Are there statistics for how many people successfully lose weight and keep it off?

Factual Questions
1

I was reading an article in NYT, called The Fat Trap, about how it’s more difficult for an overweight person who has lost weight to keep it off than it is for an average-weight person to maintain his weight.

When anyone loses weight, their body will lower their metabolism in order to help them store more fat. This mean that people who have lost weight need to maintain a higher caloric deficit in order to maintain their new weight. As a result, a lot of people become fat again.

Is there any data on how many people lose weight and keep it off? It would be interesting to find out just how hard it is maintain weight loss.

2
3

According to a recent article on Cracked.com (and I have certainly heard this before), effectively zero% of people who lose significant amounts of weight (unless by fairly drastic surgery) fail to regain most of it in, at most, a few years time. OK, it is a humor web site, but it generally seems to care about its facts, and in this case has cites to real science.

The first of those peer reviewed articles, furthermore, appears to suggest that fat people who lose significant amounts of weight are not only liable to gain it back, but to die sooner than those who never lost it in the first place.

ETA:
Note that the paper cited by Darth Panda only seems to deal with people keeping weight of for one year after initial loss, and even then the figures for amounts kept off are not that impressive.

4

Zero!? Seriously?

Has anyone told all those people lecturing overweight people on eating healthy and exercising? Almost everyone I know thinks permanent weight loss is a possibility.

Now that I think about it, I don’t really know anyone who has lost weight and kept it off for more than five years. This is unsettling.

5

It does seem that the “body as a perfect machine” theory in which your weight gain or loss is precisely correlated to the number of calories you consume or expend, is not quite accurate.

I know five people who have maintained major weight loss (50 pounds or more) for several years. Three had weight-loss surgery and the other two are distance runners.

6

At the risk of bringing the strawman in early, we’ve had this discussion before, and it always gets derailed by folks who are missing the point. Sure, it’s possible to lose weight by simply consuming fewer calories, and adjusting the calorie number to match changes in metabolism. I don’t think anyone’s disputing that. Doing that it just an application in personal willpower. I don’t think anyone’s disputing that, either, but I bet it’s what most of the responses here turn into, based on previous threads.

But in practice, basically nobody but a few outliers can do that, and even most of the outliers will fail eventually. Sure, it’s just willpower, but (to cite myself in a older thread), so is holding your breath until you pass out, and that only requires maintaining the willpower for a couple of minutes, not a lifetime. And still almost nobody can do it.

The bottom line is that,* if “diet and exercise” were a drug, the FDA would never approve it*, based on the effectiveness clause. The “obesity is a personal failing” folks may argue that claim, but in medical studies, you don’t get to discount compliance. And, for effectively all folks studied, you won’t get compliance over a lifetime except in exceptional situations.

The most common study cited here is by a doctor Stunkard, which I can’t find a copy of online any more. It’s from 1959, and has some methodological problems (it was only a sample size of 100), but it came up with a figure of 95% failure for diets (these are diets without medical control, i.e. people who are trying to diet, but not part of a controlled program) over a single year. But as one of njtt’s cites point out, the penalty for failure to maintain weight loss (in terms of health outlook) is usually worse than not having lost it at all.

7

Or in other words, losing weight is easy in the same sense that quitting smoking is easy.

8

That site defines one year as long term. Weight regain tends to be gradual, and one year is no where near long enough to determine permanence.

Five years minimum is a better standard. The rates tend to hover around 5% for that.

I have no idea what the rates are for 20% weight loss (which is the amount needed to go from BMI 30 to BMI 25) kept off for 5 years, but I’m sure it is far less than 10%.

9

The problem is even when people do lose weight and keep it off, there is no telling why. Hormones and other endocrine signals (PPY, ghrelin, leptin, T3, etc) play a major role in weight maintenance. And I don’t think we know enough to know what all hormones are important. I don’t know if studies have been done to determine if people who lose weight and keep it off have different endocrine systems or what. But studies on underfeeding and overfeeding have found vastly different rates of weight loss and gain between individuals. I remember looking at pubmed studies on underfeeding and overfeeding, some people if you overfeed turn almost 100% of the excess into fat. Some turn about 30% of it into fat and maybe 15% into muscle. Some just burn it off through NEAT and other unconscious activity. Same with underfeeding, people lose at different rates. People who do lose weight and keep it off could do so because their biology is different. But I don’t know if anyone knows how to replicate that. Even if you find that 0.5% of the public who can lose 100 pounds and keep it off for 30 years, I don’t think they can take that person’s biochemistry and replicate it en masse as a cure for obesity.

I know studies on weight loss have found that supplemental leptin can reverse the effects on the brain of weight loss and make weight maintenance easier. But it’ll be years before anything is on the market.

http://www.jci.org/articles/view/35055

As of 2012, I’d assume the best thing an obese person can do is improve their lifestyle whatever ways they can (exercise more, get good sleep, maintain good social contacts, eat healthy) and not really focus on weight loss.

10

Does quitting smoking have a success rate of less than 5% after a five year period? Losing weight is probably much harder.

11

No, absolutely not! Unless you are saying that virtually nobody successfully quits smoking, and manages to stay off,* and that would simply not be true. Quitting smoking is hard, but it can be done. Losing significant amounts of weight is hard, but it too can be done. Staying off smoking long-term, once you have initially quit is (from what I have heard) moderately difficult for some and and relatively easy for others. Certainly many people manage it. Keeping significant amounts of lost weight off long term is virtually impossible, and just about nobody manages it.

*Or unless you have completely missed the point that this discussion is about the near impossibility of keeping weight off long term, rather than about the difficulty of initially losing it.

12

As someone who has struggled all my life with weight issues the bottom line is that the needles of our personal behavior compasses regarding food consumption behavior are set at pretty young age. Modernity provides effective access to an almost infinite supply of calories for the middle class and beyond in developed countries. Some people are wired to eat well beyond satiation just for the sheer pleasure or stimulus of eating.

A tendency to strong appetites, and eating beyond satiation were non-issues in a restricted calorie, high physical exercise environment that 95% of the world lived in until the past 100 years. You effectively could not be truly fat unless you were fairly wealthy.

I think most fat people know inherently there will never be a perfect long term solution short of radical behavior modification which often takes professional assistance and ongoing financial resources. Being at a lesser “normal” weight is like diving under the water. It’s neat and enjoyable but eventually your body will force you to the surface.

I consider myself to be a fairly rational personal but when in strong diet phase you can feel the vague shadow of another “presence” in your consciousness calculating and scheming how to get you to eat. Your mind is not entirely your own, you want to be steadfast, but you are searching desperately for a reason to eat. You don’t even really have to be physically hungry. The impulse to eat enough to return to the set point your metabolism prefers is incessant. You will never win that battle unless you can modify that setpoint. That modification can be done to a degree, but it is a herculean task requiring years, possibly decades, of modified behavior, and if you screw up you’re back to an obese set point almost instantly.

Fat people are mostly rational individuals. Being truly obese (ie 50 lbs or more overweight) is a horrible way to live. It compromises your enjoyment of life on so many levels. The goal in the end for most fat people is not to be some perfect avatar of “normal” weight forever, that’s not going to happen. For the vast majority of fat people the real world goal is just to be “less fat” for however long you can maintain it.

13

I wonder if there is a difference between those people who have been significantly overweight for most of their lives, vs. people (like me) who were at a normal weight for most of their lives and simply let themselves go to seed for a few years. The distinction also needs to be made between a “diet” (which implies a short-term project) vs. a lifestyle change (which is ostensibly more permanent). People shouldn’t be surprised to gain a lot of it back if their attitude is, “Yay! I reached my goal, and now I can dispense with all this diet and working out stuff and go back to the Bic Macs and cake!”

I have no illusions that I will have to maintain my current exercise and diet choices when I am about to hit the -25% mark (243 to 186 at the moment), and I am 100% determined not to backslide. I am a firm believer that you can do quite a number of things in your life if you don’t BS yourself about it and remain totally committed and disciplined; the problem is that most people allow themselves to get lazy, will cheat and rationalize and basically not be 100% honest with themselves. I know I’ve committed all of those sins in the past, but now I have some very strong motivating factors to help keep me in line.

14

First off, losing weight is nothing at all like quitting smoking. After a few years, ten at most, there is no longer any desire to start smoking again. Indeed the idea of smoking nauseates me (it’s been 47 years). I have been fat all my life. Once got down to 206 and then, over 35 years, was up to 281 (in 2001). Eleven years later I am 196 (this morning) and hope to stay there. Will I? Who knows, but after eleven years of weight loss (not entirely steady–I lost 30 lbs, gained 10, lost 20, stabilized around 240 and then, starting Oct. 2011, I simply stopped noshing without making much change in meals and this is where I am now) I can only hope to stay here. My BMI is 27 and that seems like a good place to stop. If I can. But I could still eat more–much more–and that is where it differs from smoking. On the other hand, I have ceased to crave those mid-afternoon and mid-evening snacks, not that I could relearn to want them.

15

From the article in the OP:

It’s going to get harder to maintain your new weight than it was to lose weight until that mark. After you lose weight, your body will lower your metabolism. That means that it’ll take you less calories to gain weight than it did before.

Here is the math from the same article:

The numbers are pretty close to your situation. When you were at 243 you could eat around 2,900 calories (less than 3,000) a day and still lose weight. Now you have to eat 2,300 calories a day or you will gain weight. That’s a huge new burden for someone to carry, and it doesn’t even cover the psychological tricks the mind will play to get you to eat more.

Good luck.

16

People who have a life long struggle with weight issues people may be fat, but they are not retarded. The vast majority of life long fat people are exquisitely well aware of WHY they are fat and the specific behaviors that cause that condition. Sherlock Holmes does not need to be called in to crack the case.

People who have lost weight do not usually go nuts once the weight is off and revert immediately to old behaviors. It is gradual fight back up against their metabolism’s preferred set points that they know they will eventually lose, but it’s not like they are right back to stuffing their faces once the weight is to normal levels. They will re-acquire the bad eating and exercise behaviors but it will take a while.

Fit people sometimes wonder why many fat people have a somewhat unenthusiastic and fatalistic attitude toward dieting and weight loss. It’s because hard experience teaches them that the effort involved to get to a normal weight will probably yield a temporary benefit at best. And they are not being irrational, they are correct. If they lose weight is it likely to only be a countdown until the body re-asserts its metabolic desires and crushes higher brain opposition.

Believing that you can be a normal weight forever after requires an almost religious level of faith. It’s hard to maintain.

17

Oops, I said Oct. 2011, but it was Oct. 2012, so 20 months ago. Forty-five lbs in 8 months is not reasonable. Just missed the edit window.

18

It’s an old joke: “Quitting smoking is easy. Just look at how many times I’ve done it!” Apparently the connection was not as obvious as I though.

19

Anecdotal, but I really do know several people who have lost significant amounts of weight and kept it off. Two are from my immediate family:

My mother was obese at one time when she was in her late 40s/early 50s, but while she never became a slim woman for the last 20 years of her life she was in the “extra pounds” range but not what anybody would describe as “really fat”- I’d estimate she weighed 250+ at her biggest and hovered in the ~200 range (which I’m not calling small, but incomparable to what she had been- plus she was about 5’10 [before the shrinking commenced] and had a large frame) from her mid-50s to early 70s. That was not following any particular diet but just eating less (her 40s/early 50s were miserable due to external circumstances and she became a comfort eater), and she had a fairly active lifestyle (no actual formal exercises except for some PT after a knee surgery, but her job kept her constantly walking).

The better example is my brother-in-law. He had Type 2 diabetes in his early 40s, and it was due to constant overeating; it didn’t help that (swear to Og) he owned an ice cream parlor. He weighed around 290 lbs.; he was about 6’3 and has a large frame, but that’s still a lot of extra weight. He had a major health scare unrelated to the diabetes when he was about 45, he was hospitalized during which time he lost about 30 pounds, and though he initially gained that back when he returned home from the hospital several factors convinced him to change his ways.
He initially lost down to about 250, at which point his blood sugar improved greatly. He roller coastered for a few months but then settled around 240-250 for a couple of years, then when his diabetes returned he went on a steady decrease/maintenance and is now currently around 215 pounds, which may sound heavy but is actually slim on him. It is strictly through diet (lots of greens, very little meat, extremely limited and rare sugar/bread/processed starch intake) and exercise (daily walk and lifts). It’s been ten years since he weighed 290 pounds and I would be very surprised if was ever up to anywhere near that again. The two things I attribute his success to are the initial health scare that made him start living healthier, and my sister (who is not and has never been fat) for giving him hell whenever he went off his diet or stopped exercising. (I have God knows how many differences with my sister, but I can say that I don’t think she’d care if he weighed 150 pounds or 400 as far as vanity goes, but she absolutely adores him and is not going to be a widow a minute earlier than she has to be.)

I have known others as well, including one friend who lost well over 100 pounds on Atkins (which is not that surprising) and has kept it off for a decade (which is statistically on par with winning top prize on a scratch-off [i.e. not the PowerBall, but still very very rare]).

I’ve always been heavy. Since I’ve been an adult my weight has gone from a low of 190 pounds (for a few minutes in the early '90s) to a high of just over 300 pounds (for a few weeks in the late '90s), but for the vast majority of the time it’s stayed within a 250-270 range since I was in high school. In a way that’s really cool, because now when I see people I went to high school with I’m usually the only one who can still fit into the clothes he wore then.:smiley: (I live in Alabama, one of the most obese states in the nation, and there are many people who were skinny in high school and are now “just damn”.)

I’ve lost a lot of weight twice, once by lots of exercise and dietary changes (in my mid-20s) and once through Atkins. Both times I put it back on within months. It’s been a long time since I even tried to lose weight, but I’m ready and about to do some lifechanges. I’ve started by quitting smoking, and that encourages me somewhat; I loved smoking- loved it loved it loved it- and yet I’m totally honest when I say that after 6 months I really don’t even miss it and I’ve gotten to where I find the smell of stale cigarettes repulsive. I’ve worked in some moderate exercise (joined the Y, I’m not causing friction fires with my speed but I’m burning off a couple of thousand calories per week [cumulative, not per visit] on the treadmill and elliptical and swimming and what not) and I’ve lost about 5 pounds and hope to lose some more. (I currently have a “please give me suggestions for reading” thread on IMHO.) I’m surprisingly optimistic for somebody who’s not a natural optimist and it’s in part because I’m not starting off like gangbusters but just more of a stroll: I’m not in a great rush- it would be wonderful to lose 50 pounds by Christmas but it’s not really a goal- my goal is to look noticeably slimmer and feel better by then). I couldn’t give a damn about what my BMI is (I don’t pretend to be a fitness expert by any stretch but one core belief I do have is, if you’ll pardon me, “Fuck the BMI in its eye”- when I weighed 190 pounds you could see my ribs and people worried I had cancer or AIDS [really], but per the BMI I still had about 12 pounds to go). I’m mainly interested in having more energy and feeling good.

I already have noticeably more steam and endurance, so here’s hoping…

20

One thing to figure in, though, is how much weight the person would have gained anyway. If you are taking in enough excess calories to become obese, it’s likely you will continue to gain weight indefinitely.

So if you were 250, and 50 points, and then climbed back to 250, that’s still better than being 250 and gaining 50 pounds, hitting 300.