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

Factual Questions
141

You are indeed not reading it quite correctly. What he is proposing is that the apparent lower motality rate of the overweight group is an artifact, a result of reverse causality. He is proposing that the “normal” weight group is actually made of two subsets: those who have been stable normal weight (with a low mortality rate); and those who lost weight mainly because of illness (at a very high mortality rate). Here’s how he phrased it in his article:

Yes, in his mind they are dying (and losing weight) secondary to problems that were caused by their excess excess weight even if they were not yet diagnosed with those problems at the time of surveyed BMI measurement. Losing the weight at that point (as a result of illness) was not enough to make their undiagnosed diabetes, heart disease, or other illness, go away.

Not sure if self-reported highest ever weight is all that reliable of a number honestly. And follow up inthe BMI studies that have found a protective effect of being high normal to low overweight BMIis long enough that the concept seems a bit sketchy. But still plausible.

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Alternative explanations for the apparent protective effect of “low overweight” BMI is that the group includes both those with higher fat mass and those with high fat free body mass, the latter being protective.

143

What about this study on meal replacements for weight maintenance finding some success:

http://www.cutthewaist.com/replacement_meals.html#evidence

I don’t have access to the actual study, it seems like it was done in 1999 in the American Journal of Clinical nutrition (I assume that is what the abbreviations stand for).

If valid that implies people lost about 10% of their initial bodyweight and kept it off for over 4 years by replacing one meal a day (and one snack) with meal replacement shakes and items.

The conventional food group only lost 2-5% of bodyweight, but continued losing. The meal replacement group lost 10%, but both groups did well in the maintenance phase.

144

On another note in broscience circles there is discussion about refeed days and how it affects leptin levels and weight loss. The idea is if you eat at or above maintenance in high carb meals it will reverse the leptin drop brought on by weight loss.

Problem is they only talk about weight loss, not the maintenance phase. Is there any evidence that high carb refeed days designed to increase leptin levels help maintain weight loss?

Even if these high carb refeeds result in leptin levels going back to baseline, how long until they drop again? Overnight, 3 days, a week? I am having trouble finding that answer.

145

It would be good to have a study that tracks leptin levels over time for several feeding behaviors, including a reduced calorie diet with periodic refeeds.

The bodybuilder types who refeed stress the need to do so on carbohydrates. I guess that makes sense, the carbs will go in the glycogen stores and can then be burned off over the ensuing days so there shouldn’t be any increase in body fat.

Perhaps this is enough to reassure the adipose cells that all is well and have them secrete more leptin for a while. Of course if it’s a placebo effect, who cares?

What I’ve been doing is the “line diet” where I have a target weight every day. If I’m over the target I make sure I have good size calorie deficit, if I’m under the target I eat more. I almost never get so hungry that I can’t wait the 3 or so hours until my next scheduled meal. I believe the fact that the amount that I eat varies every few days helps reassure my body that there’s no famine so it’s ok to release fat, but that believe is not supported by any evidence other than an uncontrolled n=1 study. :slight_smile:

146

You may have noticed that I’m slightly obsessed with this subject. I’ve been reading a lot about it in recent days, and what I see is that many people have come to the conclusion that attempting to lose weight is futile because the success rate is so low.

I can understand why this is a useful approach from a public policy perspective: if it’s too hard to fix the cause, maybe it’s more useful to work on the symptoms. Or work on prevention instead. It’s also understandable that people who are obese want to believe that losing weight and keeping it off is futile, because then they’re off the hook and can stop trying guilt-free.

Obviously believing that even if you’re successful at losing weight now you’re almost certainly going to gain the weight back is not so great for people who are currently losing weight and want to maintain their weight loss.

But more importantly, if a single person loses weight and keeps it off, we know it can be done. Then the question becomes: what’s the difference between the small number of people who are successful and the larger number of people who aren’t?

One factor is that many people simply don’t realize how much they eat. Have a look at the British TV show Secret Eaters (available on Youtube) to see what I mean. It’s really shocking how people think they’re eating well but are in actuality stuffing their faces with junk.

Another factor is that many people take a brute force approach, cutting down their intake to very low levels, which both slows down their metabolism and makes them very hungry. If you’re hungry all the time you will eat at some point.

Interestingly, it seems that it’s mostly younger women who are dieting a lot and failing a lot. I’m not sure if men don’t mind being obese as much or find losing weight easier (looks like some of both). But it seems most stories of people who manage to maintain weight loss successfully are from 40+ women.

So the issue could be hormonal. Or maybe there’s a 20-year learning curve.

Here’s a bunch of variables that could explain success or failure:

[ul]
[li]Motivation[/li][li]Knowledge about nutrition[/li][li]An accurate idea of own food intake[/li][li]Having or developing enough muscles to keep resting metabolism high[/li][li]Enough exercise[/li][li]Not too much exercise[/li][li]Eating satiating foods[/li][li]Being ok with being hungry some of the time[/li][li]Avoiding being too hungry or being hungry too much of the time[/li][li]Getting enough vitamins and minerals[/li][li]Eating the magic weight loss food[/li][li]Avoiding the magic weight gain food[/li][li]Eating often enough and big enough meals/snacks[/li][li]Eating variable amounts of food to avoid “starvation mode”[/li][li]Recognizing which foods lead to overeating[/li][li]The ability to control the types of foods in the house[/li][li]Getting enough sleep[/li][/ul]

Of course very little of this can be put in a pill so there’s not much incentive to study why some people can lose weight and keep it off while others can’t.

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It is probably like Alcoholics Anonymous and statistics. Have to be mostly made up out of the air.

148

That last is what it may take. I loved a lady who weighed 315 lbs and she went to Brazil and had 50 lbs of fat vacuumed from her middle and the gastric bypass thing done and now she weighs 185. Still over weight for 5’2", but a lot better.

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  1. The success rate for sustained loss is not as bad as some make out. The biggest item is I think that many who set out to lose weight really are not thinking farther than that. The goal is the weight loss. They are not entering the process fully appreciating that weight (and more ideally fat) loss is the relatively easier first phase; maintained long term fat loss is the real prize. Thus they achieve the goal and slack off instead of buckling down for the long haul.

  2. The public policy perspective indeed needs to focus on preventing obesity in the first place, but also it need to do better at helping people set the goal that matters from a public policy perspective. That perspective is not concerned about weight for its own sake but about the health consequences of obesity. From that perspective modest weight loss (5 to 10%) sustained long term with improved nutritional habits and moderate exercise is the goal that most CAN reach and that substantially improves outcomes. Nothing wrong with losing and sustaining more fat loss. Some achieve that and great for them. But defining only that as “success” rather than the maintained healthy habits even if no more weight is ever lost and even if they are still obese by BMI, defines many who have achieved dramatic health benefits as “failures” which results in regression of the achievement made.

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Did Tom Arnold have bypass surgery as well? How’s he doing these days?

151

He lost 100 pounds over the last year. Think he can make it last more than five years?

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Part of me wonders to what degree the people who succeed (or fail) because their genetics are different. I have seen studies on both overfeeding and underfeeding which usually involve multiple sets of identical twins. They find that even if you overfeed or underfeed a set amount based on metabolic rate (say 1000 calories a day) people’s bodies respond differently and people gain and lose weight at different rates. Plus what they gain or lose is different (the amount of fat and muscle gained or lost is not the same across the board). I’d assume some people’s bodies are better at regaining lost weight, and some are worse. Some gain more than they originally lost and some gain less. I would assume individual genetics plays a reasonable role in maintenance and regain.

As a WAG, if you normally eat 3000 calories a day and burn 3000 a day that will maintain homeostasis and your weight and fat level will be stable. The degree to which your body can maintain weight is pretty impressive when you think about it. If a person has a stable weight/fat level over 10 years that means their body is maintaining the intake/usage of calories to within something like 0.1% a day (about the calories in gram of sugar). If you lose a significant amount of weight (maybe 10% of your starting weight) maybe you will start burning 2800 a day but left to your own devices will eat 3300. Plus my understanding is your body gets better at storing the excess as fat (instead of doing things like burning it by increasing your energy levels or suppressing your appetite) If you can shrink that discrepancy then at the very least you will regain slower.

I ‘think’, when a person loses a lot of weight even if they don’t make much of an effort to maintain it they usually don’t gain more than a pound a week (50 pounds a year). A pound a week is about a 3500 calorie excess, so maybe 500 a day. That is an assumption, but I think for many people the fastest they will regain lost weight if they make 0 efforts to maintain the loss is about a pound a week.

I’d like to know if there have been any studies on intermittent dieting for weight maintenance. Asking someone to constantly watch their food intake each day could really cut motivation but if you ask someone to cut their caloric intake below maintenance by maybe 1000-1500 calories 2 days a week that should slow the rate of regain and should in theory be easier to do than daily dieting.

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Actually a lot of worthwhile things in life have a small chance of success for any given attempt – starting a business; quitting smoking; kicking heroin; and yes, finding a husband or wife.

The critical question is what is the downside? I’m not a doctor, but I think if you choose a reasonable, sustainable diet, e.g. stop drinking soda and sugary drinks; don’t have seconds; and don’t eat junk food, then there’s little or no downside. If you keep it up for 6 months and then fall off the wagon, you are really no worse off than if you had been consuming soda, junk food, and seconds the whole time.

154

I was thinking about this issue and it occurred to me that the obesity epidemic itself is a confound for the analysis.

People are obese now for different reasons than 20 or even 10 years ago. A lot of people are obese today who would not have been in the recent past. Since it was more unusual to become obese in the past, it is reasonable to hypothesize that obese people in the past were more likely to have some kind of serious mental problem relating to food.

So there is a decent chance that if you are obese today, you have better cause to be optimistic than would be suggested by older studies of weight loss recidivism.

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Missed edit window by 4 years, but fifth from last word should have been couldn’t. Mainly, I am replying to this zombie. is to mention that my weight this morning was 198 so that not only did I lose nearly 30% of my weight, but I have kept it off for about five years. On the other hand, when I am visiting elsewhere I can easily gain five lbs in 10 days, but then lose it when I return home. On the other hand, after 51 non-smoking years, the very idea of resuming is disgusting.

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Congratulations on your ongoing accomplishment!