Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain

Abstract

Weight loss is difficult to achieve and maintaining the weight loss is an even greater challenge. The identification of factors associated with weight loss maintenance can enhance our understanding for the behaviours and prerequisites that are crucial in sustaining a lowered body weight. In this paper we have reviewed the literature on factors associated with weight loss maintenance and weight regain. We have used a definition of weight maintenance implying intentional weight loss that has subsequently been maintained for at least 6 months. According to our review, successful weight maintenance is associated with more initial weight loss, reaching a self-determined goal weight, having a physically active lifestyle, a regular meal rhythm including breakfast and healthier eating, control of over-eating and self-monitoring of behaviours. Weight maintenance is further associated with an internal motivation to lose weight, social support, better coping strategies and ability to handle life stress, self-efficacy, autonomy, assuming responsibility in life, and overall more psychological strength and stability. Factors that may pose a risk for weight regain include a history of weight cycling, disinhibited eating, binge eating, more hunger, eating in response to negative emotions and stress, and more passive reactions to problems.

Initiation and Maintenance of Weight Loss after Laparoscopic Adjustable Gastric Banding. The role of Outcome Expectation and Satisfaction with the Psychosocial Outcome

“…Some patients regain weight from 2 years after bariatric surgery [5,29]. Our analyses do not refute the possibility that dissatisfaction with the psychosocial outcome impedes long-term weight loss maintenance.…”

An 8-year follow-up of treated obese children: Children’s, process and parental predictors of successful outcome

“…Although weight loss is difficult to achieve, it appears to be an even greater challenge to maintain it in the long term (Elfhag & Rössner, 2005). As weight stabilization seems a more attainable goal, attention is now focused on childhood obesity.…”

Application of the Theory of Planned Behaviour to weight control in an overweight cohort. Results from a pan-European dietary intervention trial (DiOGenes)

“…The benefits of weight loss and weight loss maintenance have been well documented (Vidal, 2002). However, current approaches to overweight and obesity management have shown limited effectiveness, especially over the long term, with weight loss maintenance presenting a particularly difficult challenge (Elfhag & Rössner, 2005;Garcia Ulen, Huizinga, Beech, & Elasy, 2008;Wadden, Brownell, & Foster, 2002;Wing & Hill, 2001). Better understanding of individuals' behaviours and the differences in behaviours of those who are successful and unsuccessful at weight control will enable development of more targeted treatment options.…”