Study: Self-Regulation Maintains Weight Loss

Daily use of the scale can keep the obesity monster at bay, study finds

This Fox News/WebMD story features the results of a new study showing how people who lose weight can keep the weight off most effectively and the answer may surprise you.

Lead researcher Dr. Rena R. Wing, who is a Professor of Psychiatry and Human Behavior at Brown University and works at the Providence, Rhode Island-based Miriam Hospital, was looking for a way to explain why people who experienced weight loss seemed to inevitably begin to gain the weight back and what successful maintainers did to keep the weight off for good.

“Most dieters regain about a third of the weight lost during the next year and are typically back to baseline [their pre-diet weight] in 3 to 5 years,” Dr. Wing explained.

You might recall that Dr. Wing is also one of the co-founders of the National Weight Control Registry (NWCR) project which features over 5,000 people who have lost at least 30 pounds and kept it off for a minimum of one year. I have been critical of their apparent bias against people who are livin' la vida low-carb and I stand by that assertion based on the dietary recommendations included in this study which you will read about in a moment.

But I think they are on to something regarding people who weigh themselves regularly, which I blogged about the preliminary results of this very study one year ago. Now the full results and conclusions have been published.

Dr. Wing and her colleagues observed 314 adults who had shed an average of 42.5 pounds of their body weight within the past two years and split them up into three categories of weight loss maintenance for an 18-month period:

GROUP 1: Met in person weekly.
GROUP 2: Met in an online chat weekly,
GROUP 3: No meetings, just a quarterly newsletter on diet and health.

While GROUP 3 was obviously the control group, GROUP 1 and GROUP 2 both received additional practical application support for keeping the weight off by being encouraged to weigh themselves daily, exercise for at least one hour a day, and to stick with eating a healthy diet. In addition, they were required to report their weekly weigh-in results and were given specific instructions and encouragement for how to best maintain their weight to prevent weight gain.

Study participants were officially weighed at six months, one year and 18 months to determine their progress. GROUP 1 and GROUP 2 were designated into one of three color categories according to how well they were doing at maintaining their weight:

GREEN ZONE: Gained less than 3 pounds
YELLOW ZONE: Gained between 3-5 pounds
RED ZONE: Gained 5+ pounds

The GREEN ZONE group received "green" gifts such as green tea or money to encourage them to keep up the great work. The YELLOW ZONE group were urged to get into the GREEN ZONE as soon as possible. Finally, the RED ZONE group were nudged to get the pounds off by following regular execise and (get this!) by going on a low-fat/low-calorie diet (UGH!) (despite the fact that an internal study by the NWCR showed that more and more of their participants are choosing a low-carb nutritional approach to lose weight, they still INSIST on putting people on an artificial low-fat/low-cal diet! Why would I do that if I lost weight on the low-carb lifestyle?).

Those RED ZONE people were also provided with individualized diet counseling by telephone or e-mail to encourage them to bring their weight back down. They were supplemented with other diet resources, such as weight loss books, journals and any other tool to help them in bringing the weight under control

At the end of the 18 months, the weight gain results were in:

GROUP 1: 5.5-pound GAIN
GROUP 2: Nearly 10-pound GAIN
GROUP 3: Nearly 11-pound GAIN

The percentage of those who gained at least 5 pounds in each group:

GROUP 1: 45 percent
GROUP 2: 55 percent
GROUP 3: 72 percent

GROUP 1 and GROUP 2 had a statistically even chance of gaining at least five pounds, but the average weight gain was lowest among those who met live and in person regularly.

Dr. Wing concluded that self-regulation through weekly meetings with others desiring weight maintenance along with regular weighing on the scale is the best way to prevent the inevitable weight gain that comes for most people who lose weight.

This study was published in the October 12, 2006 issue of The New England Journal of Medicine.

Some retrospect on this study from someone who lost 180 pounds two years ago, gained about 10 pounds and has lost an additional 25 pounds so far this year (and I'm STILL losing!).

I agree that you must keep a constant eye on your weight if you ever hope to keep the weight maintained forever. If you aren't watching the pot, then it very well could boil over on you at any moment. Keeping your eye on where you stand at any given moment is an important factor in weight maintenance.

I've even tried to make it a game by challenging myself to get five pounds BELOW my goal weight so I can have a little cushion room to work with if I decide to indulge for a meal or skip my exercise for one day. Of course, I can't do those things until I create the cushion, but that gives me the extra motivation to make that happen.

Here's my question for Dr. Wing: Why do people who lose weight HAVE to gain weight at all? Every single participant on average gained at least 5.5 pounds. WHY? What is the reason they did this? If people make a commitment to a permanent lifestyle change and stick with that plan for the rest of their lives, then why oh why would there be ANY weight gain at all?

I hate this assumption that people who lose weight are destined to gain it all back. I know, I know, the statistics bear that out at fact in most cases, but I think it's a self-fulfilling prophecy. People KNOW that the vast majority of those who lose weight don't keep it off, so they think they are normal when the weight gain hits them. It's as if gaining weight has become the norm following weight loss that people stop doing those things that helped them lose weight to begin with. I don't get it.

At the end of the day, people who lose weight have put themselves in a better position to be healthy for the rest of their lives. But it is something they must continue to work on forever and ever without letting up one bit. I for one NEVER expect to gain back the weight I worked too hard to lose and I will do everything I can to make that happen and prove it can be done.

You can e-mail Dr. Rena Wing about her study at rwing@lifespan.org.