"Weight loss as little as 10% in an overweight or obese individual can reduce risk factors for diabetes and cardiovascular disease. To be successful at reducing these risk factors in the long term, weight loss must be maintained”, says Dr. Weiss.
The objectives of this analysis were to determine the prevalence and predictors of weight regain in US adults who had had substantial weight loss.

The NHANES investigators examined 1310 US adults aged 20 to 84 years who were overweight or obese (body mass index, ≥ 25 kg/m2) at their maximum weight and who had experienced substantial weight loss, defined as weight 10% less than their maximum weight 1 year before they were surveyed.

Compared with their weight 1 year before they were surveyed, 7.6% of participants had continued to lose more than 5% of their body weight, 58.9% had maintained their weight within 5%, and 33.5% had regained more than 5% of their body weight.

Traci Mann, PhD, an associate professor of psychology at the University of California, Los Angeles, not part of the study but was asked to provide his commentary, stated that, “Diets do not consistently lead to sustained weight loss, particularly among individuals who lose the most weight.” "A substantial number of people regain all the weight they lose on diets." 

Factors associated with weight regain, as opposed to weight maintenance or loss, included Mexican-American ethnicity (vs non-Hispanic white), loss of a greater percentage of maximum weight (≥ 20% vs 10% to < 15%; OR, 2.8; 95% CI, 2.0 - 4.1), fewer years elapsed since reaching maximum weight (2 - 5 vs > 10 years; OR, 2.1; 95% CI, 1.2 - 3.7), reporting greater television or screen viewing time (≥ 4 vs 0 - 1 hours; OR, 2.0; 95% CI, 1.3 - 3.2), attempting to control weight (OR, 1.8; 95% CI, 1.1 - 3.0), sedentary lifestyle (OR, 1.8; 95% CI, 1.0 - 3.0), and not meeting public health recommendations for physical activity (OR, 2.0; 95% CI, 1.2 - 3.5).

"Mexican Americans had higher odds of weight regain than non-Hispanic whites, and those who were sedentary or not meeting physical activity recommendations and those who reported greater daily screen time, such as TV, video, or computer use, had higher odds of weight regain," Dr. Weiss said. "Regular physical activity has been consistently associated with long-term weight loss maintenance; however, weight regulation depends both upon caloric intake as well caloric expenditure. Balancing caloric intake with activity level works on energy balance from both sides, what is taken in, as well as how much is used; in addition, eating a healthy diet and being physically active can reduce the risk of chronic diseases, such as heart disease or diabetes."

Practice Pearls 

• Compared with their weight 1 year before they were surveyed, 7.6% of 1999 - 2002 NHANES participants with substantial weight loss had continued to lose more than 5% of their body weight, 58.9% had maintained their weight within 5%, and 33.5% had regained more than 5% of their body weight.

Am J Prev Med. The study is published online June 5 and will appear in the July print issue of the American Journal of Preventive Medicine.

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