Landmark studies on the maintenance of weight loss with lifestyle modification are reviewed here. Overall, these studies demonstrate that weight maintenance – although challenging – is possible.

The National Weight Control Registry (NWCR)

This registry has identified the lifestyle modifications practiced by those individuals who were able to successfully maintain weight loss. The study concluded that most weight loss can be maintained over 10 years, but that it requires a sustained behavior change. The NWCR found characteristics common to successful weight-loss maintainers:

• Most self-monitored their dietary intake and physical activity
• 78% ate breakfast every day
• 75% weighed themselves once-weekly or more frequently
• 62% watched ≤10 h of television per week
• 90% exercised, on average, about 1 h per day of physical activity

The opposite was unfortunately true. A decrease in leisure-time physical activity, dietary restraint and frequency of self-weighing and an increase in the proportion of calorie intake derived from fat were associated with a greater weight regain.

The Look AHEAD

Factors indicative of the long-term success included use of meal replacements (protein shakes and meal bars), high levels of exercise, self-monitoring and individualized diets using ‘healthy meal plans’ that worked with personal and cultural food preferences.

The Diabetes Prevention Program (DPP)

‘Successful’ participants who maintained weight reductions had planned meals in advance and selected lower calorie foods, and had self-monitored their food intake, calories and weight. Moreover, weekly group sessions emphasizing these behavior skills – particularly self-monitoring – were a key component of successful long-term weight management and diabetes prevention.

Other studies mention the physiology of body weight re-gains. Some folks would call this the “fat-attack” which calls for contingency planning.