Many Dieters Keep the Weight Off

June 7, 2007 — -- You've heard the statistic before: "Ninety-five percent of all dieters gain the weight back."

Books have been written about how the odds are stacked against us. There are groups to help us lose weight, celebrity endorsements for weight loss plans, medications, surgery, hypnosis, herbs, potions and even weird gadgets.

For example, remember Vacu-pants? You hooked up a vacuum cleaner hose to these special pants and "the pounds just vanished away." People actually went for this gizmo. A former patient of mine even 'fessed up to having bought it years ago.

For all the available weight loss strategies, there are an equal number of dismal reports reminding us that absolutely nothing seems to work over the long term for about 19 out of 20 people who try them.

Of course, with Vacu-pants, it's probably 20 out of 20, but that's another story.

Yet, consumers are persistent and continue to fight the battle to lose weight and keep it off. Now, a new study suggests that, although we have a long way to go, more of us are winning than was previously thought.

Why Weight Returns for Some

The study, just published in the American Journal of Preventive Medicine, looked at 1,310 adults from the 1999 to 2002 National Health and Nutrition Examination Survey who were overweight or obese at their heaviest weight, but who had lost at least 10 percent of their maximum weight a year before the survey.

Nearly two out of three subjects either maintained their weight (within 5 percent) or continued to lose weight.

While a full third of those surveyed regained their weight, these results seem much more promising than previous studies.

The study authors also found some common factors associated with those who were most likely to regain their weight:

Lots of time spent in front of the television and computer (four hours or more per day)

Losing a lot of weight (at least 20 percent of maximum weight instead of 10 to 15 percent)

Fewer years since reaching maximum weight (two to five years vs. 10 years or more)

Mexican-American heritage

Most of these make logical sense. Too much screen time is usually a marker for being sedentary. These folks are probably less likely to get lots of exercise.

Losing too much weight too fast, either by fad or extreme dieting, can leave people feeling deprived and may end up triggering binges that go on until the weight is regained and increased.

It takes time to really adopt a lifestyle that supports weight maintenance. If you've lost the weight fairly recently, you may not have acquired all those skills yet, which may explain why those in the survey who have not been at maximum weight for many years were less likely to have regained weight.

Of, course your heritage, whatever it may be, is not controllable, but in this study, it may be a cultural marker of the kinds of food you're likely to have in the home, the portions you eat or how a culture views tolerance of weight or body size.

How Some Keep the Pounds Off

The present study focused on discovering factors that would predict weight gain among the general population.

By contrast, the National Weight Control Registry, founded in 1994 by researchers Jim Hill of the University of Colorado and Rena Wing of Brown University, set out from the start to discover what successful weight maintainers had in common. That is, they wanted to see whether they could come up with factors that predicted success.

What a concept! Too often in research, especially obesity research, we look at what goes wrong and try to come up with explanations.

National Weight Control Registry researchers had no interest in reinventing that wheel and, instead, went straight for the successes, people who lost at least 30 pounds and kept it off for at least a year.

To a large extent, both the present study and the National Weight Control Registry are attempting to answer the $64,000 question about weight loss: how to keep it off.

Face it, losing weight is really pretty easy: Go on a sensible diet, or even some fad diet, or cut out some major food group or two, and the pounds eventually drop. It may not be fun, or even healthy, but there are many ways to get it done.

What the National Weight Control Registry found was, although people lost weight differently, they kept it off similarly.

What is reinforced, to some degree by the present study, is that maintaining weight loss seems to require some common factors. Here are some traits found of successful maintainers:

Most eat a low-fat diet, but not a hugely restrictive one. They watch portion sizes.

Nearly four in five eat breakfast every day of the week.

Most are physically active, but walking is their most common form of activity and they do it for nearly an hour daily. These people probably aren't getting four or more hours of leisure screen time.

They actually find pleasure in their healthier lifestyle and the liberation from constant dieting.

Routine Preserves Results

More good news for the winners: It gets easier over time. After a while, the maintainers just knew what would work and what wouldn't, and it became much easier and more satisfying to do what worked.

As a result, most members of the National Weight Control Registry have lost at least 60 pounds, twice as much as they needed to become registered.

That contrasts from the present American Journal of Preventive Medicine study, which suggested how too great a weight loss was more likely to result in a regain of weight.

Perhaps the National Weight Control Registry volunteers, now 4,500 strong, are highly motivated and extremely proud of their success and want to tell the world. Good for them. They deserve it. Besides, aren't we all ready for a little good news on the obesity front?

See how closely you can begin to adopt the winning habits of successful maintainers. Some friendly advice: Forget the quick stuff. Slow and steady changes are easier and they really help you enjoy the ride.

Just ask the folks who have done it.

Keith-Thomas Ayoob is an associate professor in the department of pediatrics at the Albert Einstein College of Medicine in New York City.