Best Strategies for Maintaining Long Term - Weight Loss

Do you wonder why, after losing weight last year, you’re back to where you started? Are you telling yourself that this time, you will strengthen your resolve and make it stick? A surprising new Australian study helps explain that your lack of willpower may not be to blame.

Published recently in the New England Journal of Medicine, the study documented results for 34 overweight and obese volunteers. They consumed a very restrictive diet of 500-550 calories a day and after 10 weeks lost about 30 pounds, or 14% of their initial body weight.  Over the next year, participants regained some weight but were still about 17 pounds, or 8% below their starting weights by the end of the study.
Surprisingly though, participants’ blood tests showed that there were many hormones responsible for weight gain that were still not back to their starting levels, even a year after weight loss. For example, leptin, which is produced by fat cells and sends satiety signals to the brain, dipped by 65% during the weight loss period but was still found to be about 35% lower than at the start of the study. Ghrelin, a gastrointestinal hormone that drives hunger, was similarly disrupted: it rose notably during the weight loss period but still remained significantly higher than at the beginning of the study.
Beyond hunger hormones driving appetite, obesity expert Donna Ryan, MD advises that there is an additional factor causing weight-losers to pack the pounds back on. She says, “Your appetite is increased and your metabolic rate is decreased, both of which promote energy storage. That’s the double whammy that’s trying to get you to gain the weight back. It’s what we call metabolic adaptation.” Dr. Ryan is Associate Executive Director for Clinical Research for the Nutrition Obesity Research Center, Pennington Biomedical Research Center in Baton Rouge, Louisiana.
So, if there are multiple biological mechanisms that must be overcome to maintain weight loss, even after a year, what are the best strategies for success? Here’s what works:
Physical activity is the single most important factor to counteract the metabolic handicap. The National Weight Control Registry (NWCR) tracks the behaviors of more than 10,000 people who have been successful at maintaining long-term weight loss.  Almost all of them, 90% in fact, exercise on average for about an hour a day and the most frequently reported activity is walking.
Fight increased appetite by filling up on fruits and vegetables. Dr. Ryan recommends eating a healthy, balanced diet with an emphasis on low-density, high nutrition fruits and vegetables to help trigger satiety at a lower caloric intake.
Adopt and maintain a different lifestyle for good. “The metabolic adaptation to weight loss is something that never goes away,” says Dr. Ryan. A person who loses weight has a caloric handicap compared to another person who was always stable at that same weight. For example, a person who weighed 230 pounds and lost 30 pounds cannot eat as many calories as the person who always weighed 200 pounds, if she wants to maintain the weight loss. The greater the weight loss, the greater the caloric handicap will be.
Never skip breakfast. In the NWCR, 78% of successful weight-loss maintainers eat breakfast every day.
Weigh yourself daily to stay on track. This allows you to modify your diet and exercise habits as soon as your weight starts to creep upwards.
Keep a food diary. Recording what you eat can double your weight loss, according to a study from Kaiser Permanente’s Center for Health Research. But it is also an effective strategy for shedding pounds that have crept back on. Dr. Ryan puts her relapsing patients back on “the little blue book” food diary to get them back on track.