I’ve lost a pile of weight. I’m creeping up on 57 lbs lost so far, and I have every intention of maintaining a healthy weight.
However, most people don’t really lose weight and keep it off. A study found that something like only three percent of those who lose significant weight actually keeps it off. Statistically, that means I’m going to get fat again.
But that doesn’t have to be the case. I know it.
So I thought I’d dig into the science behind weight loss–and not just nutrition–to see what I could find out about how to actually keep it off.
Table 1 presents the means and standard deviations of each variable for the participants who provided data on that variable. Patients ranged in age from 20 to 77 years, with an average of 43. The average starting BMI was 41.0 kg/m 2, with a range from 30.6 to 68.9. Participants attended an average of 20.4 of the weekly sessions with a range of 4-26 weeks. The mean final BMI at the end of the 6-month program was 32.8, with a range of 21.8-53.2. The mean change in BMI was 8.2, which represents a reduction of 20% of the average starting BMI.
The mean follow-up BMI for the 52 participants was 35.0 kg/ m 2, yielding a net mean reduction in BMI for these patients of 5.0 kg/m 2 over the 23-month period. The range in the 23- month BMI change was from a reduction of 24.7 kg/m z to a gain of 5.3 kg/m 2.
Because body mass index is a difficult concept, we offer two illustrative examples. One 5’6 ~ participant weighing 246 lbs ( 111 kg; BMI = 43.7 kg/m 2) completed the program weighing 189 lbs (85 kg, BMI = 33.6 kg/m2). This person lost 57 lbs (26 kg; change in BMI = 10.1 kg/m2). At 23-month follow-up this participant weighed 236 lbs ( 106 kg). Follow-up BMI = 41.9, for a maintained weight loss of 10 lbs (4.5 kg), and a follow-up change in BMI of 1.8. Another patient weighed 267 lbs ( 120 kg) at the start (5’9″, BMI = 39.5) and lost 69 lbs (31 kg; final BMI = 29.3) in the program. This patient weighed 235 lbs ( 106 kg) at the 23-month follow-up (BMI — 34.7).
In other words, despite a questionnaire designed to make sure they would keep to the program, most of these individuals put the weight back on. The study looked at 128 individuals, so it wasn’t a particularly small study like so many of the kettlebell studies we’ve looked at, so there’s less opportunity for statistical anomalies to skew the results.
Yet what they found was that those who continued to exercise after the initial study period were those who maintained their weight loss. While the study’s authors didn’t make any comments on that due to a relatively small sample size, here’s what they did say on the topic of why some kept it off and others didn’t.
In this study of severely obese patients in a 6-month, Optifast weight-loss program, the degree of patients’ autonomous motivation for participating in the program was assessed and found to predict attendance at weekly meetings of the program and weight loss during the period. More important, autonomous motivation for participating also predicted maintenance of weight loss at the 23-month follow-up. Thus, the data confirmed that individuals’ autonomous motivation is an important predictor of whether a weight-loss program is likely to be effective not only in promoting weight loss but also, more important, in facilitating its maintenance. Given the serious health risks of severe and morbid obesity, these findings seem to be of considerable significance.
Now, what does that and exercise have to do with one another?
Well, here I’m about to interpret what I read in this study. You see, I think we have a correlation between those who maintained exercise and those who kept weight off for one simple fact, and it’s tied to motivation.
Those who were the most motivated to lose weight were the ones who had the most motivation to continue. These individuals internalized the lifestyle changes introduced through the study, so after the study period was over, they simply kept on working because that had simply become who they were and what they did.
In other words, the study introduced lifestyle changes into the subjects lives and they embraced them.
Look, no one starts a diet hoping to fail. They all want to lose a ton of weight and be nice and healthy. The problem is that most think of the changes that produce weight loss as a temporary change, hoops they have to jump through before they can lose the weight then go back to their lives.
Speaking as a former fatty, though–and I still need to lose some weight–the issue here is that if your lifestyle and how you lived it contributed to you becoming obese, going back to it will only have one inevitable outcome.
You’re gonna get fat again.
I suspect that those subjects in the study that maintained the exercise also maintained their weight loss because they understood that their past existence is what made them fat in the first place.
This isn’t the only study to suggest this, either. A 2001 study published in the Annual Review of Nutrition found:
We found that in the National Weight Control Registry, successful long-term weight loss maintainers (average weight loss of 30 kg for an average of 5.5 years) share common behavioral strategies, including eating a diet low in fat, frequent self-monitoring of body weight and food intake, and high levels of regular physical activity. Weight loss maintenance may get easier over time. Once these successful maintainers have maintained a weight loss for 2–5 years, the chances of longer-term success greatly increase.
In other words, these are people who continue with the weight loss strategies even after they lose the weight.
It seems that almost any weight loss program will yield results to some degree. The problem is what happens afterward.
Programs that supposedly want to help you lose the weight but fail to give you the coping strategies to continue on your own such as weight loss programs with their own proprietary systems that can only be managed through their services or those who simply send you food fail to fully equip people with the tools they need to continue.
The truth is, once you’ve been fat, the chances are good that you’ll always have to be vigilant against becoming overweight again.
In an odd sort of way, though, that makes me feel a lot better. I know precisely what will happen if I stop doing what I’m doing and I also know how to maintain what I’ve accomplished.
That’s a big win.
