Wednesday, July 15, 2009

Why Weight Maintenance is Harder Than Weight Loss, and How to Help it Along

An estimated 80% to 95% of people who lose a significant amount of weight will gain it back. It sounds high, yes, but I believe it. This is because I’m slowly becoming one of those people.

Full disclosure: about four years ago, I dropped 30 pounds to get to a (too) low weight of 132. Between then and now, my scale readout has slowly crept up to about 153 pounds. (Ideally, at 5-foot-9 with fine bones and the muscle tone of a newly-hatched wren, I’d like to be somewhere between 140 and 145.)

On one hand, I think I would have gained the weight back much faster had it not been for this blog. Undoubtedly, it’s helped my eating habits change for the better. I drink water, cook at home, scarf lots of produce, and avoid processed foods like it’s my job. My heart, lungs, and various other organs are in excellent shape, and my sister gets thoroughly annoyed that we can’t eat a meal without me adding some kind of crazy vinegar or seasoning. So there’s that.

On the other hand … I’ve put on 20 pounds in four years. I’m not in crisis mode (yet), but what the heck?

I know my faults. There are ongoing issues with portion control and dining out, and my reliance on cheese has grown from an occasional treat to an everyday occurrence. I just didn’t expect those factors to make this much of an impact on the circumference of my backside.

But, as the opening statistic demonstrates, I’m far from alone. Maintaining a weight loss is difficult for everyone. In fact, I would say it’s even harder than losing the weight in the first place. Why? Well, once you’ve dropped the pounds – once you’re no longer getting measurable results on the scale, and weight loss morphs from a happy goal to a ho-hum product of the past – things change. Over time, enthusiasm fades, behaviors slack, and long-ignored temptations are indulged with abandon.

In other words, eating salad for 40 days is easy. Eating salad for 40 years is hard.

Enter the National Weight Control Registry. Comprised of PhDs, MDs, and other experts in the health and obesity field, it monitors the habits of thousands of people who have lost at least 30 pounds, and have kept it off for a minimum of one year. (The average is 66 pounds over 5-1/2 years.) Workers conduct studies, publish journal articles, and are widely considered The Authority on diet and weight maintenance. And while they don’t claim to have concrete guidelines that will keep the pounds permanently off for everyone, they have discovered a few actions common among successful maintainers. (Note that these findings imply correlation, and not necessarily causation.)

In order of popularity, they are:

1) Exercise, on average, about one hour per day.
90% of successful maintainers do this.
Far and away the most common factor for weight maintenance among respondents, exercise prevents you from binging, draws you away from the television set, and … y’know, does all the good things it’s supposed to. Movement must be for life, not as part of a temporary diet plan.

2) Eat breakfast every day.
78% of successful maintainers do this.
The researchers gave three reasons for this: “First, eating breakfast may reduce the hunger seen later in the day that may in turn lead to overeating…Second, breakfast eaters may choose less energy-dense foods during the remainder of the day. Finally, nutrients consumed at breakfast may leave the subject with a better ability to perform physical activity.” Of the 2959 successful maintainers in a 2002 NWCR study, only 4% never ate breakfast.

3) Weigh yourself at least once a week.
75% of successful maintainers do this.
The NWCR calls this “consistent self-monitoring,” and claims it allows maintainers to, “catch weight gains before they escalate and make behavior changes to prevent additional weight gain.” I have not weighed myself in over a year. This explains a lot.

4) Watch less than 10 hours of TV per week.
62% of successful maintainers do this.
In a 2003 study, the American Heart Association found a strong correlation between the amount of TV one watches, the amount of fast food ingested, and the propensity for obesity. Turning the boob tube off can help sidestep this, as it allows for more activity and less mindless grazing. (Personally, I believe this point is incredibly important for kids, since they develop habits in childhood that they’ll have for the rest of their lives. Subsequently, I’d lump video games and computer time in the same category.)

The good news is, the longer you maintain your weight, the more likely you are to keep it up in the future. So, adopting these behaviors can only help. I would also suggest that beginning the whole process with long-term intentions (“This is not a diet. This is a lifestyle change.”) makes all the difference in the world.

As for me, I have to drop some pounds again. Then, I need to concentrate on maintaining it for the rest of my life. It's gonna be tough, but I feel a responsibility to readers, the Husband-Elect, our future kids, and myself to do so. Fingers crossed, these strategies will help.

Readers, how about you? What’s been your experience with maintaining weight loss?

(Photos courtesy of the University of Maryland and Documenting Success.)

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30 comments:

Liz C said...

It's hard! I've cut just about every bad habit I've ever had and eat primarily healthy, first order food but as the years go by, the scale creeps upward no matter what I do. Now that I'm almost 50 it's getting even tougher.

I'm running out of things to cut. If I ate McD's every day it would be easy to make a sweeping change there but the only changes that are left are the HARD ones.

There is no way I will ever be able to exercise an hour a day, so maybe I'm screwed?

Aimee said...

If it makes you feel any better, I gained about 100 pounds in about 1 1/2 years. OK - I had an eating disorder which dropped me WAAAAAAY below a normal weight, but 20 lbs in 4 years isn't too bad...and you're now at a healthy weight, so kudos to you! :)

Kris said...

Liz, holy cow, do I ever hear you. It's gonna be hard making further cuts, and exercise ... yeah. It's something I know I need to do, yet I keep putting off. And for some reason it got monumentally harder after I hit 30.

Aimee, thank you. And I'm glad you're healthier now :)

Hops said...

I just got my personal training certification (and wanted to brag a little). I can tell you that with respect to exercise, it's WAY easier to maintain a work out routine than it is to start exercising out of the blue. It gets easier after the first month or so to carve out that hour each day. Pretty obvs why 90% of weight-loss maintainers still do it.

Marcia said...

Well, pretty much what you listed. I am actually a member of the NWCR (just filled out my 5-yr anniversary questionnaire, and it's a long one!)

For the record, I did gain weight in the middle there...had a baby, but managed to lose it again.

spotter said...

(Sorry if this is doubled...my screen went blank mid-comment.)

I second Liz's comment: It's hard! And there's no moment of feeling like you've arrived; I'm always tweaking something or looking for a way to overcome a sneaky new self-destructive habit that seemed to have formed while I wasn't looking.

Exercise is a big part of it; I usually do put in about an hour a day (I found ways to make it harder to skip). Still, even though I've kept 50 lbs. off for four years, I don't feel like "maintenance" is the right word for what I do--it's such a nice, calm, orderly word. Rather, it feels like I'm scrambling, barely hanging onto a healthy weight by my fingernails. Don't get me wrong; it gets much easier as you go, but I suspect it's never easy.

Adam said...

In my experience, exercise is the single most important thing you can do. I keeps your metabolism revved up, and it builds muscle, which can be used to burn calories all day. I know I'd be a million pounds with the amount of food I eat :)

I think you hit the nail on the head with making dieting a lifestyle change. Besides the occasional indulgence, ask yourself whether what you are eating is taking you towards your goal.

And if chocolate and being happy are both answers, then... well ok :)

Kristi Wachter said...

I originally read that as

"this much of an impact on the circumference of my backslide"

which I think I like even better.

I definitely think regular exercise and focusing on what I need to eat MORE of (my goal? greens at EVERY MEAL. Okay, maybe that's overdoing it) have helped me a lot.

Camille Acey said...

I don't do that much exercise at all and have had very little problem maintaing a consistent weight. The biggest tips I'd give are:
1) eat out less
2) do intermittent fasts (http://www.marksdailyapple.com/how-to-intermittent-fasting/)
3) eat smaller fresher meals rather than pre-packaged fast "food"
4) lift weights and bodyweight (see here for answers to the "but i don't wanna be bulky" complaint - http://www.marksdailyapple.com/strength-training-women/)
5) do intensity intervals (HIIT or Tabatas) rather than slow cardio. i try to do a few circuits a week. fast, easy, effective.

Amy said...

I really believe (and not to for one minute take anything from people who are addicts etc) that once you have a food issue it will always have a food issue. Once you have been overweight you will always have to battle something (yourself, others, whatever) to keep that weight off. It will never be something that can be dealt with subconsciously like many others can, things are just different for former fatties and I guess you just need to accept that and adjust your lifestyle to it!

Ali said...

Kinda spooky but I am in the almost *exact* same spot as you. I dropped down to 133 after a few years of being way too heavy and I have slowly crept right up to 151. For some reason it just seems way harder to get back in the groove these days. I think a huge part of it for me is a spouse that doesn't understand that I could use some support in the form of him not bringing home treats to tempt me. Good luck in dropping those pounds! -ali

Jules Someone said...

It's hard. May of 2006 I started losing weight. In May of 2007, I had lost 50 pounds. Cut to July of 2009, and I've gained back about eight pounds. Problem is, that I was still 25 pounds away from my goal weight after the 50.

I exercise 5-6 days a week. That's the good news.

I don't drink enough water or eat enough fresh produce. I think when I start cutting out the junk and taking that step I should see the scale go down again.

It's getting to that next step that's the trouble for me.

Anonymous said...

I sympathize with your feelings, but 153 pounds at 5'9" doesn't strike me as that heavy.
Most people cannot exercise an hour a day. I average 30 minutes 4 or 5 times a week in a good week, and that's unusual. Of course if you add in walking around and walking the dog it's probably an hour, but that's not enough intensity to do more than keep your blood flowing. Should most people get more exercise? Yes, it's better for your heart. But it really doesn't remove that much weight - as is often quoted, walking the length of a foot ball field you have taken off as many calories as are in one M&M. And as far as not bulking up, I don't even lift weights and am more muscular than is socially acceptable for women.I have been watching my weight since 1973 and consider myself happy as I am not in the plus sizes, unlike many of my friends. I just turned 48. The forties and fifties are your fat years; the few friends I have that aren't heavy could really stand to gain.
Good luck. If you eat cheese less often you will lose some weight (maybe 3 or 4 pounds)but I read your blog recently unless you are hiding something your caloric intake is pretty good.

Marcia said...

I agree with what Amy said. I've read "Refuse to Regain" by Dr. Barbara Berkeley, and it goes pretty in-depth about how people who used to be obese are just different physiologically and psychologically compared to people who have never been fat.

I do regular exercise. I get about 5.5 hrs a week in. I do some long walks, some intervals, some running, some biking. On occasional weeks I'll get in up to 7 hours of exercise. With a full time job, hubby, and toddler, I tend more towards intervals (burn more calories faster) and biking to work (kill-two-birds-with-one-stone) whenever possible.

It's never gotten really easy. I still struggle to lose the 5 lbs I tend to gain on vacation.

Camille Acey said...

I gotta agree with Anonymous. 153 lbs at 5'9 doesn't seem bad to me. Weight doesn't tell the whole story. At my peak of lifting, I was 145lbs at 5'5 with a very buttkicking 19% body fat. I highly suggest you get your body fat checked to get a better measure of things.

Eleonora said...

I think you're right when you said that we should be closer to a lifestyle change than to a diet, but I think the secret of that is not necessarily to radically change your lifestyle to include massive amounts of exercise and a completely strict eating regime. I think that would alienate the people that know you and is more likely to be a lifestyle change that doesn't last.
I think the best piece of advice is to abandon the idea that you have to lose such and such weight in such and such weeks, and instead just try to cut back on "bad" habits and just learnt to resist gluttony, or anyway develop a weight loss regime that is as much as possible similar to your weight maintenance regime. Even if it takes longer, it will be more gradual and more likely to last. If you're only a dozen of pounds overweight you're not at immediate health risk, it's better to concentrate on developing a lifestyle that is not completely alien to what you had before, and that can make the passage from weight loss to weight maintenance easier.

Anonymous said...

Whatever your strategy, I do think it is a wise idea to start working on developing new lifestyle habits *now* rather than down the line. As one commenter noted, it's harder to do when you've got other family members bringing home treats. In my experience, it's harder to maintain when you've got the unpredictability of a child that can wreak havoc on your schedule. It's harder to start up with regular exercise and new habits, and thus take off the extra weight, as you get older.

Kris said...

Ali, I totes feel your pain.

Camille and Anon, I understand what you're saying, but I worry that 153 pounts, already large for my frame, is just a stop on the way back to 170, which is entirely too large for my frame. And I worry if I don't confront the issue now, it will become more difficult as I age.

Also, when you drop 30 pounds just to gain 20 back, it's frustrating. You feel like you failed somehow, and it stinks to have to do it again.

Happy Cheapskate said...

A major factor for me was an unexpected one- make sure you get enough sleep. I find that when I stay up later/wake up earlier than usual, I tend to crave more carbs and my body just seems to hang onto weight more than when I am consistently well-rested. Not sure why, but it's true.

I exercise consistently, but not particularly strenuously- I typically do some form of yoga, weightlifting, or a ballet-barre type workout in the morning, and make sure I walk the dog later in the day. That's worked better for me than trying to do hours of high-impact aerobics or whatever.

Amy K. said...

Just adding to the chorus of "Been there, done that, right there with ya!"

At 5'4" I went from 164 to 124lbs from summer '03 to spring '05. Right now I'm back at 144, with an inclination to drop to 134 (124 was freakishly thin on me). I think part of the weight gain was that move from freakishly thin to normally thin, and then I was on that weight gain momentum. Another part was our move from an apartment with fitness center to a house with time spent renovating rather than finding a new gym.

Right now I'm tracking my food in FitDay, so I can see exactly why I'm NOT losing the weight. I just need to get motivated to eat less. I'm also working on the move more side of the equation, with lunch time walks now that it has finally stopped raining, and "evening constitutionals" after dinner but before the mosquitoes come out.

It might help if I went back to Weight Watchers, but I'm not ready to spend the cash quite yet. If I felt more motivated, I would see the value (and feel relieved I would be paying for fewer weeks - just 'til i got back to my Weight Watchers goal weight).

Joy Manning said...

It's been said, but it bears repeating: At five foot nine at 153 pounds your BMI is 22.6--not even close to overweight. So this weight that you think you need to lose is a vanity thing, not a health thing. Even at 170, your BMI was 25.1--you were the tiniest bit overweight. Considering the statistics on weight loss and regain, maybe it would make sense for you to think about maintaining your current weight? I know from years of yo-yo dieting that losing more weight than your body wants to is a recipe for regaining down the line. Another question is: why do you feel the need to lose the weight if you are already at a healthy weight for yourself? I understand not wanting to gain anymore, but why do you need to be thinner than you are right now? Why not work instead on fitness, health, and self-acceptance?

Treatment Shop said...

I have learn so much of it. I think being conscious to your health and following a healthy lifestyle is all we need to live a long life.

Paula said...

Liz said:
"It's hard! I've cut just about every bad habit I've ever had and eat primarily healthy, first order food but as the years go by, the scale creeps upward no matter what I do. Now that I'm almost 50 it's getting even tougher."

I can't agree with you more - I'm in my late middle 40's :) and it is harder. The magic bullet for me has been strength training. It really helps me keep my weight under control. Walking and cardio just DO NOT work for me alone. I exercise an hour or so at a time, maybe 4 or 5 times a week on average. I find that once I get started the time just flies by. It's hard at first - I was all achy and sore - but soon I noticed that I would get cranky if I missed it!

I don't think you're screwed if you don't do it, but it's harder. Besides, muscles are sexy!

Keeping It Off said...

Losing weight is easy (I've lost hundreds of pounds) but keeping it off is a constant battle. I am determined, once I reach my goal, to keep it off this time. I know it will be a struggle but I am so ready. As much as I hate the gym, I'm there 5 days a week. Combine that with the support of Weight Watchers and I am determined to stay thin.

Anonymous said...

I have been within 2 pounds of my goal weight for about 7 years, and though it rises and falls, what work best for me (aside from all those bits of advice already given) are: avoiding processed foods, journaling honestly and attending regular support meetings. I go to Weight Watchers monthly and that weigh-in still helps me stay on track. I still obsess about food and wish I didn't; doing some sewing or gardening or needlework keeps my mind occupied and that helps, but somehow I think there is a fat lady hiding within..

kelli said...

My heaviest point was being 170, at 5'6", in 2005. The lowest I've been in my adult life was about a year ago, at 132. Since then I've gone up and down, and right now I'm at 140, looking to lose 5 more lbs and stick there.

I've realized that the most important things for me are stress management and moderating alcohol consumption (they sort of go hand in hand). I have almost no problem maintaining when I'm not emotionally distressed or stressed out, or when I have a healthy outlet for those feelings (most often, exercise).

F. Belt said...

Exercise is a big part of it; I usually do put in about an hour a day (I found ways to make it harder to skip). Still, even though I've kept 50 lbs. off for four years, I don't feel like "maintenance" is the right word for what I do--it's such a nice, calm, orderly word. Rather, it feels like I'm scrambling, barely hanging onto a healthy weight by my fingernails. Don't get me wrong; it gets much easier as you go, but I suspect it's never easy.

Sabrina said...

Liz,

Have you ever considered a food diary? The pic you used actually looks like one of the pics used in a food diary I subscribe to. I've lost 55 pounds and am in maintenance mode. I use the food diary to track how many cals I burn through exercise, how many I eat, and how many cals I can eat to maintain my weight. It's very, VERY useful. I step no the scale every morning.

Also, you may want to look up "The Full Plate Diet." It's a free book you can get online about adding fiber to your diet to increase the feeling of satiety.

You can do it!! I think that if you're more consistent about weighing yourself regularly like mentioned, that will help. But I also think that too often people "cut" certain foods without knowing how many cals they're even eating a day. Hidden calories in condiments, oils, butter, etc. are rarely considered and then it's easy to slowly gain the weight back.

Best,
Bree

Deborah said...

Actually, I find it much easier. I've been Weight Watchers Lifetime now for 7 years. I eat more than I did while losing, and I haven't given up any of the foods I love.

Reading through your post . . . perhaps you put the weight back on because you went a bit too low for your body. I'm 5'2", 134, and I find this weight pretty easy to maintain, at 58 years old.

Were I trying to maintain, say, 115 lbs, I'd likely be singing a different tune. I prefer "room" to enjoy my favorite foods, be adventurous on vacation. The monastic type of diet that might be required to keep me at, say, 115, would not be worth it to me.

Anonymous said...

I am 67 years old and have lost 50 lbs over the past 7 months. My BMI has gone from 31 to 24.3. I exercise about 1 hour per day and have begun to include both cardiovascular, as well as, strength training .

My weight-loss approach has been to monitor my caloric intake using Loseit.com. I also precisely measure my weight, daily. I use a balance beam scale which reproducibly weighs to 0.1 lbs - purchased from Amazon for about $150.

Unfortunately I have had similar weight losses in the past only to consistently regain the weight. Hopefully this time will be different.

The following is my thinking at this point: (1) it is far easier to lose weight because you simply need to consume less calories than you burn - the more the deficit the faster you lose the weight (a precise match of intake and output is not needed), (2) weight maintenance is much trickier because even small discrepancies from equilibrium will lead to continued loss or gain, (3) thus, arises the need to carefully monitor weight and adjust net calorie utilization in response to weight changes as a life long commitment, and (4) I am convinced that most of us are not able to do this careful monitoring and adjustment without considerable effort.

A few other thoughts about things I think are important: (1) eating should not be thought of as an award for "good behavior" - if you do something well reward yourself with something other than food, (2) abandon the concept of "diet" and consider weight maintenance as a new approach to living, and (3) check back with me in a year or two to see if my BMI is still below 25.