What are the Proven Benefits of a "Lifestyle Change"?

Iwishyouwell

There are a few threads going on at the moment detailing various studies that show that long term weight loss management has pretty abysmal success rates.

The common rebuttal is that said studies are reflecting participants that lost weight the "wrong" way with various fads, cleanses, diet pills, etc, and that these rates do not reflect people who did it the "right" way with a "lifestyle change".

I've been looking for evidence to back up this claim and so far I've found nothing. I also haven't seen anybody on MFP actually offer solid proof either.

So I'm asking for people to please offer links to studies that show concrete evidence that "lifestyle changes" in the area of calorie counting, slow weight loss, "everything in moderation" all lead to more successful maintainers in the long run.

Thank you.

BusyRaeNOTBusty

So you are looking for proof that weight loss can be maintained longer term when a "lifestyle change" is made? Meaning when people continue to watch what they eat and be active for the rest of their lives?

http://ajcn.nutrition.org/content/82/1/222S.long

Abstract:

There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that ≈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 and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity (≈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. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success

_Zardoz_

Why do you need studies to back up Common sense? Isn't it pretty obvious if you make positive long term changes to your life you're more likely to stick to it rather than short term fads?

If you can't see the common sense in that approach and need 'proof' I think that probably says a lot about your approach and attitude to this and maybe you need to take a step back and assess what you wish in the long term

Good luck in your search for 'Proof'

Iwishyouwell

Why do you need studies to back up Common sense? Isn't it pretty obvious if you make positive long term changes to your life you're more likely to stick to it rather than short term fads?

If you can't see the common sense in that approach and need 'proof' I think that probably says a lot about your approach and attitude to this and maybe you need to take a step back and assess what you wish in the long term

Oh how I adore people who are loud, presumptive, and wrong.

Thanks Fat, but I'm doing just fine. If you had nothing to contribute to the actual topic at hand, simply saying so, or just skipping the thread, would have sufficed.

UpEarly

The research section on this website should help you find the information you need: http://www.nwcr.ws/

For me personally, lifestyle change is the only thing that worked. All through my 20's and 30's, I rode the weight loss roller coaster with every crash/fad diet that came along. I always went back to my old way of eating. I always gained the weight back... and usually a few pounds in addition.

Making a small calorie cut, practicing moderation, eating smaller portions, focusing on whole foods, and being more active throughout my day have worked. I've made all of those things into daily habits and have maintained a 66 pound weight loss for over two years now. I know I'm just one person, and my success is anecdotal. But it works for me!

Meerataila

So you are looking for proof that weight loss can be maintained longer term when a "lifestyle change" is made? Meaning when people continue to watch what they eat and be active for the rest of their lives?

http://ajcn.nutrition.org/content/82/1/222S.long

Abstract:

There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that ≈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 and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity (≈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. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success

Their definition is useless, at least in my case. %10? That wouldn't have even taken me out of the obese range. The definition should be within a healthy weight range as determined roughly by BMI but more specifically by medical records like blood work and more accurate fat composition measurements. I want to see the percentage of people who maintain a healthy weight over 5 y, not some arbitrary and in the case of many of us minuscule percentage.

Iwishyouwell

Thanks UpEarly.

I know all about he NWC, which is an awesome cross section of the weight maintenance population. Unfortunately however it's existence doesn't cover the claims that calling it a "lifestyle change", or doing it the "right" way, statistically leads to greater long term success for weight maintenance. There are all these claims that doing a "lifestyle change" is proven to lead to greater long term success, and nothing seldom is presented to back up said claims.

But I actually love reading anecdotal evidence, and I thank you for sharing your success so far. Congratulations!

Their definition is useless, at least in my case. %10? That wouldn't have even taken me out of the obese range. The definition should be within a healthy weight range as determined roughly by BMI but more specifically by medical records like blood work and more accurate fat composition measurements. I want to see the percentage of people who maintain a healthy weight over 5 y, not some arbitrary and in the case of many of us minuscule percentage.

This. I've seen this statistic time and again. And yet even with their laughable definition of "success", the rate was only 20% for "successful" maintainers.

According to them I could gain back the majority of the over 100lbs I've lost, but as long as I didn't tip over 288lbs, and do so a day after my year anniversary of hitting 288lbs, I would still be a "success". Nevermind that do so would allow me to pile back on close to a 100lbs to still qualify for said "success".

BusyRaeNOTBusty

I'm not finding much thought a quick google search, but it is basic math right? To gain weight you must eat more than you burn. Small surpluses over time can contributed to a significant gain. To lose weight you must eat less than you burn. To maintain weight you must eat exactly the same as you burn. So people who have eat at a slight surplus all their lives except for the period of "dieting" (whatever method they use) now have to figure out how to eat at exactly maintenance (and their maintenance will be lower than someone who has never gained and then dieted down). They basically have to change the way they've always lived and keep that change basically forever. Now one would assume that this change is easiest if it's the same change they used during their dieting phase, and if it's gradual and maintainable. So it make sense that yes, a "lifestyle change" would be the most successful method of dieting and keeping weight off.

But yeah, this doesn't mean that you can't lose weight and keep it off doing other things. Since we are talking individual anecdotes I'll present my father as an example. In 2002ish he used the Atkins diet to lose about 100 pounds. Not long after he separated from my mother (who cooked and grocery shopped for him). He's maintained his weight loss mainly because he's too lazy too cook and he goes low carb again every time he see the scale start moving up a bit. He's not particularly active or anything. He has done it the "right way" but he's maintained 100lbs lost for 10+ years.

SingRunTing

People on here ask for studies to back up claims all the time. I don't understand why the OP is getting flack for doing the same.

levitateme

Well, I don't really agree that people always gain the weight back because they go on "diets". I have always lost weight by "eating less of what I used to eat" and whenever I am done losing said weight, I go back to "eating what I used to eat" and gain the weight back. I never lost weight "the wrong way" by doing VLD, fads or anything like that. This is the first time that the idea of maintaining my weight forever seems possible and that's because I'm interested in physical activity. I used to exercise to burn more calories/be more successful at losing weight. Right now I just want to be strong, so everything else is falling into place. I can eat more than I thought I could and not gain weight, as long as I remain reasonably active.

lemurcat12

Why do you need studies to back up Common sense? Isn't it pretty obvious if you make positive long term changes to your life you're more likely to stick to it rather than short term fads?

The question is for evidence that the success rate is significantly higher than the 5% or whatever it is given for dieters as a whole so long as you do it right. I'm interested in this too--although I'm willing to make a leap of faith that I can maintain anyway, with or without the evidence, since not trying gets you nothing. But as I said over in the other thread, I've never fad dieted. Before this time I dieted once, and it was a "lifestyle change" where I lost 60 lb through healthy changes to my diet, trying to understand why I gained, exercising a lot and transiting to exercise-based hobbies when I was in maintenance, not cutting out any foods (but fast food other than when on car trips, which I never went back to, including when I gained), etc. And I maintained this for about 5 years (other than an initial gain of about 5 lb), pretty easily, and would have said my way of eating was sustainable and satisfying.

Yet stuff happened and I gradually slid back into old habits. There were definitely life reasons involved--but aren't there always life reasons that come up? And the weird thing is that even after I'd dealt with the most significant of those life reasons I still couldn't get myself to care enough about losing weight to sustain any kind of lifestyle change for years. So I ended up regaining everything plus. And now I care again and am mostly enjoying the process again and feel like I've made a sustainable lifestyle change and wouldn't want to go back to my old habits.

Yet, I know I felt the same way before. So it really doesn't seem like just common sense to me. I can think of some things I'd do differently this time, but it's all dependent on me feeling about it the way I do now, and how can anyway guarantee they will?

But to me it's not a reason to throw in the towel, but just to be wary of complacency and early signs.

agrafina

Here is the paste to a list of all of the research that has come out of the National Weight Control Registry, along with links to abstracts.

Read. Enjoy.

http://www.nwcr.ws/Research/published research.htm

agrafina

This one looks at maintenance of large losses in bariatric surgery patients and NCWR patients.

http://www.ncbi.nlm.nih.gov/pubmed/19050676

Abstract
OBJECTIVE:
As large weight losses are rarely achieved through any method except bariatric surgery, there have been no studies comparing individuals who initially lost large amounts of weight through bariatric surgery or non-surgical means. The National Weight Control Registry (NWCR) provides a resource for making such unique comparisons. This study compared the amount of weight regain, behaviors and psychological characteristics in NWCR participants who were equally successful in losing and maintaining large amounts of weight through either bariatric surgery or non-surgical methods.
DESIGN:
Surgical participants (n=105) were matched with two non-surgical participants (n=210) on gender, entry weight, maximum weight loss and weight-maintenance duration, and compared prospectively over 1 year.
RESULTS:
Participants in the surgical and non-surgical groups reported having lost approximately 56 kg and keeping > or =13.6 kg off for 5.5+/-7.1 years. Both groups gained small but significant amounts of weight from registry entry to 1 year (P=0.034), but did not significantly differ in magnitude of weight regain (1.8+/-7.5 and 1.7+/-7.0 kg for surgical and non-surgical groups, respectively; P=0.369). Surgical participants reported less physical activity, more fast food and fat consumption, less dietary restraint, and higher depression and stress at entry and 1 year. Higher levels of disinhibition at entry and increased disinhibition over 1 year were related to weight regain in both groups.
CONCLUSIONS:
Despite marked behavioral differences between the groups, significant differences in weight regain were not observed. The findings suggest that weight-loss maintenance comparable with that after bariatric surgery can be accomplished through non-surgical methods with more intensive behavioral efforts. Increased susceptibility to cues that trigger overeating may increase risk of weight regain regardless of initial weight-loss method.

Iwishyouwell

People on here ask for studies to back up claims all the time. I don't understand why the OP is getting flack for doing the same.

Thanks, but I expected it. It's a very tough subject for some people to look at with any kind of objectivity. It's very easy to villainize and stigmatize anything but the "right" and standard approach, but when asked for concrete evidence to support that the "right" way has proven to have greater long term success, almost none exists. And that makes some people very, very uncomfortable to even consider.

The idea that you could calorie count, lose slowly, adjust your "lifestyle", work out, do everything in moderation, and still end up in the same boat as the dieters, fad followers, and pill poppers is very sobering. And very terrifying for a lot of people.

Ultimately I truly want to read the evidence for all of these assumptions. It could do us all well and add another layer to this conversation.

Edit: Thank you Agrafina, reading through the material now.

agrafina

I thought you might find this one interesting. It actually is on the causes of regain after weight loss, so now when you encounter the denial brigade, you have something to send them (article is free on PMC).

http://www.ncbi.nlm.nih.gov/pubmed/24533218

Iwishyouwell

I thought you might find this one interesting. It actually is on the causes of regain after weight loss, so now when you encounter the denial brigade, you have something to send them (article is free on PMC).

http://www.ncbi.nlm.nih.gov/pubmed/24533218

I've been saying this for years:

"Despite the efficacy of bariatric surgery, lifestyle modification therapies may be preferable to surgery since many patients are poor candidates for the operation and some may suffer postsurgical complications [19]. This difficulty, coupled with the limited efficacy of targeted obesity therapeutics, makes lifestyle modification a potentially favorable intervention [17]. However, a major barrier exists to its efficacy: weight regain. This regain is a common occurrence in patients who have lost weight by implementing lifestyle modifications, regardless of the dietary or behavioral intervention used. Approximately 30%–35% of lost weight is regained one year following treatment and 50% of patients will return to their baseline weight by the fifth year out from weight loss [20]. According to NHANES (1999–2006), a mere 1 in 6 overweight and obese adults reported maintaining weight loss of at least 10% for 1 year, at any point in their lives [21]."

"6. Conclusion

The evidence presented in this paper provides novel insights into the nature of weight loss and associated compensatory changes. Further, it suggests that multiple redundant mechanisms have evolved to maintain body weight and thereby counteract a reduction in caloric intake. This redundancy may in part explain the high degree of failure and weight regain observed following weight loss through lifestyle intervention [20]."

Also of note is the study in there that talks about people maintaining after a liquid diet having similar maintenance success as people who lost weight through a more standard weight loss method.

RHachicho

I really don't need scientific studies or concrete evidence. Our bodies are not magic they can't put on weight unless we let them. This is a fact. Your "objective look" frankly reeks of confirmation bias. There are health studies to suggest all kinds of hokum in the health and fitness world so by all means coddle the ones that agree with your preconceptions.

Statistics have NOTHING to do with your chance of success on weight loss. Your actions and your willpower are everything. All this study says is that most of the people that try do not have the qualities necessary to succeed. Why do you think people are so impressed when someone does.

agrafina

I really don't need scientific studies or concrete evidence. Our bodies are not magic they can't put on weight unless we let them. This is a fact. Your "objective look" frankly reeks of confirmation bias. There are health studies to suggest all kinds of hokum in the health and fitness world so by all means coddle the ones that agree with your preconceptions.

Statistics have NOTHING to do with your chance of success on weight loss. Your actions and your willpower are everything. All this study says is that most of the people that try do not have the qualities necessary to succeed. Why do you think people are so impressed when someone does.

You don't need scientific studies or concrete evidence? Congratulations. Talk about confirmation bias. You won't give heed to any evidence that directly contradicts what you want to believe and you accuse the OP of confirmation bias? Oh, right, you won't look at any evidence at all, therefore it can't be confirmation bias.

Statistics may have nothing to do with your chance of weight loss, you will either regain or maintain once weight is lost. But statistics do tell the fate of pretty much large numbers of people who lose weight. Refuse to believe the evidence all you want. It doesn't change the fact that the vast majority of people will fail to have "the qualities necessary" to succeed. And quite frankly, the idea that people who are extraordinarily successful in other aspects of their lives are somehow lacking some trait that would hinder them in weight loss but not in their success in other areas, is laughable.

jwdieter

What is the definition of a "lifestyle change"?

If it includes tracking calories and eating at or below maintenance, then it will by definition work.

If it is a high activity lifestyle with somewhat constrained eating, it should work.

If it's just an idea someone had, before sitting back down and free-eating, then it's really unlikely to work.

Iwishyouwell

What is the definition of a "lifestyle change"?

As I defined it in the OP, and is most commonly defined here on MFP:

The "calorie counting, slow weight loss, 'everything in moderation' " approach to weight loss that is time, and again, heralded as the "right" way that will lead to the golden land of weight loss maintenance success. I've read that declaration on this board over two dozen times on this board this week alone, across various threads. Time and again people trumpet that most of those people who regain their weight did so because they lost weight the "wrong" way; too fast, too restrictive, diet pills, fads, surgery, etc.

Fine. I'm simply looking for some concrete evidence that suggests people who make this "lifestyle change" have been observed to have long term management of their loss at a significantly greater rate than those who did it the "wrong" way. So far everything I've read says otherwise.

Sabine_Stroehm

I got nothin. Sorry.

Except for me. 12+ years ago I learned how to eat to fuel my body. I learned how to eat in a way that was sustainable FOR ME. I learned about food, nutrients etc. (I didn't really count calories, I NEVER weighed food, but did learn what portion sizes were). I didn't use an "everything in moderation" approach, but rather made some substitutions that were reasonable for me.

I lost weight.

I kept doing that.

The weight stayed off. Now, in menopause, I'm tweaking things. But the general principles I learned I LIVE.

I look forward to reading studies. I DO believe a lifestyle change is what's needed. I believe that a true lifestyle change means different things to different people.