It's harder than you might think!
There's a ginormous problem with dieting that nobody talks about. Weight loss is easy compared to keeping it off. Millions of people regularly lose 10-15% of their body weight doing various diet programs, but within a year most have gained nearly all of the weight back and only 5-10% of dieters manage to maintain a 10% weight loss for more than five years.
To examine this effect, researchers in Providence, Rhode Island set up an experiment (Ross, 2018). The team recruited 75 obese men and women to go on a diet and then track their weight for a year. The 75 “guinea-pigs” were all employees of a large healthcare organization; the weight loss portion of the experiment was designed as a workplace challenge with modest monetary rewards ($1-10/wk.) and other small perks. The dieters were given specific instructions on how to eat, calorie and fat limits, exercise requirements and details about how to track their weight using a “smart” Wi-Fi enabled scale that reported directly to the research team.
The weight loss diet was an intensive lifestyle intervention, each dieter was given a tailored diet specific to their starting weight and health, taught to eat specific foods, and given instructions on exercise. The participants engaged in walking, jogging, swimming, and strength training. As the diet progressed, each person logged-in to to a website for 12 weeks and tracked calories, exercise, and weight loss and were given feedback and help with challenges encountered from a team of dieticians.
The dieters all did great! The average weight loss was about one pound per week as expected. After the 12-week weight loss phase, the dieters were instructed to maintain the healthy habits they learned, but were given no further incentives, support, encouragement, or instructions. As the dieters continued to log their weekly weights for 9 more months, they regained the weight they had lost at a near linear rate of ½ pound per week until nearly all of them ended at or near their starting weight.
This experiment showed that without a support network, weight maintenance is nearly impossible. This quite clearly shows the experience of the 150-million dieters each year who regain their weight upon completion of a diet. Why can’t people help themselves? We do we require a support network to maintain?
It’s no secret that weight loss occurs much more easily when the dieter is on display and has announced his or her weight loss intentions to friends, family, and co-workers. The people around a dieter are an important part of the weight-loss effort, giving encouragement, compliments, and removing tempting treats from the dieter’s reach. The weigh-ins of The Biggest Loser™ and Weight Watchers™ are famous examples of social accountability tactics used in diet programs.
If you've lost weight recently, your battle has only just begun. One researcher describes weight maintenance for formerly obese patients as “uneven combat.”
“However, weight loss is not a milestone, but rather part of a dynamic process. Following weight loss, the weight-reduced individual enters an uneven combat, commonly resulting in weight regain (Poulimeneas, 2018).”
In fact, people that maintain over 10 pounds of weight loss for more than five years are so rare that the governments of several countries have started tracking these people to learn how they do it. Some common themes from these so-called “Significant Weight Loss Maintainers” are that they are “required to exercise more than a dieter,” and they must eat “300–400 calories lower of that expected of their body mass” (Poulimeneas, 2018).
There aren’t any diet plans that will ensure long-term weight loss. None. Nada. Zilch. Despite what the authors claim, more than 90% of all people who try any diet will fail to maintain weight loss for more than a year. Whenever you read a diet book that focuses on one style of eating such as Paleo, Keto, Low-carb, Low-fat, or any incarnation of a weight loss diet or eating style, you might as well just throw that book straight in the trash.
Diet experts consider it to be a “great achievement” to maintain a weight loss of 5-10% for more than a year. In fact, just maintaining a 3% loss in body weight for more than a year is quite rare (Soeliman, 2014). To put this in perspective, it’s not uncommon for first-time obese dieters to lose 15-20% of their body weight, for instance, a 250-pound person dieting down to a target weight of 200-pounds represents a 20% loss in body weight.
Diet forums and websites are filled to the brim with stories of people who lose up to 60% or more of their body weight. These big losses sell. The Biggest Loser is all about massive weight loss through diet and exercise, and attracts a viewing audience of over 7-million people during each episode. What would a diet book be without pages of before-and-after photos showing how the fat just melted off and revealed a svelte, younger looking person inside?
Take-home message: Losing weight is very easy compared to keeping it off. If you are on a diet, you'd be better off quitting than continuing on without a plan for maintaining your weight loss. We'll explore ideas for weight maintenance in upcoming posts.
Are you a Significant Weight Loss Maintainer? Share your story and tips in the comments!
Soeliman, Fatemeh Azizi, and Leila Azadbakht. "Weight loss maintenance: A review on dietary related strategies." Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 19, no. 3 (2014): 268.
Poulimeneas, Dimitrios, Mary Yannakoulia, Costas Anastasiou, and Nikolaos Scarmeas. "Weight Loss Maintenance: Have We Missed the Brain?." Brain sciences 8, no. 9 (2018): 174.
Ross, Kathryn M., Peihua Qiu, Lu You, and Rena R. Wing. "Characterizing the Pattern of Weight Loss and Regain in Adults Enrolled in a 12‐Week Internet‐Based Weight Management Program." Obesity 26, no. 2 (2018): 318-323.
I must admit not much of the above resonates with me (fortunately!). I think this is probably due to quite a few reasons:ReplyDelete
1. I don't drink. a couple of people I know who seem to really eat quite well drink far too much and their weight seems to suffer for it.
2. I love habit! I know what I'm eating and when day in day out with only slight variations - and I still look forward to my food! Once I find something that I think works - I want the benefits and that for me means habit. Without habit, I feel poor decisions can be made more times than not and it takes less thinking.
3. I'm more than happy with the healthy treats. When you eat like a lot on here does I assume - plenty of fibres, real food - the cravings just disappear. Looking at how fake the likes of dunkin doughnuts are - no appeal for me. A couple of dates now and again, maybe a small pulsin bar (oat based) is plenty.
4. IF and fasted training I think helps loads for leanness.
The above is what I think are the main ones for me. In fact tbh I wouldn't mind putting a little weight on - but I don't think I can do it healthily - hence I won't. I'd probably have more options if my fat digestion was better.
The biggest factor surely has to be mind set. If you are seeing a diet as a short term intervention (or it is a little extreme to be incorporated long term) - then without a backup game plan - surely most people will revert to their original eating habits over time.
Obviously none of the above ideas are my own - I do like a bit of plagiarism! I just like to test what works and use it. Certainly my thoughts around real foods has been massively impacted by my readings on here!
I've been reading a lot of papers for my book. I had no idea the depth of the problem with diets. I really think it would almost be better if overweight people just didn't diet. Not only do 95% gain back most of the weight they lost, 2/3 gain back more than they lost. Simply insane. I guess I can see why doctors are reluctant to put people on diets and just treat symptoms. Dieting wrong destroys the metabolism and leads to nutrient deficiencies. What's needed is an overhaul of our food supply and more pressure for people to exercise meaningfully.ReplyDelete
Well said. I suppose an additional problem with the yo-yo -ing effect of dieting - you would think muscle would be lost at least in part initially, whilst when the weight gain comes back - id be surprised if any muscle is gained back...Delete
What about health though? Epidemiology shows that overweight people that have taken part in a weight loss study live longer than those who have not, even though they of course regained like everyone else.Delete
It seems it can be metabolically beneficial to lose some fat occasionally, even if weight goes up again.
There are a couple of hypothesis as to why. One is that the body seems to take from the "bad" fat first, around the organs etc. And it resists putting fat back there.
The exception is people that are not much overweight, but tries to lose a little for the summer through some fad diet. They often end up losing more muscle mass, and then regain fat, thereby being metabolically worse off than before the diet.
But the case could be made for really overweight people to lose weight, even though they will likely regain.
yeah, the science is kinda all over the place. Government health groups have set the bar really, really low, saying that they consider a diet "successful" if a person can maintain even just a 5% weight loss, and that losing 10-15% of one's weight is beneficial to long term outcomes. I think they used this low benchmark because they know that that's about the best they can hope for, and even this amount is quite difficult to achieve.Delete
But, and it's a big BUT, 99% of the people in these studies and the general public are still eating SAD diets. Cutting calories from a McDonald's Value Menu is not the way to go. The diet needs to be completely overhauled. I'm 100% sure that's what's behind my success, having lost and kept off over 80 pounds since 2011. Prior to that, at 250 pounds with a BMI of 30 (high end of obese), I would lose and regain the same 20-30 pounds over and over, but did not connect what was happening with the Fry daddy on my counter and the punch card from McDonald's in my wallet.
I'm taking target at 4 things in this book: Ditching the Western diet, starting a good exercise program, sleeping good, and getting as stress free as possible. Beyond those 4 concepts, it really is just noise. So many diet gurus are looking into the minutia, ie. Weight Setpoint, insulin, leptin, blue light, etc... They miss the GIANT targets that are right in front of them.
Tim, you are right about getting those big things in first. But the diet gurus are shrewd, your four concepts aren't as sexy and will not sell as many books. The gurus knows what sounds cool and what will sell. But I'm afraid we won't see you on Dr Oz or on NY Times bestsellers list soon. However, there are other benefits to being honest and upstanding.Delete
We'll see! I really think the Diet Industry needs to start a bigger focus than just weight loss. Maybe the time is now? I'm amazed how clear it is: Losing weight and keeping weight off are two completely unrelated things. One of the worst things you can do to try to maintain your weight lost is to continue using a weight-loss diet as a maintenance diet. I did it many times, never worked. I was shocked to see this listed in many journal articles on weight maintenance failure.Delete
For instance, Weight Watchers and Atkins are awesome weight loss programs because they get all the elements right: calorie restriction, mega-support, tracking, apps, products, etc... But once the honeymoon is over and you keep trying to use those same programs for weight maintenance, you lose interest and revert to old habits, never having learned to eat right, exercise, or take care of other lifestyle factors.
This reminds about Gretchen Rubin's four tendencies https://quiz.gretchenrubin.com/four-tendencies-quiz/, obliger (60%), questioner (30%), upholder (5%), and rebel (5%). Obliger overweight dieter need support for the rest of their lives and that is not available to every obliger.ReplyDelete
As a nutrion coach and obliger myself, I have had to accept the fact that I do not do things for myself unless there is an extremely severe quick setback. I do everything else for other people but not for myself. That has been a tough lesson to learn.
Exactly, and this is why diets fail long term. Weight loss is easy because you are hyper-focused on eating and usually have a good support system. Once you are done with the diet, you have to find your own way to keep the weight off. And that's where it falls apart. I would have guessed I'm a Rebel, but after taking the quiz, it says I'm a Questioner. Makes sense, I guess, lol. Hopefully my advice works for everyone.Delete
Tim, have you come across coach Scott Abel? He's helped a lot of people keep the weight off, his method is partly diet, partly exercise, but a big part of it is the mind-body connection and making sure the metabolism doesn't slow down. And if it is already slow, speeding it up gently over time so your nervous system doesn't rebel. He talks a lot about coaxing your body into shape, not forcing it. His uses modern language, but I notice a lot of his teachings illuminate and explain the methods of the old time strong men who were in good shape (as opposed to the large and fat ones like Luis Cyr). Muscle control (not taught by Scott Abel) seems to be a common theme with the old strong men; it helps with muscle recruitment, but also helps to release muscles that have jammed up and are draining the nervous system.ReplyDelete
I have looked at Coach Abel's stuff. Solid program.Delete
I've come across occasional accounts like that of Jamie Lewis (body builder, strong man) who lost a lot of weight and has kept it off. He can go off diet for several months at a time, and the weight doesn't come back. Jamie said it took about 3-5 years for the body to "learn" its new set-point, then it sticks to it fairly well even when gorging. But most people never make it to that 3 year mark. I wonder how Wilbur is doing. :) He is at least 3 years in now.ReplyDelete
I'm not at all convinced there is a setpoint that can be easily manipulated. Hardly any research points to it, either. I think if there is a setpoint, it's DNA-based an unlikely to change much. The fitness industry rarely discusses it, but there is lots of research to show that humans basically come in three body types, ectomorph, endomorph, and mesomorph, with lots of people falling in between the major categories. I think that's the genetic component, but still a short, fat person can get very healthy and fit, but it will be harder than for a natural-born athlete. And the athletic types can get fat and sick just as easily, but much easier to recover.Delete
Wilbur's doing great! he's been trying to comment, but for some reason can't. I think I am going to move my entire blogging efforts over to my potato hack blog in the very near future, I have much less problems with WordPress.
The Potato Hack blog is nice, but aren't comments deleted after a while? I believe some serious gold nuggets have been lost for ever over there...Delete
I turned off commenting a while back on older posts because I could not keep up, if I turn them back on the comments should still be there. I'll check!Delete
That's probably it. It said comments are closed, and they were all gone. Lots of intelligent people comment at your blogs, it would be a shame to lose those words of wisdom. But buried deep in my Google Keep app, I have saved lots of them, and also from Free the Animal.Delete
Please go look now, I just turned everything back on. Looks like all the old comments are there. Let me know, please, sometimes I see something different because it's my blog.Delete
I'm checking potatohack.com right now (on PC with Chrome browser), and there's still a whole bunch of old posts saying "comments off".Delete
It looks like you'll eventually get yourself into the ideas of set-point weight or settling-point weight. Both of these seem to be key. Any thoughts on these so far in your reading?
haha, just answered about 'setpoint' above. It's definitely not a common theme in the medical literature. "Settling point" sounds more likely. I think people need to let their body dictate their final weight more than a BMI chart. People don't need to be skinny in order to be healthy.Delete