Dieters have long lamented how hard it is to keep weight off after losing it, but the results of a new study may help.
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Penn State researchers found that some of the techniques used by people who successfully maintain weight loss are quite different from those techniques used to lose weight. And the researchers say that understanding these differences may hold the key to keeping weight off for the long term.
"It's intuitive to think the same things that got you there would keep you there," said study leader Dr. Christopher Sciamanna, an internal medicine physician at Penn State Hershey Medical Center. "What we found is that that may not be the case."
Maintaining weight loss has traditionally proven to be harder than losing weight, a problem that researchers have chalked up to waning motivation.
"People may successfully lose weight, but maintaining that weight is really where the challenge begins," said Joy Dubost, a registered dietitian and spokeswoman for the American Dietetic Association. "Within 3 to 5 years, typically, all of that weight loss is regained."
What works to keep the weight off?
The researchers analyzed survey responses from 926 people who were overweight (whose BMI was over 25) and had tried with varying degrees of success to lose weight and keep it off. The responses detailed whether they used 36 specific weight-control practices either in losing weight or keeping it off. They defined successful weight loss as losing 10 percent of body weight, and weight maintenance as keeping that 10 percent off for one year.
Sciamanna said one of the goals of the study was to find cognitive techniques, or things that people should think about. The idea is that these could help weight loss, but not be as difficult to do as dieting and exercise. He added, however, that dieting and exercise remain essential to weight loss, and thoughts alone wouldn't have an effect.
The researchers found two techniques that helped with weight maintenance (but not necessarily weight loss): reminding yourself why you need to control your weight, and rewarding yourself for sticking to a diet and exercise plan.
Robert Jeffery, director of the Obesity Prevention Center at the University of Minnesota, was skeptical of the study's results.
"Most of the stuff that [the study] looked at that is associated with weight loss and weight maintenance are very much the same," he said, explaining that differences may be more a matter not of what people do, but how diligently they do it.
He said the issue with sustained weight loss comes back to motivation.
"We have information on people who have successfully lost large amounts of weight and kept it up for a long time," Jeffery said. "They exercise a lot more than most people do, and they eat a lot healthier diets than most people do.
"It's possible to do, but for most people, it's going to require something different from what most people do, and that's the struggle," he said.
Jeffery was similarly skeptical of the role of cognitive techniques in weight loss because, "Those instructions stick about as well as the instructions to eat healthier foods. People can do it for a while, but in the long term they stop doing it and whatever benefits it has go away."
"We don't have a magic bullet to create motivation out of thin air."
Tackling the issue, Jeffery said, would probably mean taking steps to prevent obesity in the first place, such as taxes on unhealthy foods. However, he acknowledged, "I think the likelihood of that happening is probably close to zero."
One point the researchers all agreed on was the importance of changing routines. Jeffery's research has focused on having people vary diets by month and sometimes taking a month during which they aren't actively being instructed on how to diet.
"People were in fact more successful at keeping the weight off in that method than using traditional methods. They were able to [on average] not start gaining weight again for at least 18 months," he said.
Sciamanna said that one of the aims of the research was to show that changes need to come to keep weight off after losing it.
"It's tempting to say, blame it on the person," Sciamanna said. "Maybe you're just not doing the right things."
The study is published online today (July 5) in the American Journal of Preventive Medicine.
Pass it on: To keep weight off, you may want to try reminding yourself why you need to control your weight and rewarding yourself for sticking to a diet and exercise plan.
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