SAN FRANCISCO — People who lose at least 30 pounds and successfully keep the weight off for more than a year share eight key characteristics, Suzanne Phelan, Ph.D., said at a meeting sponsored by the American Diabetes Association.
These characteristics may translate into weight-loss and maintenance strategies for patients at risk for diabetes, said Dr. Phelan of Brown University, Providence, R.I. Previous studies have shown that even a 5%–10% weight loss in overweight or obese people can significantly reduce the risk for diabetes.
Conventional behavioral weight-loss programs incorporating changes in diet and exercise can produce weight loss over a 6-month period, but most participants usually regain a third of the lost weight within 1 year, and after 5 years are back to their baseline weight or have gained weight, she said.
The National Weight Control Registry, established in 1994 by researchers at Brown University and the University of Colorado, analyzed data on 5,585 people who reduced their weight by a minimum of 30 pounds and maintained that for more than a year. Detailed initial questionnaires and annual follow-up surveys tracked their progress.
This cohort of “successful losers” was 77% female, 85% college educated, 95% white, 65% married, and an average of 46 years old. It's a self-selected group—“they call us because they want to join the registry,” Dr. Phelan said.
Weight loss averaged 32 kg in women and 34 kg in men, losses that were maintained for an average of 6 years; 13% of participants had kept the weight off for 10 years or more. The weight loss was achieved through diet and exercise in 89% of cases, through diet alone in 10%, and by exercise alone in 1%.
Dr. Phelan noted that 45% of respondents said they lost the weight on their own. “This still surprises me. We're investigating them further,” she said. The other 55% joined formal weight-loss programs to shed the weight. To mimic the characteristics of successful losers, Dr. Phelan suggested these eight strategies:
▸ Eat a low-calorie, low-fat diet. Energy intake averaged 1,385 kcal/day, with 27% of energy coming from fat. Using meal-replacement products may help people not only to lose weight, but to keep it off, compared with people who eat conventional foods during weight loss, studies suggest. “I think they're underutilized,” said Dr. Phelan, who has no association with companies that make meal-replacement products.
▸ Engage in a high level of physical activity. Energy expenditures averaged 2,545 kcal/week for women and 3,293 kcal/week for men.
▸ Limit TV viewing. Only 12% watched 21 or more hours of TV a week, 25% watched 11–20 hours, and more than 62% watched fewer than 10 hours a week.
▸ Step on a scale often. In all, 31% of respondents weighed themselves weekly, and 44% weighed themselves daily. Those who stopped weighing regained weight.
▸ Maintain diet consistency. About half of successful losers eat the same way on weekends and holidays as they do on weekdays.
▸ Limit diet variety. Successful losers keep fewer different types of foods on hand. Dr. Phelan suggested selecting just one or two brands of crackers or other foods for the home.
▸ Eat breakfast. The day starts with breakfast for 78% of successful losers.
▸ Limit fast food. The weight-loss maintainers ate fast food less than once a week (0.77 times a week, on average).
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