From Our 2011 Archives
Tactics Are Different for Weight Loss, Maintenance
Study Suggests Separate Skill Sets Are Needed to Lose Weight and Then Keep It Off
By Denise Mann
Reviewed by Louise Chang, MD
July 5, 2011 -- The same tactics that help you lose weight won't necessarily help you keep it off.
The new study, which appears in August issue of the American Journal of Preventive Medicine, suggests that successful losers need to switch gears to stay the course and maintain their weight loss.
Researchers surveyed 1,165 adults about 36 specific practices to determine which of these behaviors was associated with weight loss and/or weight loss maintenance. Weight loss referred to losing 10% of body weight or more in past year, while maintenance was defined as losing 10% or more of body weight and keeping it off for one year or more.
Overall, different skill sets and behaviors are involved with weight loss and weight maintenance. For example, participating in a weight loss program, limiting the sugar in your diet, eating healthy snacks, and not skipping meals may help you lose weight initially, but these practices don't have all that much to do with maintaining the loss.
Eating lots of low-fat sources of protein, following a consistent exercise routine, and rewarding yourself for sticking with your plan and reminding yourself why you want to keep your weight off were linked to maintaining weight loss, but not the earlier weight loss, the study showed.
"Realizing this difference, shortly after the six-month time period of average maximal weight loss has passed, is really important," says study researcher Christopher Sciamanna, MD, a professor of medicine and public health sciences at the Penn State College of Medicine, in an email. "It seems somewhat similar to love and marriage. What gets you to the altar is likely to be quite different than what keeps you married in the long-term. [And] not recognizing this transition and adapting with different practices will also get you in trouble."
"It's a slightly different process," he says. "To be successful one must adapt to this different process or risk being less successful," he says. "Yes, it still comes down to decreasing caloric intake and/or increasing caloric expenditure, but the practices that help you achieve those, based on our study, appear to be different."
Weight Loss vs. Weight Maintenance
Losing weight is the (relatively) easy part, says James O. Hill, PhD, a professor of pediatrics and medicine and director of the Center for Human Nutrition at the University of Colorado at Denver. Hill and colleagues are keeping track of those who can maintain their weight loss via the National Weight Control Registry.
The new study "reinforces what we have been saying about differences between losing weight and keeping it off," he tells WebMD.
It is a three-phase process: weight loss, transition to maintenance, and maintaining the weight loss, Hill says.
"Getting the weight off is only one task, which is followed by switching your mind-set to a more permanent way of living so you keep it off," he says.
The second part of the battle can be an uphill one, and it's one of the reasons that so many high-profile celebrities lose weight only to regain it. "People still want to concentrate on losing weight, but the harder part is keeping it off," he says.
Hill says that increasing physical activity is essential to maintaining any weight loss.
"Unless you are able to ramp up your physical activity in a pretty major way, you won't keep the weight off," he says. Another key ingredient is a strong social support system. "You need to create the right kind of social network to reinforce the routine of both diet and exercise."
Timothy Harlan, MD, an assistant professor of medicine at Tulane University School of Medicine, a former restaurateur known as "Dr. Gourmet," and author of Just Tell Me What to Eat!, says that the key to maintaining weight loss involves changing our mind-set.
"If you want to be healthy, lose weight, and keep it off, you need to change the way you eat," he says.
The word diet implies a beginning and an end and sets you up for failure, Harlan says,
"Eating healthy and being healthy is a lifelong prescription," he says. "If you want to lose weight and you want to keep it off, you have to completely change your relationship with food forever."
"Planning is the single most important thing people can do to lose weight and maintain that loss," Harlan says. This means planning what you are going to eat and when you are going to eat it -- same as you plan your children's schedule and your workday. This may involve packing your own lunch and not skipping breakfast.
SOURCES: James O. Hill, PhD, professor, pediatrics and medicine; director, Center for Human Nutrition, University of Colorado, Denver.Timothy Harlan, MD, assistant professor of medicine, Tulane University School of Medicine, New Orleans.Sciamanna, C.N. American Journal of Preventive Medicine, 2011.Christopher Sciamanna, MD, professor, medicine and public health sciences, Penn State College of Medicine. ©2011 WebMD, LLC. All Rights Reserved.