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Maintenance First!
It's sad, but usually true: most people who lose weight eventually gain at least some of it back - and all too many gain back more than they lost. As you might expect, preventing that bounce-back and helping people to maintain their weight loss is becoming an important part of research into overweight and obesity.

Exercise Really Is Key to Weight Loss and Maintenance
A couple of years ago I reported on a study that showed the importance of exercise in achieving and maintaining weight loss (News Bite, 11/03/06). At a minimum, the National Institute of Health and the Center for Disease Control recommend thirty minutes per day of exercise on most days of the week, or 150 minutes per week. Studies also show, however, that the difficulty is not really in losing the weight - it's in keeping it off for the long term. 

Losing Weight vs. Keeping it Off: What Works?
When it comes to the obesity epidemic, it seems that all people talk about is how to lose the excess weight (and we here at Dr. Gourmet are no exception). There's plenty of information, ideas, strategies and tips for successful weight loss - the weight loss world is positively deafening, sometimes.


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Keeping It Off

We all know that it's one thing to lose weight - and quite another to keep it off for the long term. A study funded by the National Institute of Health and published recently in JAMA (2008;299(10):1139-1148) compares two strategies people might use to help maintain their weight loss: regular personal contact with a counselor via telephone or unlimited access to an interactive weight maintenance website. Could an online program take the place of an actual human being for the purpose of helping people maintain their weight loss?

The study of weight-loss maintenance was actually the second portion of a two part study which focused first on weight loss and second on weight loss maintenance. Those people recruited into the study initially had a Body Mass Index of 25 or more (overweight or obese), were taking medication for high blood pressure or poor cholesterol scores or both, had access to both a telephone and the Internet, and were able to keep a detailed food diary during the initial screening process. Almost 40% of the participants were African-American, while over 60% of the participants were women.

After an initial weight-loss program lasting six months, the participants were randomly assigned to one of three groups: no special assistance in weight maintenance (the control group), brief monthly telephone or in-person consultations with an expert trained in counseling, or unlimited access to an interactive website designed to help with weight loss maintenance. (The website allowed interaction with other weight loss maintainers, but did not supply personal, trained counseling.) This second phase lasted for another 30 months.

As you might expect, participants in all three groups regained some weight during the weight maintenance phase of the trial. Over two thirds of the people in all three groups kept their weight lower than it had been before the weight-loss phase, which is to be expected regardless of how the weight was lost or what kind of support people received in maintaining their weight loss. However, the average amount regained varied according to which group they were in: those with no special assistance regained the most (just over 12 pounds), while those in the personal-contact group regained the least (just under 9 pounds).

What this means for you

In talking to those of my patients who have lost weight, whether using The Dr. Gourmet Diet Plan or another program, those who have involved their close friends and family seem to fare the best at maintaining the change in lifestyle that long term weight loss requires. This study supports that observation: those participants who had regular contact with others to talk about weight management strategies - either online or in person - kept the most weight off. Get your friends and family involved with you in pursuing a healthier lifestyle. The more, the merrier!

First posted: March 19, 2008