Persons Successful at Long-term Weight Loss and Maintenance Continue to Consume a Low-energy, Low-fat Diet

https://doi.org/10.1016/S0002-8223(98)00093-5Get rights and content

Abstract

Objectives To describe the dietary intakes of persons who successfully maintained weight loss and to determine if differences exist between those who lost weight on their own vs those who received assistance with weight loss (eg, participated in a commercial or self-help program or were seen individually by a dietitian). Intakes of selected nutrients were also compared with data from the third National Health and Nutrition Examination Survey (NHANES III) and the 1989 Recommended Dietary Allowances (RDAs).

Subjects Subjects were 355 women and 83 men, aged 18 years or older, primarily white, who had maintained a weight loss of at least 13.6 kg for at least 1 year, and were the initial enrollees in the ongoing National Weight Control Registry. On average, the participants had lost 30 kg and maintained the weight loss for 5.1 years.

Methods A cross-sectional study in which subjects in the registry completed demographic and weight history questionnaires as well as the Health Habits and History Questionnaire developed by Block et al. Subjects’ dietary intake data were compared with that of similarly aged men and women in the NHANES III cohort and to the RDAs. Adequacy of the diet was assessed by comparing the intake of selected nutrients (iron; calcium; and vitamins C, A, and E) in subjects who lost weight on their own or with assistance.

Results Successful maintainers of weight loss reported continued consumption of a low-energy and low-fat diet. Women in the registry reported eating an average of 1,306 kcal/day (24.3% of energy from fat); men reported consuming 1,685 kcal (23.5% of energy from fat). Subjects in the registry reported consuming less energy and a lower percentage of energy from fat than NHANES III subjects did. Subjects who lost weight on their own did not differ from those who lost weight with assistance in regards to energy intake, percent of energy from fat, or intake of selected nutrients (iron; calcium; and vitamins C, A, and E). In addition, subjects who lost weight on their own and those who lost weight with assistance met the RDAs for calcium and vitamins C, A, and E for persons aged 25 years or older.

Applications Because continued consumption of a low-fat, low-energy diet may be necessary for long-term weight control, persons who have successfully lost weight should be encouraged to maintain such a diet. J Am Diet Assoc. 1998;98:408–413.

Section snippets

Subjects

NWCR is an ongoing observational study that began in 1993. For this article, we looked at the first 463 participants in NWCR. Subjects in the registry have been recruited through newspaper, magazine, and television releases. To be eligible, participants must be aged 18 years or older and have maintained a weight loss of at least 13.6 kg for a minimum of 1 year. Although the participants’ current weight and weight changes over time are self-reported, an effort was made to increase the accuracy of

Subject Characteristics

The characteristics of the 438 subjects are shown in Table 1. The majority of subjects were women (81%) and all but 13 were white. The average age of subjects was 45 years for women and 50 years for men. Thirty-four percent of all subjects were between the ages of 40 and 49 years, 59% were between the ages of 30 and 49 years (data not shown). The sample was well educated; 88% had more than 12 years of education.

Men reported that they had lost 35.0±20.7 kg (mean±standard deviation) and women

Discussion

Our study extends the research on persons who successfully lost weight reported by Klem et al (17) by comparing the dietary intakes of successful weight-loss maintainers with intake observed in a national sample and with the RDAs. To our knowledge, this is the first study to make such comparisons and to analyze the dietary intakes of persons who successfully lost weight on their own vs those who received assistance.

Participants in NWCR who had maintained a mean weight loss of 30 kg for a mean of

Applications

It is encouraging to note that there are persons who have been successful at maintaining large weight losses for extended periods. Dietetics professionals need to continue to be involved in their clients’ progress even after their weight-loss goals have been achieved to promote successful maintenance of weight loss. Clients should be encouraged to continue to make changes in physical activity and to continue to consume a low-fat, low-energy diet to successfully maintain their weight loss.

References (36)

  • J.K Harris et al.

    Dietary and physical activity correlates of long-term weight loss

    Obesity Res.

    (1994)
  • N.P Pronk et al.

    Physical activity and long-term maintenance of weight loss

    Obesity Res.

    (1994)
  • J.M Jakicic et al.

    Prescribing exercise in multiple short bouts versus one continuous bouteffects on adherence, cardiorespiratory fitness, and weight loss in overweight women

    Int J Obesity.

    (1995)
  • T.A Wadden et al.

    Exercise in the treatment of obesityeffects of four interventions on body composition, resting energy expenditure, appetite, and mood

    J Consult Clin Psychol.

    (1997)
  • T.A Wadden

    Treatment of obesity by moderate and severe caloric restriction

    Ann Intern Med.

    (1993)
  • R.R Wing et al.

    Effects of a very-low-calorie diet on long-term glycemic control in obese type 2 diabetic subjects

    Arch Intern Med.

    (1991)
  • R.W Pascale et al.

    Effects of a behavioral weight loss program stressing calorie restriction versus calorie plus fat restriction in obese individuals with NIDDM or a family history of diabetes

    Diabetes Care.

    (1995)
  • D.G Schlundt et al.

    Randomized evaluation of a low fat ad libitum carbohydrate diet for weight reduction

    Int J Obesity.

    (1993)
  • Cited by (0)

    View full text