Successful long-term weight loss maintenance in a rural population

Abstract

BackgroundFew investigations of successful long-term weight loss beyond two years have been conducted, and none has examined weight changes in medically underserved rural populations of older adults. The purpose of this study was to assess long-term weight loss maintenance 3.5 years after the completion of an initial six-month lifestyle intervention for obesity among women aged 50–75 years residing in rural communities.MethodsOne hundred and ten obese women with a mean (± standard deviation) age of 60.08 ± 6.17 years and mean body mass index of 36.76 ± 5.10 kg/m2 completed an in-person assessment during which their weight and adherence to behavioral weight management strategies were evaluated.ResultsParticipants showed a mean weight reduction of 10.17% ± 5.0% during the initial six- month intervention and regained 6.95% ± 9.44% from the completion of treatment to follow-up assessment 3.5 years later. A substantial proportion of participants (41.80%) were able to maintain weight reductions of 5% or greater from baseline to follow-up. “Successful” participants (those who maintained losses of 5% or greater at follow-up) reported weighing themselves, self-monitoring their intake and calories, planning meals in advance, and choosing lower calorie foods with greater frequency than “unsuccessful” participants (those who lost less than 5%).ConclusionCollectively, these findings indicate that a large proportion of participants were able to maintain clinically significant weight losses for multiple years after treatment, and that self-monitoring was a key component of successful long-term weight management.

Long-term weight status in regainers after weight loss by lifestyle intervention: status and challenges

“…Champagne et al (39) , Kuller et al (40) and Svetkey et al (43) included also overweight participants. In the weight loss period, all authors (36)(37)(38)(39)(40)(41)(42)(43) applied the reduction of energy intake to at least 5020·8-7531·2 kJ/d (37)(38)(39)(40)42,43) even to very low energy diet (41) and with ready-to-use formula (Optifast) (36) . The content of fat in the diet was taken into account especially by Wadden et al (37) , Milson et al (38) , Kuller et al (40) and Svetkey et al (43).…”

“…Furthermore, in some studies data on determinants of weight management were also collected. Milsom et al (38) , for example, added a weight management questionnaire to the assessment of weight development after 3·5 years follow-up. The questionnaire results showed that unsuccessful participants were less engaged in record keeping, in regular self-weighing, in planned meals ahead of time and in goal setting subscales, e.g.…”

“…Additionally, Kuller et al (40) found that systolic blood pressure (P = 0·048), LDL-cholesterol (P = 0·026), TAG (P = 0·92), insulin (P = 0·0001), glucose (P = 0·002) and HDL-cholesterol (P = 0·0001) developed significantly differently between the Health Education and the Lifestyle Change group. In the reviewed studies, the weight changes from baseline to weight loss ranged from −4·0 to −0·2 kg; in two studies they were not reported (38,41) . However, the studies with no data on weight loss reported an average weight regain of about 4 kg (36)(37)(38) and percentage changes in body weight between 4 and 15·1 % (36)(37)(38) .…”

“…In the reviewed studies, the weight changes from baseline to weight loss ranged from −4·0 to −0·2 kg; in two studies they were not reported (38,41) . However, the studies with no data on weight loss reported an average weight regain of about 4 kg (36)(37)(38) and percentage changes in body weight between 4 and 15·1 % (36)(37)(38) . The participants were often re-contacted several times during follow-up, e.g.…”

Weight maintenance: challenges, tools and strategies for primary care physicians

“…Individualized calorie goals, based upon an individual's desire to maintain or lose more weight 61, 62 Use of meal replacements for one or more meals or snacks per day 61 Planning meals in advance 66 Individualized healthy meal plans that accommodate personal and cultural food preferences 61, 62 Self‐monitoring of food intake and calories 66 …”