Long-term weight-loss maintenance : a meta-analysis of US studies

• Published in: The American journal of clinical nutrition Vol. 74; no. 5; pp. 579 - 584
• Main Authors: ANDERSON, James W, KONZ, Elizabeth C, FREDERICH, Robert C, WOOD, Constance L
• Format: Journal Article
• Language: English
• Published: Bethesda, MD American Society for Clinical Nutrition 01-11-2001; American Society for Clinical Nutrition, Inc
• Subjects: Adult; Behavior modification; Biological and medical sciences; Body Weight; Diet, Reducing; Energy Intake - physiology; Exercise; Feeding. Feeding behavior; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Humans; Longitudinal Studies; Male; MEDLINE; Middle Aged; Obesity; Obesity - diet therapy; Obesity - therapy; Treatment Outcome; United States; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight control; Weight Loss; United States; North America; America; USA; Human; Balanced diet; Anthropometry; Body weight; Weight loss; Corporal biometry; Long term; Very low calorie diet; Feeding; Metaanalysis; Result
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/74.5.579

Current perception is that participants of a structured weight-loss program regain all of their weight loss within 5 y.
The objective was to examine the long-term weight-loss maintenance of individuals completing a structured weight-loss program.
Studies were required to 1) have been conducted in the United States, 2) have included participants in a structured weight-loss program, 3) have provided follow-up data with variance estimates for > or =2 y. Primary outcome variables were weight-loss maintenance in kilograms, weight-loss maintenance as a percentage of initial weight loss, and weight loss as a percentage of initial body weight (reduced weight).
Twenty-nine studies met the inclusion criteria. Successful very-low-energy diets (VLEDs) were associated with significantly greater weight-loss maintenance than were successful hypoenergetic balanced diets (HBDs) at all years of follow-up. The percentage of individuals at 4 or 5 y of follow-up for VLEDs and HBDs were 55.4% and 79.7%, respectively. The results for VLEDs and HBDs, respectively, were as follows: weight-loss maintenance, 7.1 kg (95% CI: 6.1, 8.1 kg) and 2.0 (1.5, 2.5) kg; percentage weight-loss maintenance, 29% (25%, 33%) and 17% (13%, 22%); and reduced weight, 6.6% (5.7%, 7.5%) and 2.1% (1.6%, 2.7%). Weight-loss maintenance did not differ significantly between women and men. Six studies reported that groups who exercised more had significantly greater weight-loss maintenance than did those who exercised less.
Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3 kg and a reduced weight of >3% of initial body weight. After VLEDs or weight loss of > or =20 kg, individuals maintained significantly more weight loss than after HBDs or weight losses of <10 kg.