Successful weight-loss maintenance in relation to method of weight loss

Abstract

This study examined the relation between method of weight loss and long-term maintenance among successful weight losers enrolled in a weight-loss maintenance trial. Participants were 186 adults (mean age = 51.6 +/- 10.7 years, mean BMI = 28.6 +/- 4.7 kg/m(2)) enrolled in the STOP Regain trial who had lost at least 10% of their body weight in the past 2 years using a very low-calorie diet (VLCD; n = 24), commercial program (n = 95), or self-guided approach (n = 67). Participants were randomized to a weight-maintenance intervention delivered face to face or over the internet or to a newsletter control condition, and followed for 18 months. At study entry, individuals who had used a VLCD had achieved a weight loss of 24% of their maximum weight within the past 2 years compared to 17% achieved by those who had used a commercial program or self-guided approach (P < 0.001). However, individuals who had used a VLCD regained significantly more weight than the other two groups and by 6 months, there were no significant differences in overall percent weight loss (i.e., initial weight loss and maintenance) between VLCD, commercial, and self-guided methods. In contrast, individuals who had used a self-guided approach maintained their weight losses from baseline through 18 months. The large initial weight losses achieved by individuals who had used a VLCD were not maintained over time, whereas individuals who had used a self-guided approach maintained their initial weight losses with the greatest success. The generalizability of these findings is limited by the sizeable weight losses achieved by study participants.

Trial registration: ClinicalTrials.gov NCT00067145.

Figure 1

Percent weight loss from maximum weight in the past two years (overall percent weight loss). A significant weight loss method × time interaction (p<.001) was found. At entry to STOP Regain, participants who had used a VLCD had lost significantly more weight than those who had used a commercial program or self-guided approach but by 6 months (and continuing through 12 and 18 months) no significant differences in percent weight reduction were present. Individuals who had used a VLCD or commercial program evidenced significant decreases in total weight losses over time while those who had lost weight on their own maintained initial weight losses from baseline to 18 months. Note: VLCD: very low calorie diet. Values are adjusted means controlling for gender, baseline weight, intentional weight loss (cycling) history, baseline fat intake, duration of weight loss maintenance, and STOP Regain treatment group.