Tag Archives: prevent weight regain

The Secret to Prevention of Weight Regain

“I couldn’t do this when I weighed 220 pounds.”

Regain of lost body fat is the most problematic area in the field of weight management.  Solves this problem for good, and you Nobel Prize in Medicine.

Why do most diets ultimately fail over the long run?  Because people go back to their old habits.

Here are the two secrets to prevention of weight regain:

1)    Restrained eating

2)    Regular physical activity

“Successful losers” apply self-restraint on a daily basis, avoiding foods they know will lead to weight regain.  They limit how much they eat.  They consciously choose not to return to their old eating habits, despite urges to the contrary.

The other glaring difference is that, compared to regainers, the successful losers are physically active.  Oftentimes, they exercised while losing weight, and almost always continue to exercise in the maintenance phase of their program.  This is true in at least eight out of 10 cases.  It’s clear that regular exercise isn’t always needed, but it dramatically increases your chances of long-term success.

Steve Parker, M.D.

Prevention of Weight Regain

Clinical Diabetes recently published a review article, “Weight Regain Prevention,” summarizing effective strategies for prevention of weight regain after a successful weight-loss program. The article is not specifically for or about people with diabetes. You are probably aware that regain of lost weight is a huge problem.

“One more rep then I’m outa here!”

The authors start with a review of various weight-loss strategies, including low-calorie diets, very low-calorie diets, commercial programs such as Weight Watchers, behavior modification therapy, meal replacements, weight-loss drugs, etc. I recall no mention of bariatric surgery.

To its credit, Weight Watchers is the only commercial program to report data from randomized controlled trials, the gold standard in clinical scientific studies of effectiveness. [Weight Watchers lost more weight than the self-help control group.]

By way of review, here is the typical pattern of a weight loss effort. Maximal weight loss occurs in the first six months, at least for people who are compliant and don’t drop out of the program after the first few weeks. After the initial six months, weight regain starts. By one or two years after start of the effort, most people – but not all – have regained all the lost weight, if not more.

The authors’ recommendations for prevention of weight regain are mostly based on well-designed, published, peer-reviewed, scientific studies. They identified characteristics of successful weight loss maintainers – what I call “successful losers.” The idea is that a person will enhance her odds of keeping the lost weight off by incorporating these habits into her lifestyle:

  • Maintain high levels of physical activity. Consider at least 60 minutes daily of moderate activity. Ouch!
  • Limit television to less that a few hours a day.
  • Eat a diet low in fat and calories. [I disagree with the accross-the-board low-fat recommendation.]
  • Maintain a consistent eating pattern throughout the week and year. Successful losers often report less variety, compared to other people, in all food groups except for fruits.
  • Eat breakfast routinely.
  • Control emotional eating.
  • Weigh frequently, whether daily or weekly.
  • Catch and address weight regain early, before it gets out of hand.
  • Consider sequential medications. E.g., sibutramine for months, then orlistat for months.
  • Individual and/or group follow-up support. Even follow-up by phone works.
  • Have realistic expectations. Most dieters only lose about half the weight they expected in the first place. The resulting sense of disappointment sabotages efforts to keep the weight off. Anticipate the universal tendency to regain lost weight.
  • Helpful diet patterns: eat more than five servings a day of fruits and vegetables, watch portion sizes, self-record food intake, plan meals, limit fast food.
  • “Exercise is central to weight loss maintenance.” And finally . . .
  • “Exercise is central to weight loss maintenance.”

Steve Parker, M.D.

Reference: Ulen, Christina, et al. Weight Regain Prevention. Clinical Diabetes, 26 (2008): 100-113. DOI: 10.2337/diaclin.26.3.100

How to Prevent Weight Regain

Losing excess weight is easier than keeping it off.

Neither is exactly a walk in the park.

Prevention of weight regain is the most problematic area in the field of weight management. You may have heard that “diets don’t work,” but they do. Many different weight loss programs work short-term, if “work” is defined as loss of five, 10, or more pounds while you adhere to the program for several weeks or months. The problem is that the lost pounds usually return.

Why? You get bored with the diet, or your willpower flags, or the diet simply stops working, or the transition from weight loss to maintenance is unclear, or you just feel too bad to go on, or you lose your commitment, or you take a job as a taste tester for Baskin-Robbins Ice Cream, or whatever.

Most diets ultimately fail in the long run because people go back to their old habits.

Read on for the secret to prevention of weight regain. They apply to a majority of weight-loss methods, although many programs ignore this problem because the cure is a hard pill to swallow.

Moving Ahead

For purposes of further discussion, I will assume that you have already lost excess weight down to your goal and now we must focus on staying thereabouts from here on out. Finally down to your goal! A grand accomplishment! You’ve got a new wardrobe, or the old clothes fit again. You have more energy and feel younger. Maybe you cured or improved some health problems. Perhaps you’re getting more attention from the opposite sex.

Our species’ scientific name is Homo sapiens. It is from the Latin sapere, which means “to be wise.” Wisdom is the ability to make correct judgments and decisions. Undoubtedly, your success at weight loss required correct judgments and decisions. You are not done yet. You will need sustained wisdom to avoid weight regain.

Be wise about this especially: you can never again eat all you want, whenever you want, over sustained periods of time.

Now that you have reached your goal weight, you must restrain yourself on a daily basis. Think about it. You became overweight because you didn’t watch what you ate and didn’t exercise enough. You can’t go back to your old ways. Reject this advice, and you have a 100 percent chance of regaining your lost weight.

Have you heard of the Energy Balance Equation?

Calorie Intake minus Calories Burned

= Change in Body Fat

You have been able to lose fat weight because you ate less energy (calories) than your body required for metabolism and physical activity. Your body remedied the energy deficit by converting fat into energy. A pound of fat contains 3,500 calories of energy. If you lost a pound per week, your body on average converted 500 calories of fat daily into energy (7 days x 500 calories = 3,500 calories = 1 pound of fat).

Now that you are at your goal weight and want to stay there, you need to add 500 calories per day back into the equation. Add the calories by eating more food, exercising less, or a combination of the two. But if you add back more than 500, you will regain weight.

The true measure of a successful weight management program is not simply how much weight is lost, but whether the lost weight stays lost over the long run. What distinguishes weight losers who keep the weight off from those who gain it back? Two factors, mostly:

1. Restrained eating

2. Regular physical activity.

“Successful losers” apply self-restraint on an almost daily basis, avoiding food that they know will lead to weight regain. They limit how much they eat. They consciously choose not to return to their old eating habits, despite urges to the contrary. The other glaring difference is that, compared to regainers, the successful losers remain physically active. They exercised while losing weight, and continue to exercise in the maintenance phase of their program. This is true in at least eight out of 10 cases. It’s clear that regular exercise is not always needed, but it dramatically increases your chances of long-term success.

In a nutshell, my maintenance phase prescription for you is: Keep exercising, and eat a little more. Keep exercising, and eat a little more.

Go out of your way to be physically active for 30 to 45 minutes on at least four days per week, if not all days. Walking is fine. The more you exercise, the more you can eat without getting fat again.

At the end of your weight-loss phase and the beginning of the maintenance phase, it is surprisingly easy to start overeating. Forewarned is forearmed. Avoid this landmine any way you can. It helps to continue monitoring food consumption and exercise on your food diary while eating an additional 200–500 calories per day. Continue weighing daily. Keep exercising. After a month or two of this regimen, you’ll have an intuitive sense of what and how much you should be eating without regaining weight. Then stop the daily log routine.

Another option for transition to the maintenance phase: if you have been exercising regularly but loathe it, you could stop exercising and stay on your current calorie level diet. In other words, don’t start eating more. See what happens with your weight. Perhaps you could later eat an extra 100 to 200 daily calories without gaining weight. Continue recording your daily intake and weight for a couple months.

Weigh yourself daily during the first two months of your maintenance-of-weight-loss phase. After that, weigh weekly. Daily weights will remind you how hard you worked to achieve your goal. When you look now at a brownie, candy bar, or piece of pie, you ask yourself, “Do I really want to walk an extra hour or jog an extra three miles today to burn off those calories?” If so, enjoy. Otherwise, forego the unneeded calories.

Be aware that you might regain five or 10 pounds of fat now and then. You probably will. It’s not the end of the world. It’s human nature. You’re not a failure; you’re human.

But draw the line and get back on your old weight-loss program for one or two months. Analyze and learn from the episode. Why did it happen? Slipping back into your old ways? Slacking off on exercise? Too many special occasion feasts? Allowing junk food back into the house? Learn which food item is your nemesis—the food that consistently torpedoes your resolve to eat right. For example, I have two—candy, and sweet baked goods such as cookies and muffins. If I just look at them I add a pound. Remember an old ad campaign for a potato chip: “Betcha can’t eat just one!”? Well, I can’t eat just one cookie. So I don’t get started. I might eat one if it’s the last one available. Or I satisfy my sweet craving with fresh fruit or a diet soda. Just as a recovering alcoholic can’t drink any alcohol, perhaps you should totally abstain from…? You know your own personal gastronomic Achilles heel. Or heels. Experiment with various strategies for vanquishing your nemesis.

It’s OK to overindulge in food infrequently (10–12 times per year), on special occasions such as birthdays, wedding anniversaries, holidays. But you must counteract the extra calories by cutting down intake or by exercising more, either before or after the feast. No big deal.

Click to read additional ideas on prevention of weight regain.

Steve Parker, M.D.