Keeping weight off: what long-term maintainers do differently

The odds are better than you have heard

You may have read that almost everyone regains. The picture is more nuanced. Rosenbaum and Leibel, reviewing the biology, cite a recidivism rate of over 80% after otherwise successful weight loss, and in the trial by Purcell and colleagues both rapid and gradual dieters had regained about 71% of their loss within three years. These are real difficulties.

Yet Wing and Phelan estimate that about 20% of people with overweight manage to lose at least 10% and keep it off for at least a year. In the National Weight Control Registry, people who had lost an average of 33 kilograms had kept it off for more than five years. And Thomas and colleagues, following 2,886 members for ten years, found that more than 87% were still maintaining at least a 10% loss at five years and at ten.

Wing and Phelan add a hopeful observation: once people have maintained for two to five years, their chances of longer-term success increase greatly.

What successful maintainers do

The registry members report a consistent set of habits.

• A lot of physical activity, about an hour a day on average.
• Regular self-weighing, which catches small regains early.
• A consistent eating pattern, without a separate set of rules for weekends.
• Regular breakfast and a diet that stays moderate in calories.

The ten-year follow-up adds the reverse view. Weight regain was greater in members whose leisure-time activity fell, whose dietary restraint and frequency of self-weighing decreased, and whose eating became less controlled. In other words, maintenance is not a state you reach. It is the continued practice of the habits that got you there.

How much activity it takes

Here exercise comes into its own. The ACSM position stand on weight loss found that, after weight loss, maintenance is better with more than 250 minutes a week of moderate activity, while noting that randomised trials on this question are lacking. The 2013 American guideline recommends about 200 to 300 minutes a week to maintain lost weight in the long term. The CDC notes that you may need more than the usual recommended minutes to maintain your weight, and that the amount varies greatly between people.

A study by Ostendorf and colleagues shows why. People who had kept off an average of 26 kilograms for about nine years spent about 812 kilocalories a day in physical activity, against about 621 for people of similar weight who had never been heavy. Their bodies seemed to rely on that extra movement to stay in balance.

Three to five hours a week sounds a lot. Walking counts: see daily steps and how much exercise per week.

Your new maintenance intake

After a loss, you need less energy than before, because there is less of you. Take an illustrative man of 46, 178 centimetres, training three to five times a week. At 94 kilograms, the Mifflin-St Jeor equation estimates his daily needs at about 2,830 kilocalories. At 84 kilograms, about 2,680. Returning to his old eating habits would place him about 150 kilocalories a day above his new needs, before counting any adaptation.

Rosenbaum and Leibel describe that adaptation: after weight loss, the body tends to use less energy than its new size predicts, and appetite rises. The calculator on this page gives your new estimate. Treat it as a starting point, then adjust with your weekly average weight. Calorie needs describes the method.

Keep the muscle you built

The ACSM position stand found that strength training may increase fat-free mass and the loss of fat mass. During maintenance, two strength sessions a week keep that muscle, along with adequate protein, as explained in protein for weight loss. The guide to strength training for executives gives a format that fits a busy week.

An early warning system

Small regains are easy to reverse; large ones less so. Decide in advance what you will do.

1. Weigh yourself at least once a week, as the 2013 guideline advises, and track the monthly average.
2. Set a trigger, for example 2 kilograms above your maintained weight, at which you return for a few weeks to the habits that worked.
3. Watch the behaviours, not just the number: missed sessions, more meals out, shorter nights. Those come first.
4. Plan the difficult seasons, holidays, intense work periods, travel, with a reduced but real version of your routine.

If your weight has stalled rather than risen, read weight loss plateau. If you are deciding how fast to lose in the first place, the pace matters less for regain than what follows, as explained in safe weight loss rate.

If you regain weight quickly without changing your habits, or if your weight swings repeatedly, talk to your doctor. Some medications and medical conditions affect weight, and repeated cycles of dieting and regain deserve professional support.

Support beats willpower

The 2013 guideline recommends maintenance programmes that provide regular contact, monthly or more often, to help people stay active and keep track of their weight. You do not need a clinic for the principle: someone who notices when you stop. That can be a coach, a friend or a group.

Keep your rhythm for the long run, with Never Skip Club

Maintenance is a matter of years, and regularity is its main ingredient. Create your free account on Never Skip Club, launch guided sessions in 20, 30 or 45 minutes, and build a crew of three to seven friends with a rhythm over one week, one month or three months: the ranking rewards the sessions you keep, which is exactly the habit that protects your result. For regular check-ins with a professional, find a coach from our network, or sign in to book your next session.