Who Succeeds in Maintaining Weight Loss? A conceptual review of factors associated with weight loss maintenance and weight regain

Introduction

. Being overweight and obesity are recognized today as major public health problems in our society. The results of long-term weight loss with weight loss programs are usually modest (1–3). Most patients regain their weight after weight loss. Thus, there is a need to better understand why weight maintenance is difficult and how to promote weight maintenance. By identifying factors associated with weight loss maintenance, we can gain a better understanding of the behaviors and prerequisites that are important for maintaining weight loss. Such knowledge will influence what strategies should be trained and encouraged in treatment, advice during the weight maintenance phase, and the selection of individuals who have the best prospects for long-term success in obesity treatment. The latter is necessary to make effective use of the limited resources available to treat today’s growing number of obese individuals. It also allows professionals to recognize the risk of exposing patients to further adverse psychological effects as they experience treatment failure (1). We were interested in describing the research findings regarding factors that may be important for weight maintenance.

Methods of Assessing Weight Maintenance First

It is necessary to examine the definition of weight maintenance. Weight loss maintenance refers to the maintenance of weight loss results achieved through therapeutic interventions and one’s own efforts. This is a general definition shared among the studies conducted. However, the specific criteria used vary. Examples of definitions include “achieving an intentional weight loss of at least 10% of initial body weight and maintaining this weight for at least one year” (4) or “losing at least 5% of baseline body weight from baseline to follow-up and maintaining below that weight for an additional two years” (5). Others classify “winners” and “losers” based on having lost or regained more than, say, 2 body mass index points after weight loss (6). To allow for a review of the literature with widely varying definitions of weight maintenance, we used a more inclusive definition of weight maintenance, meaning that the initial weight loss is maintained for at least 6 months thereafter.