Obesity or overweight is a healthcare problem that has received a lot of focus from the research aspect.
Obese people are at risk of developing chronic diseases like type 2 diabetes, cardio-vascular diseases, hypertension, increased level of blood glucose and cholesterol.
It no longer limited to adults, children as young as 5 are affected by it. 41 million children under the age of 5 and 600 million adults over the age of 18 are obese all over the world.
Gradual weight loss can be achieved by following a proper low-calorie diet and adequate exercise.
Clinical medication and surgery is another way of weight loss but is often associated with side effects.
In the majority of obese people maintaining weight after weight loss is a potential problem.
In many cases people tend to regain weight after this lifestyle intervention or medication is withdrawn.
Thus, there is a necessity of doing follow-ups and changing lifestyle after weight loss for weight maintenance.
What causes weight gain after weight loss?
There are certain factors which lead to weight regain after weight loss. Initially these factors seem to favor weight loss but in the long run, it hampers long term weight loss due to their weight regulating potential.
Their primary function is calorie restriction regardless of energy storage.
Their goal is to restore the highest sustainable weight.
Gastric emptying and subjective appetite also play a crucial role in weight regain following weight loss.
Study of data from 43 clinical trials revealed that one-third of weight lost during a weight loss program are regained in 1 year following a withdrawal of therapy.
Treatment with orlistat, anti-obesity drug along with dietary modifications and follow up strategies like internet counseling, physical activity, pharmacotherapy etc. reduced weight regains chances.
Analysis of data from other studies highlighted the correlation between the initial rate of weight loss and weight regaining capacity.
Results indicated that there is no difference in weight gaining capacity in the fast, moderate and slow group of weight loss.
The effect of weight loss though varied according to duration showing the greatest fluctuations after 18 months.
Follow up study after gastric bypass surgery in patients revealed that the majority of patients regained 21-29% of the weight lost by the surgery.
One-third of patients had excessive weight regain. The mean weight for all patients was 23.4% for maximum weight loss.
10 Proven Ways For Weight Management After Weight Loss
There are certain follow-up strategies to prevent this weight regain.
This includes extended treatment from a professional, telephone and internet counseling, skills training, food provision, monetary incentives etc. These strategies help to monitor weight maintenance.
1. Choose and stock nutritious food items
This strategy involves the intake of the right kind of foods. Often meal replacements help in this process. Choosing the best suitable meal is essential.
As in weight loss period, low-calorie food intake is essential in the weight maintenance period as well.
Follow the Centre For Disease Control and Prevention guidelines and opt for low-calorie alternatives of ordinary food items. Consume more vegetables and fruits.
A 34-week weight loss program and 86 week follow up of it compared the effect of meal replacement therapy and standard diet.
The portion restricted group showed 5% greater weight loss and maintaining capacity after 1 year than the standard diet group.
An 11-week weight loss program and 12 weeks follow up study with soy-based replacement meal showed a similar result. The weight loss was to a greater extent than ordinary diet and no reported weight regain.
What does this mean? Weight regain can be prevented by making appropriate food choices and storing healthy food items at home. Meal replacements are also found to be effective in weight maintenance.
2. Maintain the same diet you followed during weight loss phase
Dietary composition is of primary importance in the weight maintenance phase as in the weight loss phase. Low carbohydrate and high protein diet is ideal for weight control.
A 6 months weight loss program and follow up proved this point. At 6 months weight loss remained the same (around 7%) for all the diets. They start regaining weight after 12 months.
After 2 years the high protein (25%) diet showed 3.6 kg weight loss as compared to the 3kg of the low protein (15%) diet.
Both the low and high-fat diet ( 20 and 40%) showed 3.3kg weight loss.
The low carbohydrate (35%) group showed 3.4 kg weight loss as compared to 2.9 kg of the high carbohydrate (65%) group.
Analysis of data from 32 trials showed low carbohydrate and high protein diet has a greater effect on weight loss and weight maintenance.
What does this mean? Following proper dietary composition prevents weight regain. A low carbohydrate, high protein diet is found to be the best diet for weight maintenance.
3. Indulge in daily work out sessions
Exercise is crucial for maintaining long term weight loss. Proper diet and along with exercise maintains the energy intake and expenditure balance
Analysis of data from various trials spanning over 3-18 months compared the effect of the behavioral intervention and physical activity.
Physical activity alone was found to be less effective in maintaining weight but diet along with physical activity(30mins/day for 6days/week) had a greater impact.
Another study showed aerobic exercise (5days/week) attenuates the adverse effects of weight regain.
What does this mean? Similar to weight loss, exercise plays a crucial role in weight maintenance as well. Along with proper diet exercise act as a mode of preventing weight regain after weight loss.
4. Seek Professional Guidance for monitoring weight
With proper guidance from professionals like dieticians, nutritionists, physiotherapists or doctors one can maintain weight properly.
This is done by inducing a proper behavioral weight loss program which includes setting up a goal, self-monitoring of the progress and long term patient-provider contact to sustain the result.
A 6-month weight loss program followed by 3.5 years follow up study demonstrated this point.
The group with professional help showed 5% less weight regain than the group without professional help.
This is due to adequate guidance in the area of physical activity and calorie intake.
A 12 month follow up study to analyze the effect of additional alternative care on weight regain showed similar results.
The group with extended care showed better capabilities in preventing weight regain than those without extended care.
What does this mean? Research indicates that extended care helps in monitoring weight and prevents potential weight regain during weight maintenance phase.
5. Opt for Telephone counseling to discuss weight loss goals
Seeking the help of counselors and discussing your weight-related issues is another way of dealing with it.
Counseling over the telephone is an effective way.
Phone counseling involves monitoring weight by discussing their calorie intake and their adequate BMI measurements.
A 12 month follow up study after a 6months lifestyle intervention for weight loss proved the efficacy of this strategy.
The group with telephone counseling had greater ability to prevent weight regain than the group without.
Another study compared the effect of telephone and internet counseling on weight loss.
Both of them seem to have a good impact on weight loss but the telephone counseling had less weight regaining capacity than the internet one.
What does this mean? If accessing professional guidance is expensive or a difficult option, one can always opt for telephone counseling. Discussing weight loss goals and constant motivation can help in preventing weight regain after weight loss.
6. Seek help through internet and web-based counseling
Web-based anti-obesity healthcare problems are effective for guidance in the post weight loss period. Similar to telephone counseling, one can seek email counseling as well.
A 3-6month follow up study revealed the efficacy of web-based programs. Individuals following this web-based advice program showed 3% weight loss as compared to 1.2% weight loss shown by the information only web-based program group.
A 6month follow up the studied difference between in-person contact and internet contact (email) or both. The weight control was monitored in 2 groups the 5% and 7% weight loss group respectively.
Results showed that addition of in-person sessions to internet programs did not significantly improve outcomes and internet programs are a viable alternative to in-person sessions.
What does this mean? It can be safely concluded the web based programs and counseling via email has a positive impact on weight maintenance.
7. Participate in incentive-based weight loss programs
This might sound weird, but yes monetary incentives are found to be one of the strongest tools for sustained weight loss.
That is why companies design policies based on monetary incentives to improve the health and lifestyle of employees.
Monetary incentives often play a crucial role in preventing weight regain.
The money obtained can be used to sustain a healthy lifestyle by opting for healthy dietary products and well-equipped exercise regime.
This might be unaffordable to some. Thus providing financial incentives to people for losing weight is an effective strategy.
A 7-month long study showed financial incentives lead to greater weight loss and weight maintenance than ordinary weight loss program. The 2 types of financial incentive groups had 7% less weight regain than the control group.
What does this mean? Incentive based weight loss programs, especially monetary incentives, serve as a driving force in weight maintenance and also provide financial support for a healthier lifestyle.
8. Group efforts help sustain weight loss
It has been observed that people find follow up sessions more boring and frustrating than the actual weight loss program.
Hence, they often opt out of them.
Follow up sessions are crucial during the weight maintenance phase. One way to counter this is to opt for peer support group sessions over individual ones.
A 6 months trial on long term weight maintenance program included group sessions and follow up sessions for weight maintenance.
92% follow up rate was seen in this phase.
An 8-week long peer support community-based intervention program showed an increased weight loss and weight maintenance than the original group.
Another community-based peer group study showed similar results in weight reduction and maintenance.
In this study people from the community volunteered for providing nutritional supplements for 16 weeks.
What does this mean? Weight maintenance can be boosted if one gets support and guidance from his own people. Thus, peer support act as a social incentive and boost a person’s morale.
9. Consult a doctor for anti-obesity drugs
We would not really recommend this but if other ways seem to fail you can consult your doctor about anti-obesity medications.
Orlistat, is one of the approved anti-obesity drugs that help in weight loss and weight maintenance.
An 8 week very low energy diet induced weight loss program followed by a 3 year follow up study illustrated this effect.
Participants showing 5% weight reduction were put under a regime with and without orlistat in the follow-up period.
The Orlistat group showed a lesser extent of weight regain and greater reduction in waist circumference than the control group.
A 2year follow-up study showed orlistat consuming patients had half the probability of weight regaining as compared to the control group.
Similar result was seen in another 2 years follow up study. Orlistat consumption leads to reduced weight gain.
What does this mean? Orlistat, is an effective drug for maintaining weight. However take it only when advised by a doctor. You can opt for natural alternatives to orlistat. (Read Lipase Inhibitors for weight loss)
10. Develop skills like meditation, yoga, to prevent weight regain
Skill training is an effective way of dealing with post weight loss weight gain problem.
By this method people develop certain skills like meditation, yoga, cognitive abilities which has a positive impact in maintaining weight.
A 6 months follow up study on skill development like meditation, increase of concentration power and cognitive abilities validated this point.
Person undergoing this skill training shows a 10% less weight regaining capacity than those who are not.
Stress reduction and mindful eating can be included in this. An analysis of studies examined the effect of mindfulness on over-eating.
By increasing the concentration and decreasing the stress level over-eating can be reduced by 86% thus preventing weight regain.
Similar results were seen in a 6 weekly 2hr mindful eating training schedule
What does this mean? Skill developments like increasing concentration power, ability to cope with stress is a effective way of dealing with weight regain.
Weight maintenance period is as crucial as the weight loss. Thus, weight should be closely monitored at this phase and adequate changes should be made accordingly.
Proper guidance in the form of in person or telephone or email counselling should be availed whenever necessary.
Making appropriate dietary choices and following a similar diet, making an exception for a few food groups like dairy and whole grains, as the one followed in weight loss can help in weight maintenance.
Regular exercise and developing cognitive skills like meditation, yoga and mindful eating benefit in weight management after weight loss.