The odds of long-term weight loss success

24

Replies

  • cwolfman13
    cwolfman13 Posts: 41,865 Member
    try2again wrote: »
    cwolfman13 wrote: »
    try2again wrote: »
    CSARdiver wrote: »
    Data is not destiny.

    It doesn't matter if X % of population A does B. What matters is what you do.

    I would hope that no one would take a statistical percentage and use it to decide their "destiny" as it pertains to weight management, just as I would hope a person with cancer wouldn't let mortality rates dictate whether they sought treatment or not. But we are usually still interested in the numbers, and often it can provide motivation.

    Unfortunately, a lot of people do...I personally don't understand the mindset of "destiny"...we are all more or less in control of the way we choose to live our lives and thus the outcome.

    I guess I should have phrased it differently... I know some people are bound to do that. Just wondering if the implication was that it's a disservice to people to discuss the #s?

    I don't think it's a disservice necessarily...but I also don't find those numbers to be particularly meaningful. As mentioned above, I think looking at the trends of long term successful people and what they typically do in their day to day lives to be more helpful and insightful.

    As a person going on 5 years maintenance I can pretty much tick off most if not all of the boxes of those trends or qualities of people who have maintained long term.
  • catherineg3
    catherineg3 Posts: 127 Member
    "research has shown that approximately 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg (73#) and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity ( approximately 1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2-5 y, the chance of longer-term success greatly increases."
    https://www.ncbi.nlm.nih.gov/pubmed/16002825
    This is at least better than <5% :)
  • Need2Exerc1se
    Need2Exerc1se Posts: 13,575 Member
    try2again wrote: »
    NorthCascades wrote: »
    I don't think maintaining is very difficult. If you made it through the weight loss, now you get to eat more.

    Yes, but many approach weight loss as a short-term project and once the weight is gone, or they've achieved a significant amount of loss, they slowly (or quickly) ease back into the bad habits that got them there in the first place.

    I don't think it's always that. I think reward plays a significant role. When you are losing weight there are constant rewards. The scale going down, smaller sized clothes, compliments from others, etc. But that mostly goes away in maintenance.
  • LilFoxtrot
    LilFoxtrot Posts: 91 Member
    cwolfman13 wrote: »
    People are generally really bad at reinventing themselves and making long term changes to the way they go about their lives.

    I guess I'd like to believe more people are capable of doing it than the reality might be.

    Either way, I think using a statistic like this to gauge your own rate of success is demoralizing. I don't want to look at the odds and think 'well *kitten* why bother'. I'd rather believe everyone is capable than believe in only 20% of us.
  • cwolfman13
    cwolfman13 Posts: 41,865 Member
    LilFoxtrot wrote: »
    cwolfman13 wrote: »
    People are generally really bad at reinventing themselves and making long term changes to the way they go about their lives.

    I guess I'd like to believe more people are capable of doing it than the reality might be.

    Either way, I think using a statistic like this to gauge your own rate of success is demoralizing. I don't want to look at the odds and think 'well *kitten* why bother'. I'd rather believe everyone is capable than believe in only 20% of us.

    Everyone is capable...being capable and actually doing what is necessary long term are two different things entirely.

    When I first started over 5 years ago I was obese, my diet was rubbish, I did nothing in the way of exercise, my general activity was very low due to sitting at a desk most of the day, I was a 2-3 PAD smoker and I could barely walk my dog around the block without feeling like I was going to die.

    I lost weight, but I also made a commitment to live a more healthful life...my diet is a far cry better than it used to be...I exercise regularly...I no longer smoke cigarettes...I don't spend all my free time sitting around drinking beer. A lot of time and effort went into developing healthier habits and dropping old bad habits and it wasn't particularly easy...it has also required discipline to maintain those healthy habits and not fall back into the lazy life I once lived.

    While everyone is capable, many people simply won't make that long term commitment...not to mention, a lot of people get to maintenance and it's kind of a "now what" kind of thing...there is no longer a goal of some particular weight...there's no longer the anticipation and excitement of watching the scale go down, etc...the compliments and accolades cease...it's just boring old maintenance...which is where fitness goals and whatnot come in pretty handy...
  • SueSueDio
    SueSueDio Posts: 4,796 Member
    NorthCascades wrote: »
    NorthCascades wrote: »
    I don't think maintaining is very difficult. If you made it through the weight loss, now you get to eat more.

    Three people marked this woo. Who thinks eating more is harder than eating less?

    Maybe they're still thinking of it in the "woohoo!" sense?

    Although I will say that, on the very first "maintenance break" I took on my journey, I found it very stressful to eat more. While I was in a deficit I had a buffer that would absorb any logging errors or deliberate overeating, but once I was at maintenance calories that buffer was gone. It really scared me for a few days, until I realised I'd have to overeat for many days in a row to start gaining again.

    I would think that a lot of the failure to maintain that gets talked about in these studies and articles is due to the initial approach - a lot of people think of "a diet" as a short term, temporary thing, after which they go back to "eating normally". I had to learn that I can't ever do that again, and I guess everyone else has to come to the same realisation before they can be successful at long-term maintenance.
  • augustremulous
    augustremulous Posts: 378 Member
    Family and friends have to play a role in it too. The same people who played a minor role in you gaining weight in the first places aren't necessarily making the changes along with you. And it's easy to work really hard to lose the weight for a short time and then slip into old habits when all the people around you are living in a less healthy way.

    And I really do think the culture of fat shaming does play a role. It's what gets fat people to lose weight as quickly as possible in an unsustainable way, which is hard to maintain. I myself have found that the weight comes off more easily when I'm feeling confident and happy.
  • MegaMooseEsq
    MegaMooseEsq Posts: 3,118 Member
    I think the numbers are interesting, as is the public health question about how the results of studies like this are reported. Science reporting and literacy in the United States is abysmal, so it doesn’t surprise me that people would be discouraged by headlines like “95% of diets fail!” (or that misleading clickbait headlines like that are written in the first place). I spent a lot of time reading about successful weight loss and maintenance before I started trying to lose weight, because I couldn’t motivate myself to get started if I thought I would inevitably regain. The National Weight Control Registry was a big help in looking at how people actually succeed.

    As for the numbers themselves, so many questions come to mind. What counts as a diet? What counts as failure? Are we including people at a healthy weight trying to lose “vanity pounds”? It’s tempting to jump to simple conclusions, but you really do need to drill down before the data are at all useful.
  • lorrpb
    lorrpb Posts: 11,463 Member
    Think of it this way, of all the people you know who’ve ever lost any weight, how many have kept it off forever? I bet it’s not even 1 in 10. There are lots of positive role models here on MFP! Let all those who regained be your motivation to keep on track.
  • LovesDogsAndBooks
    LovesDogsAndBooks Posts: 190 Member
    I started losing weight using MFP and exercising in March of last year and lost about 30 lbs by September, then I gave myself a break and maintained, plus the 4 or 5 weeks leading up to Christmas I really indulged (on purpose) and put on 4 lbs. Right after the holidays I stepped up exercising and eating at a deficit again without any problems. I was worried that once I get off the deficit and maintain for a while, it would be really hard to get on the deficit again, so that came as a pleasant surprise. I'm about halfway to my goal weight, and I am somewhat confident that I can achieve this and will be able to maintain afterwards. But then, I know so many people who lost weight and weren't able to keep it off, plus the forums here are full of people who do this for the umpteenth time, that it makes me wonder whether I am too optimistic?
  • OhMsDiva
    OhMsDiva Posts: 1,073 Member
    NorthCascades wrote: »
    NorthCascades wrote: »
    I don't think maintaining is very difficult. If you made it through the weight loss, now you get to eat more.

    Three people marked this woo. Who thinks eating more is harder than eating less?

    I would not say it is harder eating more, but I have found that it is easier to eat too much if I allow myself to not be strict on my food plan. I also wanted to comment on the post talking about making lifestyle changes. I never had, and really still do not have, a specific weight goal. What has worked for me is eating in a specific calorie range and exercising. In the past 3 years I have had some gains. I think the most was 20 lbs on vacation. I do not get worked up when I gain weight. I know what I have allowed myself to eat too much and the scale shows it.
    I also am working on not allowing myself to go overboard on "special occasions". I am at a point where I am comfortable with my weight and I have a range that I do not want to go over. For me this is still a learning process.
  • try2again
    try2again Posts: 3,562 Member
    mrsnattybulking wrote: »
    Once you know, you can't unknow and it's really hard to fail.

    Just want to say, I really like this line. I don't think it necessarily prevents a person from lapsing back into overeating, but in my own case, I know I am confronted with having to make a conscious decision every time I overeat, because I know the calories involved from years of experience logging and know how much is too much for my body. No excuses.
  • gracegettingittogether
    gracegettingittogether Posts: 176 Member


    Eating more is definitely easier than eating less, however, I personally find maintenance requires more effort than the weight loss phase. It's not exciting to see the scale stay the same; it's years later and no one compliments your accomplishments; motivation has waned (probably several times lol) but you keep on keeping on. It's definitely not more difficult from a physiological standpoint but from a psychological one I find it tiring and requiring more effort and discipline than the weight loss stage.
    [/quote]

    Maybe this is why losing weight slowly is helpful for maintaining. Because when it's really slow, you have to keep putting in the daily effort, with few to none compliments and visible results. Hmm, helpful!
  • wizzybeth
    wizzybeth Posts: 3,578 Member
    try2again wrote: »
    NorthCascades wrote: »
    I don't think maintaining is very difficult. If you made it through the weight loss, now you get to eat more.

    Yes, but many approach weight loss as a short-term project and once the weight is gone, or they've achieved a significant amount of loss, they slowly (or quickly) ease back into the bad habits that got them there in the first place.

    this
  • snarlingcoyote
    snarlingcoyote Posts: 399 Member
    edited January 2018
    mrsnattybulking wrote: »
    Most of the people I know (I know, I know, anecdotal but it's all I have) that understand thermodynamics don't gain back, or stop themselves earlier when they creep up past a comfortable limit. Once you know, you can't unknow and it's really hard to fail.

    I know plenty of folks from way back, 15 or more years, who understand weight loss quite well, have taken classes in it, some of whom have advanced degrees in various medical arts. . .they have as much trouble with maintaining weight loss as anyone else.

    I don't doubt your anecdotal experience, but it may well be that the people you know who are maintaining are a self-selecting group with a requirement of 1. Knowledge and 2. keeping their weight off. Folks who don't have both requirements may, very quietly, fall out of communication because they have failed to fulfill requirement #2.

    I only say this because I've seen it happen in many a message board and Facebook group, so the appearance is that everyone is doing X, when really, the folks who aren't doing X have absented themselves quietly.

    Also, something else to think about - a very positive thing - one of the few things I've seen across the board in studies trying to find out WHO maintains weight loss, is that strong support really raises the probability of one keeping weight loss off. Good, strong support is, by definition, likely to include a LOT of knowledge.
  • snarlingcoyote
    snarlingcoyote Posts: 399 Member
    edited January 2018
    There are 2 very long term studies with large samples that are very tightly controlled and considered gold mines of information that include work on diet and weight. They're called the Nurse's Studies (They're currently recruiting for #3, btw. . .)

    In 2011, some of the results of study #2 were published. The findings are for 121K people over 20 years. It involves self-assessment surveys, but the surveys were cross-checked against independent observations to ensure validity.

    It doesn't directly address the very narrow question about who keeps off weight loss, but it does address the question why people gain weight. (The charts are amazing.) It's really useful for thinking about weight and gain and how to maintain at a particular weight.

    nejm.org/doi/full/10.1056/NEJMoa1014296#t=article

Categories