July 2008 Issue

The Seven Secrets of Successful Weight Loss
By LuAnn Soliah, PhD, RD
Today’s Dietitian
Vol. 10 No. 7 P. 50

Losing weight is only half the battle—maintaining the loss is the other half. See how dieters in the NWCR are winning the weight war on both fronts.

How do some people successfully lose significant amounts of weight and maintain the loss while others lose and then regain weight in repeating cycles? A research team led by Rena R. Wing, PhD, and James O. Hill, PhD, has studied and documented the answer to this question.

A database called the National Weight Control Registry (NWCR) includes the team’s work. The information in this database represents a longitudinal, prospective study of more than 4,000 adults aged 18 or older who successfully lost at least 30 pounds and have maintained the loss for more than one year. The NWCR has a dual purpose: to identify a large group of people who have been able to lose and then maintain weight loss over an extended period of time and to describe the dieting methods they use to achieve and maintain the loss.

NWCR Member Facts
According to the latest statistics, the subjects in the NWCR are 80% women and 20% men. Most of the participants are aged 44 to 49 and are Caucasian; few minorities are represented. Weight loss ranges from 30 to 300 pounds, with an average of 66 pounds. The average length of time to maintain the weight loss is 5.5 years (range of one year to 66 years).

Most of the subjects in the registry gained weight early in life. Almost one half were overweight by the age of 11, 25% were overweight by the age of 18, and the remainder became overweight in adulthood. Almost one half of the registrants had one parent who was overweight, and 27% reported that both parents were overweight, indicating that many participants may have had a genetic susceptibility to obesity. Thus, losing weight was probably even more challenging for them than for the typical adult trying to adhere to a weight loss diet.

Approximately 55% of the participants lost weight by joining a formal commercial weight loss program, and the remaining 45% lost weight on their own. Their motives for losing weight varied considerably, but the most common were health concerns, appearance or self-improvement goals, and emotional reasons. Now, how did they accomplish their weight loss?

The Seven Secrets of Successful Weight Loss

1. The dieters consume a low-kilocalorie, low-fat diet.  The participants consume 1,300 to 1,680 kilocalories per day, 25% of which are from fat.

2. The dieters have a consistent food intake from day to day, and they eat about four to five times per day.

3. The dieters consistently eat breakfast.

4. The dieters are very physically active.  The average person in the database exercises for about 60 to 90 minutes per day at moderate intensity. If they choose to walk, they take about 11,000 to 12,000 steps per day, which is the equivalent of almost 6 miles.

5. The dieters frequently weigh themselves—weekly or even daily.

6. The dieters limit their television viewing to less than 10 hours per week.

7. The dieters do not allow even a small amount of weight gain to occur without corrective action. They deliberately respond to small weight gains by reducing their food intake and/or increasing their exercise level.

Are these individuals’ experiences unusual, or could the typical weight loss participant learn from the whole group? Let’s take a more in-depth look at each of the seven strategies.

Strategy No. 1: Eat a low-kilocalorie, low-fat diet.
To lose weight, one must create an energy deficit. Contemporary recommendations encourage a gradual, slow weight loss of about 1 pound per week. People can generally reach this goal with a deficit of 500 kilocalories per day. Sustaining this kilocalorie deficit for several weeks should produce a 10% weight loss within a few months for most people, depending on weight loss needs.

A low-fat diet appears to be beneficial for several reasons. First and foremost, fat contains 9 kilocalories per gram compared with 4 kilocalories per gram for carbohydrates and protein. Second, high-fat food is often dense; thus, large portions are relatively easy to consume. Additionally, high-fat foods are generally tempting, so it is easy to eat more than intended.

People who have successfully lost weight and maintained the loss have been able to continue to eat in a manner consistent with the original weight loss routine. In other words, they do not start and stop a diet like most dieters are accustomed to doing. Rather, they continue to select low-kilocalorie, low-fat food that allows them to sustain long-term weight loss.

Strategy No. 2: Eat a consistent diet from day to day and eat several times per day.
In addition to decreasing kilocalorie and fat intake, eating a consistent diet from day to day may help people lose weight and maintain the loss because their food decisions take on a routine nature. Consistent food choices may also encourage self-control, minimize unplanned food temptations, foster self-discipline, and increase people’s ability to persevere with the dieting routine. Eating patterns are difficult to accurately assess, but research suggests that individuals who have a consistent daily meal pattern tend to be leaner than those with an inconsistent, random, or chaotic meal pattern. This observation is also in agreement with the recommendation to avoid skipping a meal for the purpose of reducing kilocalories.

A relationship also seems to exist between the frequency of eating and body weight. Nibblers or grazers consume small amounts of food several times per day and tend to be thinner than individuals who eat large but infrequent meals.

Strategy No. 3: Eat breakfast.
Numerous obesity researchers recommend eating breakfast every day. Including this meal in the daily routine is a common denominator for successful weight loss and maintenance. The explanations for this observation include the possibility that breakfast does the following:

• suppresses midmorning hunger;

• produces better blood glucose control and elevates basal metabolic rate;

• yields fewer episodes of imbalanced, impulsive, or excessive eating later in the day;

• increases fiber intake (eg, from cereals, fruits, and whole grains);

• reduces dietary fat intake; and

• encourages improved health consciousness.

Clearly, including breakfast in the daily routine is associated with attaining and maintaining a healthy body weight.

Strategy No. 4: Incorporate physical activity.
Physical activity is one of the most important elements of successful weight management. Recent public health recommendations state that individuals need 30 to 60 minutes of physical activity each day to prevent weight gain and 60 to 90 minutes of physical activity to prevent weight regain.

Additionally, physical activity can favorably affect body composition, decrease the risk for several diseases, elevate metabolic rate, and improve an individual’s mental outlook. Physical activity is also associated with less abdominal fat. This is a noteworthy observation because abdominal fat is considered a risk factor for type 2 diabetes, coronary heat disease, hypertension, metabolic syndrome, and some cancers. Therefore, daily physical activity is important for both weight management and health improvement.

Strategy No. 5: Check body weight frequently.
In addition to a reduced-kilocalorie diet and physical activity, frequent weighing appears to be an integral part of successful weight loss maintenance. Monitoring weight on a regular basis is a form of accountability and self-monitoring, and consistent self-monitoring is associated with improved weight loss.

Strategy No. 6: Limit television viewing.
Research has correlated successful weight loss over an extended period of time with a minimal amount of time spent watching television. The records of the successful NWCR dieters have confirmed this recommendation. A high percentage of the registrants (about 62%) reported watching 10 or fewer hours of television per week, and more than one third of the registrants (about 36%) watched less than five hours of television per week. The remainder of this group viewed more than 21 hours of television per week.

The national average time for watching television is 28 hours per week, or four hours per day, for the average American adult. This is a tremendous amount of time people spend engaged in sedentary activity. Similarly, childhood obesity specialists report a direct correlation between pediatric weight control problems, increased body mass indexes, and excessive television viewing. Attempts to reduce accumulated weight and enhance physical fitness may begin during childhood by including more physical activity in leisure time.

Strategy No. 7: Take corrective action when weight is regained.
Numerous dieters report that long-term weight maintenance is even more challenging than following the initial weight loss diet, and obesity researchers have reported that preventing individuals from regaining weight is one of the most difficult dilemmas that dieters encounter. Many formal weight loss programs report that dieters frequently regain weight three to five years after they achieve their weight loss goals.

The NWCR’s successful weight maintainers report that paying careful attention to all aspects of behavior modification is necessary for long-term weight management. People must detect and correct small amounts of weight gain before weight escalates and becomes unmanageable. It is also possible that frequent and consistent weighing is an indicator of interest in and enthusiasm for weight control efforts.

Conclusions
Successful weight management requires a sustained and lifelong commitment to healthful food selection, regular physical activity, and diligently monitoring weight. These behaviors necessitate self-control, self-discipline, and moderate lifestyle choices. For all of these reasons, weight loss and maintenance are difficult to achieve over a lifetime.
 
Adult weight management is even more challenging today than in previous decades because of the abundance and accessibility of tasty high-kilocalorie foods and the modern conveniences available at work and home. Nevertheless, health improvement that results from weight loss and maintenance is a commendable goal that is worth the effort required to accomplish it.

— LuAnn Soliah, PhD, RD, is the director of nutrition sciences and a professor at Baylor University in Waco, Tex.

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