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Why Does Everyone Gain Back the Weight?

Here’s the claim that diet books, weight loss promoters, and other “experts” make: once you lose weight, you’ll know how to eat, you’ll be motivated, and you’ll keep the weight off. Of course, that’s not true. What actually happens is that people tend to reach their maximum weight loss after six to eight months (1) and then gradually regain the weight (and often end up weighing more than they did in the first place) over a period of one to five years.

Why does this happen?  There are many explanations, based largely on the body’s physiologic response to weight loss (and not on being weak or lazy or undisciplined). Jay and I are among only 20% (2) of people who have successfully achieved long-term weight loss, and we’ll share with you our secrets — strategies that that are backed up by actual science and not just marketing ploys.

This Is What Works:

  • Get Moving

Here’s the dirty little secret about sustaining weight loss: once you weigh less, your body adapts and needs fewer calories to maintain the lower weight (3). As if that’s not bad enough, the body also adapts to weight loss by making you hungrier (4,5,6). Which means you need to eat less. But you’re already eating so much less!  What’s the solution to revving up your metabolism?  Exercise. While physical activity doesn’t have a large role in initial weight loss, at least compared to decreasing caloric intake, exercise is essential in maintaining weight loss. (3,7). An average of 30 minutes a day is great; 60 is super (or super-human, if you ask me).

  • Pay Attention to the Numbers

In our previous post on self-monitoring, we discussed the pros and cons of tools such as weighing yourself and counting calories. In order to maintain weight loss, however, the pros definitively win out — self-monitoring is highly effective (8). Jay and I have each discovered how easy — and depressing — it was, once we stopped weighing ourselves regularly, for the weight to creep back on. So now we’ve each gone back to that more disciplined approach. What do people you maintain weight loss have in common? There’s lots of evidence showing that they monitor and record their weight, their food intake, and their physical activity (9).

  • Train Your Brain

(1) A Relapse Is Not a Sign of Failure

Old coping strategies die hard, and slip-ups happen; they’re inevitable. Of course, you want to prevent them as much as possible, but sometimes you can’t — or just don’t. The important thing is not to submit to “discipline fatigue” and abandon your healthy approach to eating. One candy bar doesn’t “ruin” the day. One day of crazy eating doesn’t “ruin” the week. You’re not a failure. Those people who are the most successful at staying on track are those who continue to focus on their positive progress (10), who feel a greater sense of self-worth (11), who value the health benefits of healthy eating, and who continue to develop strategies for avoiding future lapses (12).

(2) Focus on the Good Stuff

Warnings from doctors, criticism from loved ones, even financial incentives — they all may work — but only in the short run (13,14). Jay and I hate the short run — I mean, what’s the point? If you go back to your unhealthy habits, then you just feel more frustrated and pessimistic than ever. Sustained weight loss happens because people develop their own strategies that are meaningful to them and enjoyable enough that they’ll stick with them (13,14). So if you feel like you’ve eaten enough salad for a lifetime, then try something else! If going to the gym is less fun than going to the dentist, then go dancing or walking with a friend. You get the point.

(3) Forget Your Old Coping Strategies

A pint of mint chocolate chip makes you feel oh-so-much better, right? Yes, right — for five minutes. And then the self-recrimination, the disgust, and the shame set in. If you’ve lost weight in a good way, then you have already developed new coping skills for dealing with stressful situations. Dust off those skills again, and keep going. 

It Gets Easier!

Sure, we can change what we decide to eat, but can we change what we want to eat?  Can we change our food preferences? The good news is that we can.  And here’s where the science gets really interesting. Using MRI scanning, researchers discovered that by repeatedly choosing foods for health value and not just taste value, it eventually becomes easier for people to want to choose the healthy option (15). The brain adapts. Think about it: this is literally strength training — except without the barbells!  How cool is that?!?

Remember Why You’re Doing This

Along with the discipline of eating healthy, non-processed foods, being physically active, and monitoring the numbers, there’s something else of equal importance: kindness. It’s not about the weight. Really. It’s about feeling good physically, feeling confident emotionally, and feeling deserving of taking care of yourself.

Staying fitter and slimmer has not been a cakewalk, so to speak, for either Jay or myself. But neither is our success a mystery. We each figured out the strategies that worked for us in the first place, and we go right back to them when we have a little lapse. We don’t go to that old space of giving up on a diet or giving up on ourselves. Eating well means taking care of ourselves in a grownup way. It’s a much better way to live.

 

References

1. Santarpia L et al.  Body composition changes after weight-loss interventions for overweight and obesity.  Clin Nutr 2013; 32:157-61.

2. Anderson JW et al. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 2001; 74 (5):579-84.

3. Rosenbaum M et al.  Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight. Am J Clin Nutr 2008; 88 (4): 906-12.

4. Greenway FL. Physiological adaptations to weight loss and factors favouring weight regain. Int J Obes 2015; 39(8:)1188-96.

5. Ochner CN et al. Treating obesity seriously: when recommendations for lifestyle change confront biological adaptations. Lancet Diabetes Endocrinol 2015 3 (4): 232-4.

6. Polidori D et al. How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake. Obesity 2016; 24 (11): 2289-95.

7. Pronk NP. Combined Diet and Physical Activity Promotion Programs for Prevention of Diabetes: Community Preventive Services Task Force Recommendation Statement. Annals  Int Med 2015; 163(6):465-8.

8. Peterson ND et al. Dietary self-monitoring and long-term success with weight management. Obesity 2014; 22(9):1962-7.

9. Butryn ML et al.  Behavioral treatment of obesity. Psychiatr Clin N Am. 2011; 34(4):841-59.

10. Testa RJ, Brown RT.  Self-regulatory theory and weight-loss maintenance.  J Clin Psychol Med Settings 2015; 22:54-63.

11. Kozica S et al.  Initiating and continuing behaviour change within a weight gain prevention trial: a qualitative investigation.  Plos One/DOI 2015: 1-14.

12. Hall KD, Kahan S. Maintenance of Lost Weight and Long-Term Management of Obesity. Med Clin N Am 2018; 102:183–97.

13. Halpern SD et al. Randomized trial of four financial-incentive programs for smoking cessation. NEJM 2015; 372(22):2108-17.

14. Vo
lpp KG et al. Financial incentive-based approaches for weight loss: a randomized trial. JAMA 2008; 300(22):2631-37.

15. Schonberg T et al. Influencing food choices by training: evidence for modulation of frontoparietal control signals. J Cogn Neurosci 2014; 26(2):247-68.