Dieting: How Much Weight You Can Expect to Lose
A review of weight loss trials that included counseling has shown sobering results.
Out of 46 trials (that met the criteria) - the weight loss after 12 months was just 6% of start weight. As time goes on it gets worse...
Half of the initial weight loss was typically regained after 3 years. What about after this? The research reports that:
"relatively few data points were reported after 36 months. [...] This rate of weight regain suggests that, on average, patients would return to their baseline weights after approximately 5.5 years."
In other words there were very few trials that checked back beyond 36 months. But the trends during a maintenance phase show that most dieters would be back to start weight after 5 years.
The only "commercial" diet included in the analysis was Weight Watchers, all other trials had a goal of weight loss by limiting fat or calorie intake.
Notes
- The object of the analysis was to check the effect of dietary counseling (advice to change dietary patterns) on weight.
- Where exercise was part of the program, weight regain was not as bad (however exercise-only programs were not tested). This concurs with other research about exercise and weight maintenance.
What to expect?
Many people embark on diets with wildly short-term expectations. A more realistic expectation is that once you've reached goal weight - your work has only just begun.
Unfortunately this is not a popular sentiment - nor particularly marketable.
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I think this goes to show that too many people still have unrealistic expectations about losing weight and look at weight loss as a temporary diet plan. They tend to go right back to old habits after hitting goal, if they stick with it that long.
Also, many people want to lose weight without the effort of exercise. I've come to believe that weight loss without exercising is almost a sure way to gain back what you've lost.
Brian
ReplySo true! Losing weight and keeping it off requires a lifetime commitment. I'm just as guilty of having that temporary mindset in the past. :( I wish I was smarter than that before!
ReplyLosing weight and keeping it off can be achieved. My own experience with that challenge took me from 225lbs and 5'6" to 140 over the course of 18 months and I have kept it off for over ten years. HOW? I STOPPED EATING PROCESSED FOODS!!! Imagine that, eat what you want ... the only requisite is that you have to make it from scratch from real ingredients. The energy you expend shopping and cooking ( and cleaning up after the effort ) on a regular basis goes along way to meeting your exercise requirement and your quality of life will increase beyond your wildest expectations. Real food is powerful medicine in our society. Make some today!
ReplyThis article is even more discouraging than your average "you gain it back" result. The studies that the authors chose were those that included diet counseling. These were diet plans that were attempting to attack face-on the issue that Brian raises.
An interesting point that I don't know how to take: weight-loss programs for people with diabetes were significantly less effective than those that excluded people with diabetes. Hum.
A small ray of hope: the authors seem to suspect that some health benefits remain for those who regain their weight. This is an interesting thought.
A comment: these studies are frustrating to me, because they focus on average behavior. Most (perhaps all?) of us know of people who have lost significant amounts of weight and kept it off. There are probably such people in these studies. I would love to see some research that, instead of focusing on average behavior, considers outlier behavior. Considering only the controlled variables addressed in this study, does dietary counseling, exercise, calorie reduction, or fat reduction increase the fraction of people who keep significant amounts of the weight off? Similarly for the fraction of people who eventually weigh more than their initial weight.
ReplyI agree, this is a bit depressing. Just as we all know of people who are the exception, and have lost large amounts of weight and kept it off, there also seem to be a lot of people who do all the right things and don't seem to lose much. I think keeping the focus on "health" as much as possible, rather than "pounds lost," may be the only way to sustain motivation for the long haul.
And I agree with the other commenters, that whole foods and lots of exercise are an important part of the equation too, not just calories.
ReplyThis blog post is misleading.
The study is not an indictment of 'diets' is was looking at the effectiveness of "counseling interventions" - not the diets themselves.
BTW, Michelle - congratulations, to you!!!
ReplyAnd... as Quito says. In many ways that makes this more sobering. I've always believed that education was the answer. That long periods of good counsel would empower people to make lasting changes...
ReplyOk, so when I was a teenager and was about 60 lbs overweight, I went "on a diet" for a couple weeks every so often and lost maybe 10 lbs, then I'd go back to my old eating habits and gain the weight back. My mom and dad have "done Weight Watchers" about 7 or 8 times and each time they are on the program, they do lose weight, but then they go "off Weight Watchers" when it becomes inconvenient or whatever and they gain the weight back.
I did a modified version of WW to lose weight in college. I looked at it as a new way of eating, not as a diet. I lost all my extra weight and have kept it off for 6 years because I never really went "off the diet", plus I added in daily exercise to help my body burn more calories.
I also agree on avoiding processed foods. I eat hardly any processed foods and I barely even have to watch what I eat anymore. I eat foods high in nutrients and low in calories, drink lots of water, and eat plenty of fiber. So I guess I'm one of those atypical people that actually kept weight off long term. I plan on keeping it off too!
ReplyA lot of my clients are dissapointed when I inform them of the work it takes to keep the weight off. Many of them think that you go back to what they were doing to gain the weight from the beginning.
ReplyExercise is our normal activity. If we lose sight of that we become unnaturally sedentary.
ReplyHunger is a normal part of the rhythm of every day. If we become afraid to feel a little hungry we eat too much.
Diet-and-exercise plans that are meant as short-term fixes leave out the information that we are supposed to be active and get a little hungry sometimes. If you have a physical or emotional reason you can't live with a normal level of activity and hunger, you have to find help for that problem somehow. With me, I get into lazy physical habits when I have a lot of mental work to do or emotional stress. I have the feeling I've been more active than I have been. I fight that by making myself move, even if just to wriggle or do bicycles while reading, etc. I fight fear of slight hunger by reminding myself that it's part of life and I won't starve in ten minutes. i deal with the constant food ads by thinking, that's ludicrous. You weren't designed to eat all that at one sitting. It's gross.
First off, I'd be happy to lose 6% of my weight. Yes, I'd like to lose a lot more, but I try not to be scornful of any pound that I earn.
I'd be interested to know what sort of counseling was involved. I've frequently heard that people that have a strong support system are more likely to be successful weight losers. Many of us on the internet are blogging, reading, posting to message boards, etc. Perhaps we know more "outliers" (aka, success stories), because we know people (online) who are getting -- and giving -- this support.
Weight Watchers is only once a week. But those of us online are able to reach out nearly any time of day and get some encouragement when we need it.
ReplyI participate in a twelve-step recovery program for people struggling with addictions. I believe for many of us who struggle with being overweight, we are actually struggling with an addictive behavior. Since this study deals with those who are receiving counsel, such as might occur in the context of a Twelve-Step group, it is alarming. Those of us who are overweight do not have a temporary problem. Just as an alcoholic doesn't hope to go back to drinking after being sober for 2 years ... neither can we expect to go back to eating out of control once we drop the weight. It isn't a weight loss issue so much as it is a control issue. Food ... and the thought of eating ... controls us. Break the cycle!
ReplyThe attitude of going on/off a diet is *so* prevalent. And it's reinforced by the diet industry. Have you ever noticed how adverts for weight loss programs *always* focus how quickly the person lost weight - never on how long they have kept it off?
ReplyThe question isn't 'how much can you expect to lose (when you go on a diet)', it should be 'does counseling make a difference when added to a diet program." In other words, "How much MORE can you expect to lose if you ADD nutritional counseling to a weight loss program?"
According to the study, the answer is, "Nothing. The addition of nutritional counseling resulted in outcomes that were similar, if not identical, to dieters who did NOT have counseling."
The only thing 'sobering' (imo) about the study is that much government money, as well as, consumer money is spend on the ADDITIONAL of an intervention (counseling) that (apparently) doesn't make a difference.
Replyhmm, I had some typos above...
The only thing 'sobering' (imo) about the study is that much government money, as well as, consumer money is spent on the ADDITION of an intervention (counseling) that (apparently) doesn't make a difference.
So there, Jim, you and I are in 100% aggreement. But I think that most people will read this post, and not see that point...the focus will be on 'diets' that supposedly fail...when the interesting part of the study is the failure of the additional intervention...
(sorry to nitpick... ;) 0
ReplyOne more thing we have to keep in mind that the media is trying convince us that dieting is not going to work. Well it is not the media but the Fast food Industry and the Big pharmas that are doing it through the media. They want us to "consume" more and then use drugs to keep us thing. The new fat blockers are aiming exactly at that. The pharma companies are doing research to find a way in which we can remain think while eating all the junk food. Big Pharam is doing it as a "repayment" to the Fastfood Industry(and all companies that produce adultrated foods with color and toxin preservative) for bringing them so much of business. Trust me stop eating junk and you will not need prozac or your antacid pill.
ReplyI'd say you have a point, as many processed foods are unealthy, but this is not going to work for everyone. I don't eat processed foods -- never have -- and I am still 50 pounds overweight. I am an excellent cook and use a lot of local ingredients. I just cook, maybe, a little too well. And I bake well too. I really enjoy eating good food, and I eat a lot. I cook for my family, and I cook for friends, and food is always around. For me, giving up processed foods is not the answer. Some of the things that are helping me are giving up most snacking, eating more slowly, eating at regular times, being more aware of portion size, trying to find other ways to reach out to people, besides with food...
I'm always a little envious of people who have easily identifiable bad habits, like eating at fast food restaurants a lot, drinking soda several times a day, eating all white flour, etc. I feel like it would be so easy to just get rid of one of my bad habits or substitute a new, better habit. Instead, I'm having to make changes that are less easy for me to pinpoint.
ReplyI'm going to take issue with what you said about prozac. Maybe you don't really understand clinical depression and the use of drugs to treat it, but telling people to just stop eating junk food so they won't need their prozac anymore is an inaccurate statement.
People who have depression often do need drugs such as prozac in order to have a "normal" life. I agree that eating less junk food is good for anyone, but carrots are not a substitute for life-saving drugs.
Reply
The crux of this issue is that people started GAINING during the maintenance phase. The counseling intervention helped people to LOSE - but it always comes back to maintenance (thus why recently there has been a lot more material on this blog about weight maintenance).
Yes! The fact that anyone is here reading these comments means that they take an active interest in nutrition - compared with the vast numbers who want the instant quick fix (no research required).ReplyI have found that for me to remain at our near my "ideal" weight I have to:
--be hungry all the time, except for about an hour after eating
--exercise 2+ hours a day
--Obsess about it constantly -- basically make it my hobby
I don't think it's a simple matter that people go back to their old habits. I think that overweight people who lose weight are DRIVEN to eat more. I know I was constantly fighting the urge to eat more when I was 30 lbs thinner.
ReplyThanks, Different Nic, took the words right out of my mouth.
ReplyI was just wondering.. For most average weight individuals who are interested in losing around 5 to 7 pounds, how long does it usually take?
ReplyThe reason people with diabetes have worse diet outcomes is because the standard 'diabetes diet' advice gives you rollercoaster blood sugar levels that make your hunger insane and gives you low blood sugar when you try to exercise, which you have to treat by eating.
Counseling is not the same as support. The counseling in this study was probably no more than we hear on the news every day, just in smaller groups or one on one. Most people can follow that advice for a while but anyone who has a significant amount to lose has to do it for years. Who can go for years always being hungry every day and killing yourself running for 60-90 minutes several days a week? I, and the people around me, could only stand it for about 4 months and I was lucky I didn't kill someone.
It's easy to say all you have to do is eat less and move more when you only have 10-20 pounds to lose. The only way most fat people can lose a significant amount of weight and keep it off is if they can find a way that doesn't make them miserable every day so they can keep doing it forever.
ReplyO my gosh...I feel so freakin fatt...Everyday I am gaining more and more weight...I want to scream for help, but every diet I have tried does not seem to work. HELP!!!
ReplyDeirdre, you sound like some of my southern aunts. If that is the case - your problems are - too many bad fats (butter), portions are way too large, not enough fruits and vegetables (raw without sauces), and too many of your calories are consumed late in the day when you won't burn them.
You probably enjoy a large dinner, followed by a large yummy dessert. For starters, try cutting portions, and making up for it with fresh fruits and vegetables. As a good cook, it will be easy for you to learn to make fantastic food that is lighter on the calories.
And then, you can write a new recipe e-book with your lighter creations to help more people!
Good Luck!
ReplyCarole
Thank you Carol! Much of your post is probably quite right.
ReplyTotally accurate information. It's all so true. I think our culture is conditioned into wanting immediate gratification in all things. People tend to do things emotionally (like emotionally eating which gets them into trouble in the first place, many times) instead of approaching their weight problems intellectually. If you watch the Biggest Loser, it's all about emotional trials and breakthroughs, which are drastic and occur over a very short period of time. I would be interested to see empirical data about the stats on how the Biggest Loser contestants fair, say, 5 years after the show airs its finale. I think they will fair better than the average, non-television contestant because the experience is so profound and televised that if causes life-changing transformations of mind, body and spirit. Maybe the key here is groups, creating life long ties with others that mutually support their commitment to a permanent change in lifestyle. It's always a nice thing to have that sense of commonality and collective bonding to motivate you throughout life.
ReplyThe travesty is that people want to lose weight, but they really don't want to change their habits.
If I started meeting people who said, "I want to change my eating and fitness habits for the better" I could show you people who would keep their weight off.
Instead, we only hear about people with a short term vanity goal of losing weight, and the result is that they get what they desired-- short term vanity weight loss.
It's all about habits.
ReplyI find this study to actually be encouraging! My weight loss goal is almost exactly 6% of my starting weight and I would be happy to be at that weight in a year!
Also, the fact that they regain the weight after 5.5 years isn't so bad. If they hadn't dieted in the first place, doesn't the average person gain something like 2 pounds a year? So they are better off after 5.5 years than if they had never lost the weight anyway.
Reply