Losing weight, keeping it off might require distinct skill sets

A new study indicates that the practices that help people to lose weight and the practices that help them keep it off do not overlap much.

“No one announces to a dieter, ‘You’re moving into the weight-maintenance stage. You’ll have to do things differently,’ said lead author Christopher Sciamanna, M.D. His group investigated whether two distinct sets of behaviors and thought patterns were involved in weight loss and its maintenance.

Practices associated with successful weight loss only were:

•    Participate in a weight–loss program       

•    Look for information about weight loss, nutrition or exercise

•    Eat healthy snacks

•    Limit the amount of sugar you eat or drink

•    Plan what you’ll eat ahead of time

•    Avoid skipping a meal, including breakfast

•    Do different kinds of exercise

•    Do exercise that you enjoy

•    Think about how much better you feel when you are thinner

Practices significantly associated with successful maintenance only were:

•    Eat plenty of low-fat sources of protein

•    Follow a consistent exercise routine

•    Reward yourself for sticking to your diet or exercise plan

•    Remind yourself why you need to control your weight

If the two stages do demand different practices, then weight loss programs might need to guide people about key strategies for each phase explicitly, said Sciamanna, a professor of medicine and public health sciences at the Penn State College of Medicine.  The study appears online and in the August issue of the American Journal of Preventive Medicine.

Lawrence Cheskin, M.D., director of the Weight Management Center at Johns Hopkins Bloomberg School of Public Health, said, “We do often tell patients about the different skills that are needed and the different approaches to take to achieve weight loss and weight maintenance. This work adds substance to that general statement.” Cheskin has no affiliation with the study.

Sciamanna’s group surveyed a random sample of 1,165 adults by telephone. Some had been successful at losing weight; some had also maintained a weight loss. They asked them about 36 things they might do and think about to lose weight and keep it off. The researchers defined long-term success as losing at least 30 pounds and keeping if off for a year.

Fourteen practices were associated with either successful loss or successful weight loss maintenance, but not both. The overlap between practices associated with weight loss and those associated with weight loss maintenance was 61 percent, not much higher than that expected by chance.

“Some people are ‘black and white,’” Cheskin said. “They’ll diet strictly, eating nothing they’re not meant to eat, or they won’t be careful at all. Maintenance requires something in between. This research could have implications for what we should emphasize when we are trying to help people lose versus maintain their weight.”