DALLAS – Researchers identified behavioral, psychological, and environmental predictors of continued weight loss maintenance vs. weight regain in a large cohort of members of WeightWatchers who had successful long-term weight loss.
On average, the participants had lost 25.5 kg (56 lb) and kept it off for 3.5 years, when they entered the 1-year study.
At study entry and 1 year later, the participants replied to several questionnaires that asked about predictors of weight loss maintenance.
Compared with people who gained weight over the 1-year study,
They also had reduced disinhibition (tendency to overeat) when faced with food cues, as well as less pain and a more positive body image “at any weight, shape, or size,” Suzanne Phelan, MD, PhD, reported.
Dr. Phelan, from the department of kinesiology and public health, California Polytechnic State University, San Luis Obispo, presented the study in an Obesity symposium at the annual meeting of the Obesity Society, and it was simultaneously published in the journal. The study was selected as one of five top papers submitted to the journal to coincide with the meeting.
Future interventions to prevent weight regain should target overeating in response to internal and external food cues and declines in self-monitoring and body image, Dr. Phelan said.
The study aimed to identify behaviors that might predict who might “beat the odds” and sustain long-term weight loss, she said in an interview.
The findings suggest that the people who maintained their weight loss had developed skills to help them cope with cravings and not respond by eating, she said. Continued self-monitoring and body acceptance and appreciation (all body sizes are beautiful) were key elements of successful weight-loss maintenance.
No antiobesity drugs or surgery; don’t forget behavioral stuff
Importantly, although 43% of the study participants regained more than five pounds during this 1-year study, they still remained at 18% below their starting weight, “indicating that they were largely successful at weight loss,” Dr. Phelan said.
Michael D. Jensen, MD, editor-in-chief of Obesity, echoed this.
The researchers “did find some weak predictors of success,” said Dr. Jensen, from Mayo Clinic, Rochester, Minn. “But perhaps as important,” he said, “was that at the end of the trial, even those who had regained some slight weight still had 18% weight loss – which is not trivial – after, on average, 4.5 years with a standard commercial weight management program.
“At every talk I go to here,” the message is, “Let’s stampede towards use of the drugs and skip diet and exercise and behavioral stuff,” he observed. “I would argue,” he said, “that when it works, it works really well, and it’s free. So this idea that we shouldn’t even try it, because we know it’s going to fail, is wrong.
“If you have the right group, they have a decent chance of having a sufficiently good response that you don’t have to give the medications and you don’t have to send them for bariatric surgery.
“Once you learn from these programs what to do, you’re not paying $1,000 a month for a drug and you haven’t had bariatric surgery,” Dr. Jensen noted. “Their 3 years of follow-up of WeightWatchers cost less than 1 month worth of one of these [antiobesity medications].”
The predictive findings were like ‘”icing on the cake,” he said. Anybody can find five people who’ve done well with therapy, but this study was in more than 2,800 people who did well with a commercial program that is not expensive.