We all want to be lean, mean, healthy and ready to take on the world. Unfortunately, societal norms have dictated otherwise. With late night cravings, 24 hour fast food readily available to satisfy those cravings and the constant go, go, go during the day, who has time to get healthy, lose weight, eat right and worst of all, once you finally commit to that change, go through the transformation and lose the weight, who wants to keep that new challenging lifestyle up to maintain the weight loss? According to research that is out there, the answer is a resounding NOBODY!
That is not entirely true and that does not paint the entire picture. The reality is that the answer is emphatically not NOBODY, in fact I would venture to guess that the answer lies more towards the other extreme of almost 100% of the people who lose the weight want to keep the weight off and maintain that new lifestyle. What causes the weight gain to occur after a successful transformation comes more from a lack of preparation, planning and understanding of how to do this as opposed to simply reaching the goal and then going back to the old habits. According to one study, it was determined that one of the psychological determinants for the weight re-gainers is the ability to mentally handle obstacles such as a slight increase in weight during a maintenance phase so rather than regrouping and getting the weight back off, it derails them into a relapse. (1) Another factor noted is regarding caloric intake and binge eating. These two factors pair nicely as a perfect storm to cause failure. One thing that should be common knowledge to anyone reading this article is that to lose weight, one must change his or her caloric intake, usually in the form of a reduction in daily calories and according to this same article, their intake of dietary fats (1). The problem for most people is that just like we have daily habits, our stomach also has a mind of its own with its very own habits as well. One of those habits, especially for someone who has been obese and eaten as such is that our stomachs then grow to expect a certain number of calories. However, this number of calories that our stomachs are used to taking in is a level that will not sustain our new weight and will cause calories to be converted into body fat and all the hard work put in to lose the weight starts to diminish in return value. One of the cause and effects of this stomach habit is to set out for the day with the intent to consume an adequate amount of food for your current weight which will most likely be less than you are used to consuming and with the lack of motivation stemming from the challenge of losing the weight, it is easy to give in at the end of the day to those cravings for sugar, fats and other oh so tasty treats through an action called “binge eating”!
Now lets talk about some statistics and numbers. From 1996-2005, a study was conducted that included 14,306 test subjects from across the United States. These test subjects ranged in age, gender and ethnicity, socio-economic background. This populous of test subjects comprised the NHANES or the National Health and Nutrition Examination Survey (2). The parameters for being considered successful maintaining their weight was an initial reduction in bodyweight by 10% and staying at that level for one year or longer. The results of this study showed that 1 out of 6 people were able to successfully complete this challenge of long-term weight loss maintenance or approximately 16.7%. In another study that broke down the specifics between genders conducted in 2001 that had test subjects check in annually for a re-weigh and follow-up for 4 straight years and had the strict criteria that to be successful, the subject had to maintain 100% of their initial weight loss over the duration of the study showed that there was a drastic variance between the two sexes (3). In layman’s terms, women kicked the butt of the men in the study. The statistics were viewed two-fold, meaning they were looked at directly and accounted for those that managed to meet the criteria at each of the 4 annual check in meetings and then a cross-sectional that had a less strict criteria, allowing test subjects to miss a year in the middle but as long as weight loss maintenance was maintained at the end of the 4 years, they would be deemed successful. In looking at the first review of test subjects meeting across the board of all 4 years, 0.9% of men and 5.3% of women met this challenge successfully (3) which is not a good looking statistic. However, in looking at the cross-sectional data, the numbers were a bit more optimistic. The numbers from this view of the data showed 2.6% of the men studied and 28.9% women showed positive results. The take-away that was garnered from this data is that when someone sets out to lose weight and reaches that goal; it is then a battle of going up and down and not something that is simply going to be maintained in a static way across the board. This ties back in to the earlier statement around having that self-control and psychological ability to handle obstacles such as minor fluctuations in weight over the course of a 4-year study.
At this point it is blatantly clear that weight maintenance is a difficult challenge. There are a number of contributing factors that led an unsuccessful attempt at maintaining a test subjects weight loss, the ones already mentioned as well as not having a support network in place to encourage continued behavioral changes, lack of self-motivation to keep a person going once the initial weight loss challenge is completed, complacency in actions such as lack of discipline to not give in to “cheat meals” and snacking temptations as often as previously allowed and a number of other factors (4). Along with all of the psychological and environmental factors mentioned, another highly contributing factor was a lack of any sustained levels of physical activity (5).
So with all of this negative statistical data and a proverbial laundry list of barriers stopping a person from successfully maintaining their weight loss after completing a transformation lets determine some steps that a person can put into place to set themselves up for success as opposed to becoming another statistic. According to a study published in the International Journal of Behavioral Nutrition and Physical Activity, there is in fact a list of traits that are common in test subjects that over the course of various studies have been shown to assist in maintaining weight loss. Some of them we have mentioned. The list of the top five common traits or lifestyle changes that successful subjects implemented were, starting with the most common trait, 1. Reduced daily total caloric intake (79.6% of successful weight loss maintainers). 2. More fruits and veggies consumed (71.37%). 3. Smaller portions consumed at each meal (64.57%. 4. Less high fat foods (60.13%). 5. No sweetened beverages (56.5%).
These 5 traits or a large combination of them were common in a lot of successful participants in the study so it cannot be a coincidence that these traits work. Another contributing factor was, as mentioned earlier, an inclusion of physical activity. In this particular study, exercising for at least thirty minutes a day was the 6th most common trait amongst the successful participants with a common inclusion rate of 46.91%. The idea of exercising is a daunting thought. First, all of these lifestyle changes regarding a persons nutrition have to be implemented and now they are faced with the task of getting up off of the couch and breaking a sweat everyday. Fear, lack of time, too many responsibilities such as family, work, etc and a myriad of other excuses can easily come to mind to avoid getting in a daily dose of physical exercise. But the proof is in the pudding that coupling the lifestyle and nutrition changes with a daily physical activity can have immensely greater results in maintaining weight loss.
In the study published in the IJBNAPA mentioned earlier, it was concluded that those attempting to lose and maintain weight loss had as high as a 76% greater chance of being unsuccessful if they did not include at least 30 minutes of physical activity per day (5). That number is staggering and goes to show that the entire process of losing weight and maintaining weight is a multi-faceted undertaking.
In conclusion, obesity is running rampant in the United States, there is no denying that. With the advent of social media with things such as Facebook, Instagam, Twitter and the like, there has never been more information so readily at a person’s disposal on any topic they want. That includes nutrition and fitness. So with the rebirth of the fitness craze, similar to the one that spawned itself in the early 1980’s and 90’s, people are flocking to the gym, Whole Foods grocery stores, local farmer’s markets and doing everything they can to jump on the bandwagon. The problem is once they lose the weight; they have no clue what to do next. This is apparent by the low success rates of multiple studies on the topic of weight maintenance. However, with a properly planned approach and some self-accountability and motivation there are methods to set people up for success. There are 2 halves to most sporting events. In this case, the initial phase of weight LOSS is simply the first half and to win the game, a person needs to be ready to come out of halftime with their game face on and be ready to go for the second half!
(1) Elfhag J, Rossner S. Who Succeeds in Maintaining Weight Loss? A Conceptual Review of Factors Associated with Weight Loss Maintenance and Weight Regain. Obesity Reviews. 2005. 6, 1. 67-85.
(2) Kraschnewski JL, Boan J, Esposito, J, Sherwood NE, Lehman EB, Kephart DK, Sciamanna CN. Long Term Weight Loss Maintenance in the United States. International Journal of Obesity. 2010. 34. 1644-1654
(3) Wing RR, Hill JO. Successful Weight Loss Maintenance. Annual Review of Nutrition. 2001. 21. 323-341.
(4) Gupta H. Barriers to and Facilitators of Long-Term Weight Loss Maintenance in Adult UK People: A Thematic Analysis. International Journal of Preventative Medicine. 2014. 5, 1. 1512-1520.