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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. 

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 inJAMA (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.


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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.

But once you lose the weight, how do you keep it off? Studies show that about one-third of the average dieter's total weight lost is regained within a year - and the rest comes back within 3 to 5 years. A team of researchers noted that the typical attitude toward weight maintenance is just that - maintaining the strategies that helped with weight loss over the long term. Given that so much of weight lost is eventually regained, it seems clear that just continuing those weight loss strategies doesn't work. What does?

The researchers began by recruiting over 950 adult men and women who had lost at least 30 pounds and had been successful at keeping it off for at least 1 year (Am J Prev Med 2011;41(2):159-166). Through in-depth interviews, the researchers were able to identify 36 strategies that were most frequently used for weight loss or maintenance.

The participants were then surveyed on those 36 practices, asking them to describe how often, on a 5-point scale, they utilized that practice. The percentage of participants who indicated a high usage of that particular strategy was correlated with the individual's initial weight loss and their maintained weight. This allowed the researchers to see which strategies were most often associated with weight loss, weight maintenance, or both. For example, planning what they were going to eat ahead of time was more strongly associated with weight loss than weight maintenance. On the other hand, those who most often ate "plenty of low-fat sources of protein" were more likely to report maintaining their weight loss as opposed to losing weight.

Here are the strategies that were most strongly associated with weight maintenance, but NOT weight loss:

  • Eat plenty of low-fat sources of protein
  • Allow yourself to eat a small amount of some unhealthy foods
  • Follow a consistent exercise routine
  • Remind yourself of why you need to control your weight

What this means for you

It's clear that just continuing your weight loss strategies after you reach your goal weight isn't going to help you maintain that weight loss for the long haul. Look at the second item on that list above: "Allow yourself to eat a small amount of some unhealthy foods." That means balance, which is at the core of Just Tell Me What to Eat! and The Dr. Gourmet Diet Plan. As you look at these lists, keep in mind that these are just the strategies the individual participants said that they used most often - this does NOT mean that these strategies are proven to work.

And for those who want to know the strategies most strongly associated with weight loss, (and not maintenance) the list:

  • Participate in a weight-loss program
  • Look for information about weight loss, nutrition or exercise
  • Eat healthy snacks
  • Limit the amount of sugar you eat or drink
  • Plan what you'll eat ahead of time
  • Avoid skipping a meal, including breakfast
  • Do different kinds of exercises
  • Do exercises that you enjoy
  • Think about how much better you feel when you are thinner

And a few of the strategies associated with both weight loss and weight maintenance:

  • Weigh yourself
  • Limit the amount of unhealthy food in your home
  • Drink plenty of water
  • Control your portions

First posted: August 10, 2011