Many of us have heard the depressing old wive's tale that only 5% of people who try to lose weight can keep it off. The good news is that rumor is not true! The number is a little better than that - around 20% succeed - and even better news is that we have studied those successful "super losers/super-maintainers" to find out what strategies they have in common. While individuals vary in details, there are in fact common "patterns" of behavior that the successful "elite losers" employ. Learning from their experiences can help more people be successful! The National Weight Control Registry is a great source of this information, and other studies have also provided us with key clues and tactics.
Our goal at Physicians Healthy Weight Center is to show you the research, and then customize that research to fit the successful strategies into YOUR lifestyle - with your unique challenges, circumstances, preferences. We show people the "why", then work with them on the "how" of long term weight success. We also help them get back on track when they inevitably slip off the wagon. (In fact, learning how to avoid falling off the wagon, AND how to get back on track, is a key part of long term success.)
While the best results of course are going to be achieved with individual counseling, treatment, and support, we would like to share some of the research so you can start thinking about what works.
Here are excerpts from an excellent article from the American Academy of Family Physicians about weight loss maintenance, along with some of our "translations into English" in italics:
http://www.aafp.org/afp/2010/0915/p637.html
Excerpts from the AAFP article Weight Loss Maintenance:
Weight Loss Maintenance
SAMUEL N. GRIEF, MD, University of Illinois at Chicago, Chicago, Illinois
ROSITA L.F. MIRANDA, MD, MS, Clay County Hospital, Flora, Illinois
Am Fam Physician. 2010 Sep 15;82(6):630-634.
“... Approximately 65 percent of adults in the United States are overweight or obese. Almost one half of the adult population is trying to lose weight at any given time. Although losing weight can be very difficult, the real challenge often is maintaining the weight loss...Research has shown that approximately 20 percent of overweight or obese persons are successful at long-term weight loss...Successful approaches to weight loss maintenance include consulting with a physician, (ideally with a physician who is board certified in Obesity Medicine), nutritionist, or another support source; adhering to a stable diet with a limited variety of food (keeping things simple and choosing "easy favorites" helps with success); monitoring weight (at home or at physician's office for extra accountability); eating breakfast (higher protein breakfasts help weight loss maintenance in research); and exercising regularly (exercise must be tailored to the individual).
Long-term pharmacologic treatments ("weight loss medications") for weight loss maintenance have been studied and were found to have modest success (weight loss medications can help certain people get on track more quickly while they establish new eating and lifestyle patterns, and can help later if people face new challenging life circumstances which may put them at risk of relapse)...
(How success is defined, and by whom): Successful weight loss maintenance is defined as losing at least 10 percent of one's initial body weight and maintaining the loss for at least one year. The 10 percent threshold was initially suggested because weight loss of this magnitude can lead to (health benefits)...in lipid ratios (cholesterol numbers), blood glucose homeostasis (blood sugar control), and risk of heart disease, all of which have been well-documented...the definition of successful weight loss maintenance was selected based on criteria from the Institute of Medicine.
Long-term adherence to a diet and exercise program is the key to success (it is important to create long-term, livable strategies, rather than short-term gimmicks or extreme diets)...The National Weight Control Registry (NWCR) is the longest prospective compilation of data and information from persons who have successfully lost weight and maintained their weight loss..(a majority) of registry participants reported receiving some type of help with weight loss (e.g., commercial weight loss program, physician, dietitian or nutritionist)...
The most common dietary strategies for weight loss were to restrict certain foods (*“trigger foods”*) (87.6 percent), limit food quantities (44 percent), and count calories (43 percent). Regardless of the diet employed, the strategy for successful weight loss maintenance usually entailed dietary modification plus physical activity... Research has determined that certain strategies, such as weighing oneself, planning meals, tracking fat and calories, exercising at least 30 minutes daily, and adding physical activity into one's daily routine, are important in successful weight loss maintenance. Barriers to exercise (e.g., being too tired, having no time or no one with whom to exercise, finding it too hard to maintain an exercise routine) were associated with being unsuccessful at losing weight (barriers need to be identified and addressed) ... time pressure and lack of social support seem to be important hindrances in achieving exercise-related goals (successful people need strategies to simplify their routines to save time, and they also need to have a support team.) Reducing consumption of fast foods can also assist persons in keeping weight off (cutting out junk food/addictive food improved success.)
Long-term pharmacologic treatments ("weight loss medications") for weight loss maintenance have been studied and were found to have modest success (weight loss medications can help certain people get on track more quickly while they establish new eating and lifestyle patterns, and can help later if people face new challenging life circumstances which may put them at risk of relapse)...
(How success is defined, and by whom): Successful weight loss maintenance is defined as losing at least 10 percent of one's initial body weight and maintaining the loss for at least one year. The 10 percent threshold was initially suggested because weight loss of this magnitude can lead to (health benefits)...in lipid ratios (cholesterol numbers), blood glucose homeostasis (blood sugar control), and risk of heart disease, all of which have been well-documented...the definition of successful weight loss maintenance was selected based on criteria from the Institute of Medicine.
Long-term adherence to a diet and exercise program is the key to success (it is important to create long-term, livable strategies, rather than short-term gimmicks or extreme diets)...The National Weight Control Registry (NWCR) is the longest prospective compilation of data and information from persons who have successfully lost weight and maintained their weight loss..(a majority) of registry participants reported receiving some type of help with weight loss (e.g., commercial weight loss program, physician, dietitian or nutritionist)...
The most common dietary strategies for weight loss were to restrict certain foods (*“trigger foods”*) (87.6 percent), limit food quantities (44 percent), and count calories (43 percent). Regardless of the diet employed, the strategy for successful weight loss maintenance usually entailed dietary modification plus physical activity... Research has determined that certain strategies, such as weighing oneself, planning meals, tracking fat and calories, exercising at least 30 minutes daily, and adding physical activity into one's daily routine, are important in successful weight loss maintenance. Barriers to exercise (e.g., being too tired, having no time or no one with whom to exercise, finding it too hard to maintain an exercise routine) were associated with being unsuccessful at losing weight (barriers need to be identified and addressed) ... time pressure and lack of social support seem to be important hindrances in achieving exercise-related goals (successful people need strategies to simplify their routines to save time, and they also need to have a support team.) Reducing consumption of fast foods can also assist persons in keeping weight off (cutting out junk food/addictive food improved success.)
Persons who maintain a stable day-to-day diet and do not appreciably change their diet on weekends, holidays, or special occasions tend to experience less weight regain over the subsequent year and are 1.5 times more likely to maintain their weight loss (don't turn weekends into a free-for-all, and you'll be more successful long term.)
Brief, monthly personal contact between patient and physician or patient and educator has been shown to be more effective in accomplishing weight loss maintenance than other methods of interaction, including Web-based technology (face to face support and accountability is a key to success.)
Physicians can assist their patients with maintaining weight loss by reinforcing healthy dietary and exercise habits; regularly monitoring weight, body mass index (BMI), and waist circumference; encouraging additional support from nutrition counseling and cognitive behavior therapy, when indicated; and addressing other risk factors for weight regain (a comprehensive approach works best, including counseling/life-coaching by a trained physician.)
Social support, better coping strategies, and the ability to handle life stressors are factors associated with successful weight loss maintenance (it's not just about food and exercise, life challenges also need to be addressed.)
Food journaling is an additional proven strategy for short-term weight loss and successful weight loss maintenance (journaling is not fun, but it works. It can be a 'detective tool' to identify problems, so they can be fixed.)
Physicians can assist their patients with maintaining weight loss by reinforcing healthy dietary and exercise habits; regularly monitoring weight, body mass index (BMI), and waist circumference; encouraging additional support from nutrition counseling and cognitive behavior therapy, when indicated; and addressing other risk factors for weight regain (a comprehensive approach works best, including counseling/life-coaching by a trained physician.)
Social support, better coping strategies, and the ability to handle life stressors are factors associated with successful weight loss maintenance (it's not just about food and exercise, life challenges also need to be addressed.)
Food journaling is an additional proven strategy for short-term weight loss and successful weight loss maintenance (journaling is not fun, but it works. It can be a 'detective tool' to identify problems, so they can be fixed.)
Pharmacologic treatment may be considered as an adjunct to lifestyle changes (weight loss medications are not meant to replace healthy lifestyle, they are supposed to facilitate healthy lifestyle.)...Indications for pharmacotherapy (criteria to quallfy for weight loss medication) are a BMI of at least 30, or a BMI of at least 27 with weight-related comorbidities (anyone with a BMI of 30 and above may be considered for weight loss medication, and anyone with a BMI of 27 or above who has a health problem related to excess weight, such as high blood pressure or diabetes, may be considered for weight loss medication.)
A recent prospective case-control comparison of surgical and nonsurgical methods in NWCR participants demonstrated no statistical difference between either method in achieving weight loss maintenance. (Bariatric surgery does not result in better weight loss maintenance than nonsurgical treatments.) This suggests that behavioral changes can achieve the same results as surgical interventions when patients are sufficiently motivated and supported." (This actually comes as a surprise to many patients, and even to many physicians who are not weight loss specialists - that weight loss surgery is no more successful than nonsurgical treatment, when the nonsurgical approach is comprehensive, and the patients are given support and motivation.) We can help you with all phases of the process - setting up a healthy weight loss lifestyle strategy, supporting you while the new lifestyle becomes "second nature", and then we can help you stay on track during maintenance. It is our job to translate the science into real-life strategies that fit your unique needs and health/medical challenges. We are glad to help! Read more about our program at healthyweightcenter.com .
Call any time at (6030 379-6500.
References:
1. http://www.aafp.org/afp/2010/0915/p637.html
2. The National Weight Control Registry http://www.nwcr.ws/
3. Unites States Preventive Services Task Force: "The USPSTF recommends screening all adults for obesity. Clinicians should offer or refer patients with a body mass index (BMI) of 30 kg/m2 or higher to intensive, multicomponent behavioral interventions. " http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/obesity-in-adults-screening-and-management#Pod2
4. New US Obesity Guidelines: Treat the Weight First; January 16, 2015 http://www.medscape.com/viewarticle/838285
