Weight Maintenance -- What Works?

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It can be difficult for overweight or obese people to lose weight, yet many do so. What seems to be much harder is maintaining weight loss -- and the health benefits that can accompany it -- for the long term.

Dr. L.P. Svetkey and colleagues (JAMA 299; 1139-1148) compared different strategies for sustaining weight loss in a two-phase trial. They found that having brief, monthly personal contact with a weight loss interventionist offered a slight benefit over either an interactive technology-based intervention (a website) or simply self-directed methods.

Participants in the study were 1,032 overweight or obese adults (38% African American and 63% women) who had high blood pressure, abnormal blood lipids, or both and thus were at increased risk of cardiovascular disease. They participated in a 6-month weight loss program, and lost at least 4 kg during this first phase of the program. The initial weight was about 97 kg or about 213 pounds, and the average loss was 8.5 kg or about 19 pounds. At the end of this program, they were randomly assigned to one of three groups -- monthly personal contact (typically a 10-15 minute phone conversation), interactive technology-based intervention, or a self-directed control group. These groups were then followed, with periodic monitoring of food intake, body weight, and activity, for an additional 30 months.

Once the initial weight loss phase of the study ended, all three groups tended to regain weight -- but none returned to their original weights by the end of the thirty-month maintenance period. The greatest degree of weight maintenance was achieved by the personal interaction group, which regained 1.5 kg less than those in the self-directed control group. Overall, about 37% of the participants remained 5% or more below their original entry weight. Although this seems like a modest effect, the authors point out that "even modest weight loss can improve cardiovascular risk factors."

These results should be encouraging to those who need to improve health by losing weight -- they indicate that long-term weight loss can be attained and then maintained by a variety of methods.

Ruth Kava, Ph.D., R.D., is Director of Nutrition at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).