The odds of long-term weight loss success
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cwolfman13 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.2 -
"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%
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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.2 -
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.1 -
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...4 -
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?9 -
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.4 -
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.
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NorthCascades wrote: »I don't think maintaining is very difficult. If you made it through the weight loss, now you get to eat more.
You wouldn't think it would be....
I've lost 70 lbs, and put 60 back on
Lost 30 lbs and put 40 back on
I'm down 65 lbs again, and this time I'm keeping my 'fat' clothes in storage....here's to hoping....9 -
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.1 -
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.4
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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?
In a way maintenance is eating less. It may be more than the last big of weight loss, but it's not more that most who start a weight loss program were eating before they started. And perhaps not more than for most of the time they were losing if they started off very large and had to continually lower their daily caloric intake as they got smaller.
Whatever the reason, statistics would suggest that it is indeed harder. Or perhaps it's just the amount of time you have to do it that makes it harder.6 -
Personally I don't find maintenance hard at all. Been at maintenance approaching 5 years in July and there are plenty of people on this site who are maintaining as well. Its not without effort though so I guess its up to the individual how much they want to stay at their goal weight range.
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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?1
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our youngest son lost 120 lbs when he was 19 & is now 34, hasn't gained any back15
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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.0 -
I feel like those stats are that low because a bulk of the people embarking on a diet plan go keto, paleo, eating clean, or any other magic-results promising diet without UNDERSTANDING the mechanics of weight loss. We have a lot more resources to get to good information now; we dont' have to rely on Susan in accounting who "lost 10lbs putting butter in her coffee 2x/day." 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.8
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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.3 -
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?
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.
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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.
Absolutely agree. When I gained back 15lbs over the last 2 years I didn't curse my metabolism, my genes or my lack of secret nutritional knowledge. It was 100% my personal responsibility and I was and always am in control.11 -
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.
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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!2 -
mrsnattybulking wrote: »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.
Absolutely agree. When I gained back 15lbs over the last 2 years I didn't curse my metabolism, my genes or my lack of secret nutritional knowledge. It was 100% my personal responsibility and I was and always am in control.
Some people really need to have their "woo" button taken away...8 -
I am actually one of the 15%. I lost just shy of 100 pounds back in 2012 - 1013, after a pretty devistating cancer. I was only given a 20% of surviving 5 years, then found out that research has determined that many adult onset cancers can be slowed or even stopped from returning with a combination of diet, exercise and weight loss. So I lost that 100 pounds over the course of a year, and I have stayed within 10 pounds of my lowest point for all of the 4 years since. Right now, I'm about 3 pounds over my lowest weight after the weight loss. I'd say that puts me in the ranks of those who manage to keep the weight off.22
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I have long been under the impression that the percentage of those who lose a significant amount of body weight and maintain it was extremely low... like <5%. ... But today I was looking for the data, and though it sounds like it hasn't been widely studied, the info I found points to about 1 in 6 (>15%) being able to maintain at least a 10% loss long-term. ...But why the discrepancy?
These studies are quite unreliable because the data comes from
(1) incidental results,
(2) studies with very small sample sizes, or
(3) self-reporting studies.
That is, any "general" long-term weight loss study is usually an extrapolation of results obtained from other, largely unreliable, studies. Basically, the only studies that actually exist
(1) study a particular product (e.g., lap band surgery, The South Beach Diet, Weight Watchers) and use long term weight loss results to draw a conclusion about the effectiveness of the product;
(2) follow a group of program participants (e.g., The Biggest Loser contestants) over an extended period of time; or
(3) have people respond to a survey.
These methods are unreliable because
(1) doesn't require a control group,
(2) always uses sample sizes less than 1000 people, and
(3) is often skewed because the people who had long term success are more likely to respond to these surveys than those who did not have long term success (like Yelpers usually only review when they have a strong opinion about a business).
In any case, these stories are dangerous to consider because your weight loss journey is a personal one. And once you start comparing others' journeys, you start looking outward, thereby sabotaging your own success. You're no longer focusing on your personal goals, but using others' successes and failures as a measuring stick for where you "should be."7 -
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?
Because it's not my experience at all.
Maintenance is much harder for me because I'm overall way hungrier. I was doing fine on a 400ish deficit then went on vacations and started eating a bit more to prepare for maintenance, and my appetite spiked horribly. It was easy for me to use up 300-400 calories a day of treats when losing. Now, if I do that, it pretty much guarantees that I will get hungry.
There's so much more to eat than 'it's easier to eat more than to eat less'. There's hormonal changes as your body gets leaner, there's activity changes (I'm quite sure that me being more active spiked my hunger too), there's getting older and needing less calories as you go (or your body starting to get sore faster).
And yeah, there's the fact that a lot of people cut out food groups or whatnot, and adding more 'empty' calories is just not making it easier.6 -
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.
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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.4 -
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
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I confess, I really only came in here to post this gif. I do apologize.
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JHStillRunning wrote: »I confess, I really only came in here to post this gif. I do apologize.
I like it... you're forgiven 5
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