Is Maintenance Really Impossible?

rosesandsuch

Everywhere I look I am confronted by statistics saying anybody who loses a significant amount of weight WILL gain it back, there is almost no doubt. They said 99% of people who diet will regain all the lost weight and then some...

I can understand that some people are naturally larger, and maybe just don't have the right genetics to maintain any significant loss...

It would also make sense that, if somebody went on a diet, lost the weight, then went back to eating like they did before the weight would return.

Maybe if you struggled with a binge eating disorder or some sort of physical condition long term success would be limited...

But none of this applies to me, I have always been a little chubby due to never learning about healthy eating or exercise habits, but when I moved out I gained a large amount of weight because I was always at home, never cooked, and straight up binged on junk, especially when I was depressed.

I lost 50+ pounds (through Medifast) but I have been off their prepackaged meals for almost a year now and actually lost weight even while I was eating regular food again! I know I can never go back to eating like I used to, and I have committed to being more active, and I LIKE these changes, I wouldn't want to return to constantly overindulging and sitting around all day!

What circumstances would cause the weight to return? Am I doomed? Is there anybody who has kept weight off for over 5 years, or is that completely impossible, as statistical evidence seems to suggest?

Of course, with age comes some weight gain but I am only 19 I still have a while to go, right?

It is just a terrifying thing to hear over and over when I have worked so hard to get where I am today.

Timshel_

I know my weight has always fluctuated around +/- 10 lbs over time. But I am okay with that as long as I stay around my goal weight...whatever that ultimately ends up being. If I start getting up too much, I will cut back as I am now.

sunshyncatra

I don't think we are doomed if we treat this as a lifestyle change and don't go back to eating junk when we reach our goal.

thecakelocker

People lose the weight doing stupid insane crash diets, lose a bunch of muscle mass, stop starving themselves and then gain it back as almost all fat.

BinaryPulsar

As long as you maintain an active lifestyle with a regular exercise program and are eating in moderation (counting calories is very helpful for that) you should be fine. If you have emotional eating issues you can deal with that to prevent a relapse. Like others said, you just keep an eye on it and make changes early on if needed to prevent weight gain.

kw85296

I agree. I don't think we are doomed if we treat this as a lifestyle change and not a diet. I also think that having tools like MFP may change some of the statistics as time goes on. I think that the accountability and encouragement here will help to keep it off. Don't fret over the problems of the 99% (although I think that figure is a lot higher than I have read) just concentrate on being that 1%.

hmuh

It's absolutely possible to maintain. It's just not that easy.
Best wishes!

rosesandsuch

kw85296: I definitely could be wrong about the exact number, my anxiety just spikes it I think...

dpollet2

It's not always true that people only gain the weight back by losing it irresponsibly. In 2010 I was 225lb. and decided I had to lose weight and get fit. I used MFP and started running. I lost 70 in a little over a year, and in Nov. 2011 ran my first half marathon.

The next spring I started back to school, and I just did not devote the time I needed to log my food and exercise. I didn't have time to cook every night like I did before so I was eating out a lot. As of 1 month ago I had gained back up to 210lb. I've come to realize that I have to look at my weight as sort of medical condition that I will have to manage the rest of my life.

They say that it takes a smoker several attempts at quitting before it's permanent. I'm hoping that it's like that with weight loss, and eventually it will just be second nature.

MercenaryNoetic26

I'm totally maintaining (on purpose). I decided I liked 119/120 and am staying there by eating at my tdee for moderate activity. IPOARM works.

ETA: sorry, didn't read all the way to the end. I've never been overweight, but had enough pregnancies to have to work hard to get back down. I always make it back to 120 and maintain it. I'm currently 9mos post-partum and 2mos in weight training.

alyhuggan

That's because most people who want to lose weight want the fast route. The only real way to lose weight and keep it off is doing it slowly and controlled or else your metabolism will make sure you put back on every single pound of fat you just lost.

actlc

I stayed a little chubby for the past 20 years because I let myself over eat and not doing enough exercises.
If I can stay chubby for 20 years, I can stay fit for the next 20+ years if I let myself eat healthy and doing exercises. (assume no other health complications)

What we need is persistent. Like others said, a lifestyle change permanently! Not just a 30-day diet, done and back to old self.

I am starting my journey this year to stay fit & healthy.

Blegg30

Being someone who has lost a lot of weight several times (first time a total of 50, and second time a grand total of 80) and gained about 40 back, I know that I gained because I was eating what I wanted but was exercising enough to balance/maintain. UNTIL I was injured during a run and wasn't able to exercise for a few months. Suddenly those eating habits were no longer working for me and I slowly gained.

Don't be on a "diet." Change the way you eat to one that is healthy and filled with real food, and eat in a way that you can eat for the rest of your life. Dieting and losing weight and then expecting to be able to eat whatever you is not an ineffective method.

kcoftx

I think even those who maintain for great periods of time can have a period in their life when it backslides a bit. I could be due to a number of factors. If you pay attention to changes in energy and food input/output during these times or are monitoring throuout these times, then it can typically be caught before losing control. By life event, it could be anything... Change of jobs, a move, divorce, marriage, pregnancy, surgery, illness, etc. this is assuming no extenuating circumstances and assuming you learned some habits as you were losing and treated it not as a temporary diet but a lifestyle change.


The other part of that equation is recognizing that our goals should always progress over time. It truly is a process and not a destination.

So in that sense, the statistics are not the whole story.

highervibes

I lost and re-gained weight in the past. I did WW back in 2007 and then went back to SAD. Time will tell

YcatsFursworth

I've lost and regained but the thing is my BIG amount I've keep off. 50 lbs lower then my heaviest! when I get to the point I want to be at I plan to still step on the scale every month to make sure it doesn't creep back on. I've been told 3 pounds is the magic number. if you put on three pounds to just start dieting again to get it back off before it becomes a problem. I think the 3 lbs is a bit low but still the idea is still there!

johnbatzer

I've lost a pretty significant amount weight - but don't worry, I found it all again!

Is maintenance possible? Yes, I do believe it is. For me, I know that when I stop paying close attention to what I'm eating, I'll put on weight . . . it's a very simple formula - if I monitor what I'm putting into my body, I'll control my weight. If I don't monitor what I put into my body, I'll gain fat.

Twice, I've thought "I'll never be like that again," but went on to find myself, slowly but surely, falling into my old habits. Yes, I believe maintenance is possible - it just has to be a conscious decision for me -- I'd LOVE to just "go on autopilot," but I know that's not a reality for me.

babbs770

I was over 190 at my highest, and am now fluctuating between 160-165. I have been stable for over a year, no sweat. If it is a LIFE change then you can do it. If it is a flash diet with unrealistic eating habits, then you will gain it back. Good luck!

rileysowner

Doing some quick searching I find numbers from 90-98%, the shear amount of different numbers tells me that there seems to be a lack of hard information on this. I personally think maintenance is possible, but it will require a lifelong change in habits. It is not something that is easy, but it is possible. I think the first step for many is realizing you will be counting calories for the rest of your life. Yes, it is a pain, but for the vast majority of those who are severely overweight that is the reality. Their sense of proper amounts to eat simply is that messed up so eating intuitively is likely not ever going to be possible for them.

carolemorden9

As long as you continue on the path you are on right now, you should be able to maintain. Once I get down to my ultimate goal weight, I'm still going to log what I eat and exercise because it's important to me.

etoiles_argentees

just copying an old post of mine.

While I'm not keen on the entire set - point theory, I do think genetic inheritance plays a very important part in the body returning to a "comfortable" weight. I really think weight is due to a combination of both genes and environment. After reading articles like the following I can't help but wonder if dieting is just too hard for some. My thinking (at the moment ) leans towards the possibility that people who relapse are just tired of the struggle to maintain the constant vigilance. Maybe it's due to a shifting of values where remaining thin is no longer a top priority in life, or counting calories and thinking about food becomes too time consuming and starts taking away from someone's life instead of adding to it. It's nice to be free from analyzing your options every time you eat something, to be able to eat something because that's what you "want", and not what you "should" have.


I'm sure there are many reasons, just throwing some possibilities out there.

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May 8, 2007
Genes Take Charge, and Diets Fall by the Wayside

By GINA KOLATA
Correction Appended

It was 1959. Jules Hirsch, a research physician at Rockefeller University, had gotten curious about weight loss in the obese. He was about to start a simple experiment that would change forever the way scientists think about fat.

Obese people, he knew, had huge fat cells, stuffed with glistening yellow fat. What happened to those cells when people lost weight, he wondered. Did they shrink or did they go away? He decided to find out.

It seemed straightforward. Dr. Hirsch found eight people who had been fat since childhood or adolescence and who agreed to live at the Rockefeller University Hospital for eight months while scientists would control their diets, make them lose weight and then examine their fat cells.

The study was rigorous and demanding. It began with an agonizing four weeks of a maintenance diet that assessed the subjects’ metabolism and caloric needs. Then the diet began. The only food permitted was a liquid formula providing 600 calories a day, a regimen that guaranteed they would lose weight. Finally, the subjects spent another four weeks on a diet that maintained them at their new weights, 100 pounds lower than their initial weights, on average.

Dr. Hirsch answered his original question — the subjects’ fat cells had shrunk and were now normal in size. And everyone, including Dr. Hirsch, assumed that the subjects would leave the hospital permanently thinner.

That did not happen. Instead, Dr. Hirsch says, “they all regained.” He was horrified. The study subjects certainly wanted to be thin, so what went wrong? Maybe, he thought, they had some deep-seated psychological need to be fat.

So Dr. Hirsch and his colleagues, including Dr. Rudolph L. Leibel, who is now at Columbia University, repeated the experiment and repeated it again. Every time the result was the same. The weight, so painstakingly lost, came right back. But since this was a research study, the investigators were also measuring metabolic changes, psychiatric conditions, body temperature and pulse. And that led them to a surprising conclusion: fat people who lost large amounts of weight might look like someone who was never fat, but they were very different. In fact, by every metabolic measurement, they seemed like people who were starving.

Before the diet began, the fat subjects’ metabolism was normal — the number of calories burned per square meter of body surface was no different from that of people who had never been fat. But when they lost weight, they were burning as much as 24 percent fewer calories per square meter of their surface area than the calories consumed by those who were naturally thin.

The Rockefeller subjects also had a psychiatric syndrome, called semi-starvation neurosis, which had been noticed before in people of normal weight who had been starved. They dreamed of food, they fantasized about food or about breaking their diet. They were anxious and depressed; some had thoughts of suicide. They secreted food in their rooms. And they binged.

The Rockefeller researchers explained their observations in one of their papers: “It is entirely possible that weight reduction, instead of resulting in a normal state for obese patients, results in an abnormal state resembling that of starved nonobese individuals.”

Eventually, more than 50 people lived at the hospital and lost weight, and every one had physical and psychological signs of starvation. There were a very few who did not get fat again, but they made staying thin their life’s work, becoming Weight Watchers lecturers, for example, and, always, counting calories and maintaining themselves in a permanent state of starvation.

“Did those who stayed thin simply have more willpower?” Dr. Hirsch asked. “In a funny way, they did.”

One way to interpret Dr. Hirsch and Dr. Leibel’s studies would be to propose that once a person got fat, the body would adjust, making it hopeless to lose weight and keep it off. The issue was important, because if getting fat was the problem, there might be a solution to the obesity epidemic: convince people that any weight gain was a step toward an irreversible condition that they most definitely did not want to have.

But another group of studies showed that that hypothesis, too, was wrong.

It began with studies that were the inspiration of Dr. Ethan Sims at the University of Vermont, who asked what would happen if thin people who had never had a weight problem deliberately got fat.

His subjects were prisoners at a nearby state prison who volunteered to gain weight. With great difficulty, they succeeded, increasing their weight by 20 percent to 25 percent. But it took them four to six months, eating as much as they could every day. Some consumed 10,000 calories a day, an amount so incredible that it would be hard to believe, were it not for the fact that there were attendants present at each meal who dutifully recorded everything the men ate.

Once the men were fat, their metabolisms increased by 50 percent. They needed more than 2,700 calories per square meter of their body surface to stay fat but needed just 1,800 calories per square meter to maintain their normal weight.

When the study ended, the prisoners had no trouble losing weight. Within months, they were back to normal and effortlessly stayed there.

The implications were clear. There is a reason that fat people cannot stay thin after they diet and that thin people cannot stay fat when they force themselves to gain weight. The body’s metabolism speeds up or slows down to keep weight within a narrow range. Gain weight and the metabolism can as much as double; lose weight and it can slow to half its original speed.

That, of course, was contrary to what every scientist had thought, and Dr. Sims knew it, as did Dr. Hirsch.

The message never really got out to the nation’s dieters, but a few research scientists were intrigued and asked the next question about body weight: Is body weight inherited, or is obesity more of an inadvertent, almost unconscious response to a society where food is cheap, abundant and tempting? An extra 100 calories a day will pile on 10 pounds in a year, public health messages often say. In five years, that is 50 pounds.

The assumption was that environment determined weight, but Dr. Albert Stunkard of the University of Pennsylvania wondered if that was true and, if so, to what extent. It was the early 1980s, long before obesity became what one social scientist called a moral panic, but a time when those questions of nature versus nurture were very much on Dr. Stunkard’s mind.

He found the perfect tool for investigating the nature-nurture question — a Danish registry of adoptees developed to understand whether schizophrenia was inherited. It included meticulous medical records of every Danish adoption between 1927 and 1947, including the names of the adoptees’ biological parents, and the heights and weights of the adoptees, their biological parents and their adoptive parents.

Dr. Stunkard ended up with 540 adults whose average age was 40. They had been adopted when they were very young — 55 percent had been adopted in the first month of life and 90 percent were adopted in the first year of life. His conclusions, published in The New England Journal of Medicine in 1986, were unequivocal. The adoptees were as fat as their biological parents, and how fat they were had no relation to how fat their adoptive parents were.

The scientists summarized it in their paper: “The two major findings of this study were that there was a clear relation between the body-mass index of biologic parents and the weight class of adoptees, suggesting that genetic influences are important determinants of body fatness; and that there was no relation between the body-mass index of adoptive parents and the weight class of adoptees, suggesting that childhood family environment alone has little or no effect.”

In other words, being fat was an inherited condition.

Dr. Stunkard also pointed out the implications: “Current efforts to prevent obesity are directed toward all children (and their parents) almost indiscriminately. Yet if family environment alone has no role in obesity, efforts now directed toward persons with little genetic risk of the disorder could be refocused on the smaller number who are more vulnerable. Such persons can already be identified with some assurance: 80 percent of the offspring of two obese parents become obese, as compared with no more than 14 percent of the offspring of two parents of normal weight.”

A few years later, in 1990, Dr. Stunkard published another study in The New England Journal of Medicine, using another classic method of geneticists: investigating twins. This time, he used the Swedish Twin Registry, studying its 93 pairs of identical twins who were reared apart, 154 pairs of identical twins who were reared together, 218 pairs of fraternal twins who were reared apart, and 208 pairs of fraternal twins who were reared together.

The identical twins had nearly identical body mass indexes, whether they had been reared apart or together. There was more variation in the body mass indexes of the fraternal twins, who, like any siblings, share some, but not all, genes.

The researchers concluded that 70 percent of the variation in peoples’ weights may be accounted for by inheritance, a figure that means that weight is more strongly inherited than nearly any other condition, including mental illness, breast cancer or heart disease.

The results did not mean that people are completely helpless to control their weight, Dr. Stunkard said. But, he said, it did mean that those who tend to be fat will have to constantly battle their genetic inheritance if they want to reach and maintain a significantly lower weight.

The findings also provided evidence for a phenomenon that scientists like Dr. Hirsch and Dr. Leibel were certain was true — each person has a comfortable weight range to which the body gravitates. The range might span 10 or 20 pounds: someone might be able to weigh 120 to 140 pounds without too much effort. Going much above or much below the natural weight range is difficult, however; the body resists by increasing or decreasing the appetite and changing the metabolism to push the weight back to the range it seeks.

The message is so at odds with the popular conception of weight loss — the mantra that all a person has to do is eat less and exercise more — that Dr. Jeffrey Friedman, an obesity researcher at the Rockefeller University, tried to come up with an analogy that would convey what science has found about the powerful biological controls over body weight.

He published it in the journal Science in 2003 and still cites it:

“Those who doubt the power of basic drives, however, might note that although one can hold one’s breath, this conscious act is soon overcome by the compulsion to breathe,” Dr. Friedman wrote. “The feeling of hunger is intense and, if not as potent as the drive to breathe, is probably no less powerful than the drive to drink when one is thirsty. This is the feeling the obese must resist after they have lost a significant amount of weight.”

This is an excerpt from Gina Kolata’s new book, “Rethinking Thin: The New Science of Weight Loss — and the Myths and Realities of Dieting” (Farrar, Straus & Giroux).

Correction: May 12, 2007


An article in Science Times on Tuesday about the role of genes in weight gain misstated the publication date for an article in the journal Science describing the biological controls over body weight. The article was published in 2003, not 2000.


Lots of comments after this article at the New York Times if you're interested - most not as depressing as this article and a few by readers that are maintaining a large loss of weight.

You'll probably just need to remain vigilant and aware.

The_Enginerd

Not impossible for sure. The longer you maintain, the more likely you are to keep it off. You just cannot treat it like a diet, it has to be a lifestyle change. I still log everything, and I met my weight goal back in November of 2011.

jorge_007

It is possible. I've been able to maintain my weight. Then again my maintenance is 3000 calories a day. If I eat 2000 I'll start dropping like 2lbs a week which I don't want. Running everyday really makes maintenance easy.

devil_in_a_blue_dress

I've maintained a 50 pound loss for 8-9 years. Pick a realistic goal, lose slowly and don't do anything that isn't sustainable for the rest of your life. Also, don't fear the bad days/weeks -- just restart when they happen. I could technically lose 8 more pounds (I am happy where I am). But I leave my ticker that way to inspire me to do my best.

themedalist

I've been at maintenance now for almost a year. It isn't too hard but I do have to be vigilant. I allow my weight to fluctuate by 2 pounds but when it exceeds that threshold (only happened about 3 times since July) I take action by curbing my calories a bit or upping the exercise until I'm back in range. I remind myself that it's easier to lose 2 pounds than it is to lose 20.

Don't lose heart...maintenance is very possible. You can buck the odds and join us!

katevarner

I have lost and gained many times, but I find that I gain it back when I get lazy. As long as I am mindful of what I eat and take time to fit in exercise, maintenance is easy. When I quit moving and start eating what's easy instead of what's healthy, I regain.

I also have to weigh on a regular basis. Last time I regained it all (and then some--just like every time), I quit weighing when I didn't like what the scale said instead of moving more. This time, I'm going to keep weighing, almost daily for now, altho I'd eventually like to back it off and only weigh 3 or 4 times per month. Not ready for that yet, but I've only been maintaining 7 months. Hopefully the bad news on the scale will light a fire under my lazy butt.

mattschwartz01

Yes, it is possible but only if you've made a lifestyle change. The first time I lost weight, I failed to make that lifestyle change. This time is different - I've got the benefit of 10 years more of accumulated wisdom.

BunkyBumBum

I lost 75 pounds. 65 of it on Weight Watchers very gradually 3 years ago. 10 of it I lost due to a lot of stress, not eating much, and extra walking 2 years ago, I gained that back and that was in no way a healthy loss.

Even when I don't track or exercise, I'm not gaining it all back. I've been stuck at a plateau for a year, I'll gain or lose 3 pounds here or there, but in general, I stay the same weight. I suppose that's good and bad, good because I'm not gaining the weight back, bad because I'm also not losing my last 15.

I do "kick it up" if I notice my jeans getting a little tight, and I think that's the important part of keeping it off. Don't go eating whatever you want and buying new, bigger clothes and fooling yourself into thinking you're not gaining. That's how people wake up and realize that 50 pounds they lost is back. It'll creep back on a pound or two at a time, but if you pay attention you'll always nip it in the bud before it gets past 5-10 pounds. AS LONG AS YOU LOST IT HEALTHFULLY. People who lose weight by drinking only a shake or by eating only protein or starving themselves are not losing it in a way that they can live the rest of their life and I bet most of them do gain it back. If you've changed your lifestyle, one bad week isn't going to put all the weight back. You'll say "oh crap, my jeans are a little tighter" and you'll remedy it right away. Some people will say, "Oh crap, my jeans are a little tighter" and they'll step into an old pair a size up until they forget the smaller size they were and get comfortable in the bigger size, then it'll happen again and again until they're back in their fat pants and wondering what happened. I'm in a "tight jeans" phase right now, I gained 3 pounds because we've been eating out too much (sick and lazy) and I can feel my jeans rubbing on my thighs more than they used to. Now I'm watching my food and exercising and those 3 pounds, if history says anything, will come off easily in the next couple weeks.

dognamedpig

You'll probably just need to remain vigilant and aware.

This was a very interesting argument and I agree with your thoughts on the shifting values where something that was once a focus of so much attention becomes not as important when other things in life begin to gain.

OP, also I think that being young is a point of favor. Your neural connections are more easily built and maintained when it's taken effort to reach a goal. IMO

kimad

I don't think we are doomed if we treat this as a lifestyle change and don't go back to eating junk when we reach our goal.

^^ this

and I also think exercise plays a huge role. I think people who are active have an easier time with weightloss and with keeping it off.

I was able to keep my weight the same since last August...I was in spitting distance (lol) of my goal and I started to get comfortable and slacked off some - then took a vacation. I had to reel it back in, but it's becuase I have formed new habits, I never stopped working out, I was able not to fall completely off the wagon, back to the old Kim.

I think it's in your mindset, a diet ends ... a lifestyle change doesn't.

ETA: as a yo-yo'er I have also realized I will be using MFP for life. I will be weighing myself for life. I will be following this new lifestyle change for life.

longtimeterp

It is possible. I've been able to maintain my weight. Then again my maintenance is 3000 calories a day. If I eat 2000 I'll start dropping like 2lbs a week which I don't want. Running everyday really makes maintenance easy.

even every other day is great, and the more weight i lose, the easier on me the running is, the more i can do, the more i can eat! I love that math!