results of 20year study reveal weight loss is unattainable

Why do so many people here automatically assume all the studies done around weight loss and maintenance are based off participants who lost weight with pills/fad diets/cleanses/etc?


I've never seen a single person here post anything to back this assumption up. So it really just sounds, at this point, like wishful thinking.

I was looking through pubmed for some citations to address that claim, and am not finding much to back it up. One study I found that looked at fast, moderate and slow losers one a 1200 calorie diet + behavioral therapy + extended care had pretty unimpressive maintained losses at 18 months (max was 5 lbs or so for the fast losers), and less (though not a statistically significant difference) for moderate and slow losers.

http://www.ncbi.nlm.nih.gov/pubmed/20443094

I would question the assumption that if only they looked at people who "made a lifestyle change" or counted calories we would see a higher success rate. The people in this study were prime candidates for "making a lifestyle change", given the behavioral component and extended care, and still could only maintain a 5 lb at most loss by 18 months.

What does research actually say?

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.

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

The majority of weight lost by NWCR members is maintained over 10 years. Long-term weight-loss maintenance is possible and requires sustained behavior change.

http://www.ncbi.nlm.nih.gov/pubmed/24355667

What success factors matter?

Weight maintenance: self-regulatory factors underpinning success and failure.
McKee H1, Ntoumanis N, Smith B.
Author information

Abstract
OBJECTIVES:
To investigate the differences in the contributing factors involved in weight maintenance success and failure.
DESIGN:
Semi-structured interviews were conducted with both successful and unsuccessful weight maintainers. Eighteen participants were recruited (16 women), nine of who had lost 10% of their body weight and maintained this weight for a minimum of 12 months (Maintainers), and nine individuals who met the above criteria for weight loss but had subsequently regained their weight (Regainers). A thematic analysis was employed to compare the differences between the two groups.
RESULTS AND CONCLUSIONS:
Two main themes highlighted the differences between the two groups, these were: goal regulation and self-control. Within these overarching themes, successful weight maintenance was related to the following subthemes: long-term, realistic goal setting, consistent use of routines and self-monitoring, avoiding deprivation and effective coping skills. Unsuccessful maintenance was related to short-term unrealistic goal setting, inconsistent routines and self-monitoring, experiencing deprivation and poor coping skills. These factors are explained in terms of the interrelationships that they have on one another and their subsequent impact on weight maintenance success or failure.

Yeah, weight loss is unattainable.. People like me who lose weight and keep it off clearly don't exist.

As have I (for 12+ years). We're the 5%.

Keeping it off is a challenge. You have to be ready to do almost exactly what you did to lose, and then be ready to tweak it as your metabolism and/or hormones change with age.

HOW i keep it off at 49 is different than HOW I kept it off at 39.

A few months ago there was a thread asking how many regained all their weight and were back. We need a "who's kept it off for 5+ years" thread, where folks can talk about how they've kept it off. Most folks are good at losing it. Folks should be sharing the secrets of keeping it off for years and years (not just months).

I should have remembered the link but there is a study that was just recently released stating that obesity is here to stay. a 20 year study proves that dieting at any level is not going to help you lose weight if you are overweight. The study goes on to state that only 5% of dieters are successful in losing weight and keeping it off.
The other 95% may lose the desired amount of weight but in every case they regain that weight and sometimes more over a period of 5-10 years.

I think you've misunderstood the study. That's true to the extent that people don't make permanent lifestyle transformations. Dieting doesn't work, this is true. Lifestyle changes do work!

What in_the_stars posted in the other thread on this issue is far more enlightening to me than rawr rah rah willpower, get some!

"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. "

http://www.nytimes.com/2007/05/08/health/08fat.html?pagewanted=all&_r=0


This is no ordinary test of willpower. This requires extraordinary willpower. Failing to acknowledge that is setting ourselves up for failure.

Well!


Guess we'll just have to prove that study wrong, won't we?

woohoo! this ^

That's because most people don't diet in sustainable ways. They diet with too big a deficit and too restrictive a diet, they frequently don't exercise (which increases the risk of losing lean mass and slowing the metabolism in the process) and so they set themselves up for having a really hard time maintaining.

Fact is that with the right approach and attitude, maintaining can be a lot easier, and is totally possible.

It's really annoying that the scientists have concluded that health services etc should just give up, rather than have a radical overview about the effectiveness of the specific advice they're giving people for weight loss. How many doctors just stick people on 1200 cals/day diets? ... lots do. How many doctors advise people to lift weights to protect their lean mass while dieting? not many. ....... and most people don't even follow diets prescribed by their doctors, they do this cleanse or that fad.... there's so much misinformation out there it's no surprise that 95% of people fail to maintain long term... that doesn't mean it's impossible for people to lose weight and keep it off... it means the approaches that most people are taking to do that are flawed!!

Seriously if scientists took that approach to any other field of science we'd never develop any technology because they'd just have given up the whole project on the grounds that their current approach wasn't working....

Why do so many people here automatically assume all the studies done around weight loss and maintenance are based off participants who lost weight with pills/fad diets/cleanses/etc?


I've never seen a single person here post anything to back this assumption up. So it really just sounds, at this point, like wishful thinking.

The assumption isn't that they all did fads, cleanses etc (at least not as far as I can see)...... the assumption is that they "went on a diet" then "went off their diet" and that they didn't make a conscious effort to make their diet sustainable or put much effort into the maintenance phase of dieting. The study was on a random sample of joe public......... when you consider people who diet in general... how many of them put in the effort to make sustainable lifestyle changes as opposed to looking for quick fixes, or even if they diet with sensible deficits and exercise, how many "go on a diet" then revert back to their old ways? There's a whole load of different mistakes being made by people (cleanses and fads being one of a whole range)..... no way is it the case that 95% of people are doomed to gain back weight no matter what they do. I don't believe that for one minute. For people who don't want to be in that statistic, they need to identify all the things that yo-yo dieters are doing wrong and avoid them, and identify what successful long-term maintainers are doing right, and do those things instead.

Tracking and life-style changes (exercise, active, selective food choices) perhaps? (Note - I don't necessarily agree with the low fat reasoning at the bottom of this post but it is one researcher's conclusion vs high fat diet (probably not isocaloric)

Long-term weight loss maintenance in the United States.

Kraschnewski JL1, Boan J, Esposito J, Sherwood NE, Lehman EB, Kephart DK, Sciamanna CN.
Abstract

CONTEXT:

Although the rise in overweight and obesity in the United States is well documented, long-term weight loss maintenance (LTWLM) has been minimally explored.

OBJECTIVE:

The aim of this study is to estimate the prevalence and correlates of LTWLM among US adults.

DESIGN, SETTING AND PARTICIPANTS:

We examined weight data from 14 306 participants (age 20-84 years) in the 1999-2006 National Health and Nutrition Examination Survey (NHANES). We defined LTWLM as weight loss maintained for at least 1 year. We excluded individuals who were not overweight or obese at their maximum weight.

RESULTS:

Among US adults who had ever been overweight or obese, 36.6, 17.3, 8.5 and 4.4% reported LTWLM of at least 5, 10, 15 and 20%, respectively. Among the 17.3% of individuals who reported an LTWLM of at least 10%, the average and median weight loss maintained was 19.1 kg (42.1 pounds) and 15.5 kg (34.1 pounds), respectively. LTWLM of at least 10% was higher among adults of ages 75-84 years (vs ages 20-34, adjusted odds ratio (OR): 1.5; 95% confidence interval (CI): 1.2, 1.8), among those who were non-Hispanic white (vs Hispanic, adjusted OR: 1.6; 95% CI: 1.3, 2.0) and among those who were female (vs male, adjusted OR: 1.2; 95% CI: 1.1, 1.3).

CONCLUSIONS:

More than one out of every six US adults who has ever been overweight or obese has accomplished LTWLM of at least 10%. This rate is significantly higher than those reported in clinical trials and many other observational studies, suggesting that US adults may be more successful at sustaining weight loss than previously thought.

http://www.sciencedaily.com/releases/2014/01/140106115351.htm

esearchers from The Miriam Hospital have published one of the first studies of its kind to follow weight loss maintenance for individuals over a 10-year period. The results show that long-term weight loss maintenance is possible if individuals adhere to key health behaviors. The study is published in the January 2014 issue of the American Journal of Preventive Medicine.


J. Graham Thomas, Ph.D., is the lead author on a 10-year observational study of self-reported weight loss and behavior change in nearly 3,000 participants. The participants had lost at least 30 pounds and had kept if off for at least one year when they were enrolled in the National Weight Control Registry (NWCR).

The participants were then followed for 10 years. Thomas explains that the goal of the study was to determine how well they kept the weight off and to identify predictors of successful weight loss maintenance.

Thomas says, "On average, participants maintained the majority of their weight loss over this extended follow-up period, and better success was related to continued performance of physical activity, self-weighing, low-fat diets, and avoiding overeating."

Other findings from the study show that more than 87 percent of the participants were estimated to be still maintaining at least a 10 percent weight loss at years five and 10. The researchers found that a larger initial weight loss and longer duration of maintenance were associated with better long-term outcomes. Conversely, they found that decreases in physical activity, dietary restraint and self-weighing along with increases in fat intake were associated with greater weight regain.

http://www.ajpmonline.org/article/S0749-3797(13)00528-X/pdf