30 min a day of moderate activity, 5 times a week, and those who met the "sustaining weight loss" guidelines of moderate activity 5 or more times a week, greater than 60 minutes a day.

Other factors considered where no statistically significant effects on weight regain were found:
  • Gender
  • Age
  • Education level
  • BMI one year ago
  • Smoking status
  • Average weekly restaurant food consumption

The paper has a lot of discussion of relative risks of regain for each of these associations and the statistical confidence intervals, that I won't go into here. Note that this paper is about as far as it gets from my own area of expertise, but I didn't find any egregious errors or extravagant claims and was generally impressed with the quality of the study. I think it points out a number of areas to look in more deeply.

Again, what I consider to be the biggest eye opener of the study, almost 2/3 of the people who have lost 10% of their maximum weight, are maintaining most of that weight loss a year later. This is fantastic news! Note that this isn't people maintaining a goal weight, or never gaining an ounce for the rest of their lives, but from a health perspective these numbers are very significant. I am encouraged.

Anne
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Old 07-07-2007, 07:53 PM   #6
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This is very interesting, and I love what you said in your original post:

Quote:
Originally Posted by wndranne View Post
Maintenance works best when it starts at the first pound lost, and not the last.
I'm completely determined to maintain the loss I've had and the future loss I will have as I get to goal and beyond (I'm in the process of setting a new goal). All along the way, I've been planning for maintenance. One of the biggest reasons I got into running was because I believe a commitment to an athletic lifestyle (for reasons beyond weight loss) will help immensely with keeping the weight off.

I think the key difference between people who maintain and people who regain is careful planning, both before reaching goal and during maintenance. I know I'll have to remain vigilant and be careful about my eating for the rest of my life. Accepting that is also key to maintenance.

Oh, and I'll be all over that Maintainers Forum!!

Thanks for posting this, Anne.
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