Research: Structure Your Weight Loss and Maintenance Plan to Guarantee Success

Weight Loss MaintenenceWeight Loss Maintenence

Why so many pounds regained weight after weight loss and how to prevent the weight gain? 

Energy Balance
Energy Balance

I am nearly 100% certain that this is not the first time you have tried to or have lost weight.  I know there are some folks out there that are blessed with a good metabolism but they are probably not reading this blog post.  Anyone who has attempted to lose weight and maintained the new weight knows how tough preventing regain is.  The task should be as simple as calories consumed equals calories burned but in practice, preventing weight gain after weight loss is nearly as impossible as keeping a toddler on task for hours or herding cats.  

So why do we fail to prevent regain?  The inherent problem is how we look at weight loss and the way we attack it. Our approach and methods are flawed so we set ourselves up to fail from the start.    

Flaws in most weight loss and maintenance plans:

  1. The temporary diet.  The term diet is the problem.  To professionals in medicine and nutrition, diet is a term that means simply what an individual consumes.  To those trying to lose weight, it is a temporary change in food intake to reach a bodyweight goal.  This perception of a temporary change is the problem because it needs to be a long-lasting change to improve health.  If you go back to the old status quo, you will regain the weight.  
  2. We focus on weight loss.  We choose to focus on weight loss and not fat loss.  If you lose muscle, it will be easier to regain the lost weight, and your metabolism will decrease more.  Your basal metabolic rate (BMR), which is the total number of calories your body burns without exercise, will decrease as you lose weight.  There is nothing you can do to prevent that because BMR is dependent on body weight and muscle mass.  The formulas for BMR is less exact in those that get further from the average body type.  For example, obese versus very muscular.  You can get better testing in fitness and wellness centers through CO2 testing.
  3. Your maintenance plan is nonexistent or lacking.  Often dieters have no maintenance plan other than to return to the old habits.  They stop the daily weigh-ins and slowly start wearing the old fat pants.  One day they step on the scale, and you hear a long list of expletives coming from the bathroom. Your plan must have structure and continue long after you meet your goal.
  4. You can not exercise away poor decisions.  Two pieces of cake have an enormous amount of calories.  Depending on the size, a piece may have 500-800 calories or more.   That would be 50-80 minutes of walking at a pace that most of us cannot keep for an hour duration.  You must lose and maintain weight with decisions you make in the kitchen.  Exercise is important but is only 20-30% of the plan.    

Research on Weight Maintenance:  

Five very obese fat men on the beach
Five obesely fat men on the beach
  • Having structure is important.  There are a lot of studies that have looked at long-term weight loss.  I would recommend each of you take a look at one study from the American Journal of Clinical Nutrition entitled “Long-term weight-loss maintenance: a meta-analysis of US studies”​[1]​.  It is a fantastic meta-analysis that looked at structured diets and the weight loss maintenance success.  They concluded that five years after completing structured weight-loss programs, the average individual maintained a weight loss of over 3 kilograms or 6.6 pounds and reduced weight of over 3% of initial body weight.  You can set the structure yourself, and you do not need a group to stay on track, but they do help because peer pressure is tough to fight.  
  • Your metabolism will decrease.  A depressing study from the National Institutes of Health looked at the contestants of the “Biggest Loser” reality show.  The researchers followed 14 participants[2]. During the 30 weeks, the contestants had dramatic weight loss that was very impressive.  They lost an average of over 125 pounds per person. Unfortunately, only one maintained the results.  This study did show that the average contestant had an unexplained 500 calorie slowing of their metabolism that could not be explained by the change in body weight.  A review of this research in a post on The Conversation in which the author claims that “all but one gained back most of their lost weight, despite continuing to diet and exercise”[3].  The research does not indicate to what degree they continued any diet or exercise so I am not sure you can make this statement.  I suspect that the contestants slipped back into their less structured lives and began to slowly inch back toward their original weight.  
  • Social support is an important part of the structure of maintenance.  To avoid weight gain, social support is an essential element of the structure.  One study looked at adding social support to standard behavioral treatment (SBT) and found that 66% of those with social support versus on 24% of those with SBT alone[4].  There are other studies, but all show a clear indication that social support is key to successful maintenance.  Now with online support emerging it is even easier to get some form of social support.  
  • The Bottom Line:  You can do very little to increase your BMR except increase your muscle mass.  Exercise is important but only accounts for 20-30% of the calories you burn so you must keep your intake lower to avoid regain.   Structure your lifestyle and you will be more successful at weight loss.  Although “guarantee” might be a word that is too strong but structuring your plan is as close as you can come to a guarantee of success.   

    [1]Anderson et al., “Long-Term Weight-Loss Maintenance: A Meta-Analysis of US Studies.”
    [2]Fothergill et al., “Persistent Metabolic Adaptation 6 Years after ‘The Biggest Loser’ Competition.”
    [3]McLeod, “Why so Many People Regain Weight after Dieting.”
    [4]Wing and Jeffery, “Benefits of Recruiting Participants with Friends and Increasing Social Support for Weight Loss and Maintenance.”


    1. Anderson, JW, EC Konz, RC Frederich, and CL Wood. “Long-Term Weight-Loss Maintenance: A Meta-Analysis of US Studies.” The American Journal of Clinical Nutrition 74, no. 5 (November 1, 2001): 579–84. [PubMed]
    2. Fothergill, Erin, Juen Guo, Lilian Howard, Jennifer C. Kerns, Nicolas D. Knuth, Robert Brychta, Kong Y. Chen, et al. “Persistent Metabolic Adaptation 6 Years after ‘The Biggest Loser’ Competition.” Obesity. Wiley-Blackwell, May 2, 2016. doi: 10.1002/oby.21538
    3. McLeod, Kenneth . “Why so Many People Regain Weight after Dieting.” The Conversation. Accessed February 4, 2017.
    4. Wing, Rena R., and Robert W. Jeffery. “Benefits of Recruiting Participants with Friends and Increasing Social Support for Weight Loss and Maintenance.” Journal of Consulting and Clinical Psychology. American Psychological Association (APA), 1999. doi: 10.1037/0022-006x.67.1.132
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    About the Author

    I am a family physician who has served in the US Army. In 2016, I found myself overweight, out of shape, and unhealthy, so I made a change to improve my health. This blog is the chronology of my path to better health and what I have learned along the way.

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