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Know how to keep weight off before you lose it
October 30th, 2012
12:01 PM ET

Know how to keep weight off before you lose it

With all the talk about obesity in America, you might be surprised to know that most people are pretty good at losing weight.

Weight loss programs have proven effective in helping people drop pounds. But keeping them off is another story.

Studies have shown that overweight participants typically give up their newly learned health habits and regain 30 to 50% of the weight they lost within one year, even if they participate in a post-weight loss maintenance program.

“There’s something we’re missing in terms of what it takes to maintain our weight,” says Michaela Kiernan, an expert in behavioral weight management at the Stanford Prevention Research Center.

Kiernan is the lead author on a new study publishing in the Journal of Consulting and Clinical Psychology titled “Promoting Healthy Weight with ‘Stability Skills First.’”

Kiernan and her colleagues hypothesized that people would keep weight off better if they practiced doing so first. Their hypothesis was based on social cognitive theory – that having confidence in your ability to do something actually helps you do it.

The study

More than 260 overweight and obese females were split randomly into two groups. Both groups participated in a six-month “intervention” period that included a weight loss program and a weight maintenance program.

In the “weight loss first” group, the women participated in a 20-week behavioral weight loss program, followed by an eight-week “problem-solving” maintenance program. Their maintenance program addressed obstacles the women might face in the upcoming year.

In the “maintenance first” group, the women participated in an eight-week “stability skills” maintenance program, where they were asked not to lose any weight.

They learned how to fine-tune their eating behaviors – savoring food mindfully, for instance, or leaving small amounts on their plate – “to get away from the idea that you’re either on a diet or off a diet,” Kiernan says. That group then participated in an identical 20-week weight loss program.

The results

Both groups lost an average of 16 pounds during the six-month intervention program. But after 12 months, the “weight loss first” group had gained back an average of seven pounds. In comparison, the “maintenance first” group had only gained back three pounds.

Why?

The study capitalizes on two key factors for weight loss maintenance: Confidence and motivation, says Kim Gorman, weight management program director for the Anschutz Health and Wellness Center at the University of Colorado. Gorman was not involved with the research.

Asking “maintenance first” participants not to lose weight during the first eight weeks allowed them to learn important skills without fear, Gorman says.

“I say fear because so many of my folks lose a significant amount of weight and then fear a slight shift upward means the boat is sinking. I think (the study authors) contended with the emotional impacts associated with the scale … in short, they were prepared.”

Gorman was pleased to see that the “maintenance first” group didn’t lose their motivation for losing weight – evidenced by the fact that both groups dropped the same amount in six months.

Kiernan says the maintenance group may have benefited from that early energy. “Most of the time by the time they get to maintenance, they’re pooped,” she says. “This way it’s kind of a protected time to try things.”

Going forward

Because the study incorporated new timing (maintenance first) and new skills (stability over problem-solving) for one group, it’s impossible to tell if one or both was behind the “maintenance first” group’s success. Going forward Kiernan would like to “untangle” those, she says. “Is it the content or the order?”

The researchers would also like to duplicate the study in men and see if technology – like e-mail alerts or online classes – could play a bigger role.


soundoff (140 Responses)
  1. Dani

    @RJW:

    First, you have to commit to learning how to prepare/cook meals for yourself at home. No one ever lost weight cheaply by eating out all the time. By doing this, YOU can take control. How to grocery shop, good article on WebMD: http://www.webmd.com/food-recipes/features/10-tips-for-healthy-grocery-shopping

    If you do eat out, most problems lie in portion size. You can get healthy meals but it may be too much. Ask for a to-go box and immediately box up half of your meal for later. Voila, 2 meals for the price of one.

    Other tips:
    ~ Limit your alcohol: the less you drink, the less calories. If you do drink, limit it to one beer/one glass of wine/one shot per day.
    ~ Do not add salt if you can help it!
    ~ Buy frozen or fresh vegetables and fruits, never canned. Canned produce has way more sodium and sugar to help the foods last. East as many vegetables and fruits as you want, and raw is better. If you must cook, try sautee in a pan with virgin olive oil, or baking. Watch out for sauces with high sodium levels, like soy. I have gotten into eating raw peppers/tomatoes/carrots with hummus – nutritious and filling.
    ~ Buy lean meats. 2 servings of fish/seafood a week, baked/grilled skinless chicken, minor red meat. Bacon > sausage. Eating a lot of meat will work if you are muscle building (i.e. heavy weightlifting), but it is hard on your kidneys.
    ~ DO NOT, as one reader suggested, eat 4 eggs a day. Yes eggs have good nutrients and are filling, but they have tons of cholesterol. For someone who is reasonably healthy, you can probably get away with one a day.
    ~ DRINK MORE WATER. Most of us do not consume enough water, and filling your stomach may suppress the feeling of hunger without consuming any calories.
    ~ Learn to be just a little bit hungry all the time.
    ~ Eating several small meals throughout the day, or 3 meals with snacks, can help regulate your blood glucose levels.

    These are just some tips I have seen help people; I am an RN in a cardiac ICU, so I see overweight patients all the time with heart disease. We are constantly helping people understand how to take better care of themselves, and most patients are overweight. Losing weight is NOT easy, no matter what people say, but with perseverence comes results. I am not a nutritionist; a visit to one might benefit you. As always, consuming less and burning more calories will mathematically shed pounds. Be sure to get 30 minutes of cardio at least 3 times a week (if not more!) and make sure you are winded enough so that you can't say the pledge of allegiance without losing your breath. If you can, you aren't working hard enough. Also be sure to incorporate weight training for bone density and muscle building.

    As for diet programs, the only ones I have (and friends and family) had success with are Weight Watchers and the Paleo diet. Weight Watchers doesn't limit WHAT you eat but HOW MUCH. You are rewarded for making healthy choices and for exercising. Every food item has a points value and you get so many points per day and per week. The downside is you have to keep track of everything and look up points values, and it might be expensive to get started (I borrowed the books from a friend). The paleo diet uses the idea that one should only eat foods that might have been available to a caveman. In other words, meat, fresh fruits and vegetables, beans and nuts. Nothing that has been made by man. Here the plus is you are cutting out anything processed with added sugar and sodium, and you can eat as much as you like. The downside is no breads or cheeses or sweets (which I personally couldn't live without!).

    Hope this helps, even if only a little! 🙂 Good luck!

    December 1, 2012 at 06:22 | Report abuse | Reply
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    December 7, 2012 at 01:59 | Report abuse | Reply
  3. Peter

    I have found that having a good support structure when starting an exercise routine really makes a difference. Recently I have started using a Beachbody coach. Here is her site http://www.beachbodycoach.com/samanthaarcher and her daily blog http://coachsamantha.blogspot.ca.

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    January 28, 2013 at 21:20 | Report abuse | Reply
  4. kidsartbynatalie

    Ah yes, actually keeping it off seems to be the issue we all run into!
    The thing I've found that works is actually changing the way I do day to day things. I walk more, I take the stairs rather than the elevator, I park further away from the store, and at work now I use a standing desk rather than sitting.
    This, really, has been the biggest change. I feel more energetic, my posture has improved, and I have lost weight. I recommend making this change to anyone!
    The one I use is called a NextDesk Terra which you can see here: http://www.nextdesks.com/terra
    Let me know what you think!
    Natalie

    February 6, 2013 at 13:07 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.