The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race?
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Controversy exists regarding the optimal rate of weight loss for long-term weight management success.
This study examined whether gradual initial weight loss was associated with greater long-term weight reduction than rapid initial loss.
Groups were drawn from participants in the TOURS trial, which included a sample of middle-aged (mean = 59.3 years) obese women (mean BMI = 36.8) who received a 6-month lifestyle intervention followed by a 1-year extended care program. Participants were encouraged to reduce caloric intake to achieve weight losses of 0.45 kg/week. Groups were categorized as “FAST” (≥0.68 kg/week, n = 69), “MODERATE” (≥0.23 and <0.68 kg/week, n = 104), and “SLOW” (<0.23 kg/week, n = 89) based on rate of weight loss during first month of treatment.
The FAST, MODERATE, and SLOW groups differed significantly in mean weight changes at 6 months (−13.5, −8.9, and −5.1 kg, respectively, ps < 0.001), and the FAST and SLOW groups differed significantly at 18 months (−10.9, −7.1, and −3.7 kg, respectively, ps < 0.001). No significant group differences were found in weight regain between 6 and 18 months (2.6, 1.8, and 1.3 kg, respectively, ps < 0.9). The FAST and MODERATE groups were 5.1 and 2.7 times more likely to achieve 10% weight losses at 18 months than the SLOW group.
Collectively, findings indicate both short- and long-term advantages to fast initial weight loss. Fast weight losers obtained greater weight reduction and long-term maintenance, and were not more susceptible to weight regain than gradual weight losers.
- Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obes Res 6: pp. 51S-209
- Wing, RR, Hill, JO (2001) Successful weight loss maintenance. Annu Rev Nutr 21: pp. 323-41 CrossRef
- Jeffery, RW, Epstein, LH, Wilson, GT, Drewnowski, A, Stunkard, AJ, Wing, RR (2000) Long-term maintenance of weight loss: current status. Health Psychol 19: pp. 5-16 CrossRef
- Perri, MG, Fuller, PR (1995) Success and failure in the treatment of obesity: where do we go from here?. Med Exerc Nutr Health 4: pp. 255-72
- Wadden, TA, Butryn, ML, Byrne, KJ (2004) Efficacy of lifestyle modification for long-term weight control. Obes Res 12: pp. 151S-62 CrossRef
- Perri, MG (1998) The maintenance of treatment effects in the long-term management of obesity. Clin Psychol: Sci Pract 5: pp. 526-43 CrossRef
- Klein, S (2001) Outcome success in obesity. Obes Res 9: pp. 354S-8 CrossRef
- Krebs, JD, Evans, S, Cooney, L (2002) Changes in risk factors for cardiovascular disease with body fat loss in obese women. Diab Obes Metab 4: pp. 379-87 CrossRef
- Moore, LL, Visioni, JJ, Wilson, PW, D’Agostino, RB, Finkle, WD, Ellison, RC (2000) Can sustained weight loss in overweight individuals reduce the risk of diabetes mellitus?. Epidemiology 11: pp. 269-73 CrossRef
- Elfhag, K, Rössner, S (2005) Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obes Rev 6: pp. 67-85 CrossRef
- Vogels, N, Diepvens, K, Westerterp-Plantenga, MS (2005) Predictors of long-term weight maintenance. Obes Res 13: pp. 2162-8 CrossRef
- Wadden, TA, Foster, GD, Wang, J (1992) Clinical correlates of short- and long-term weight loss. Am J Clin Nutr 56: pp. 271S-4
- Carels, RA, Cacciapaglia, HM, Douglass, OM, Rydin, S, O’Brien, WH (2003) The early identification of poor treatment outcome in a women’s weight loss program. Eat Behav 4: pp. 265-82 CrossRef
- Fogelholm, M, Kukkonen-Harjula, K, Oja, P (1999) Eating control and physical activity as determinants of short-term weight maintenance after a very-low-calorie diet among obese women. Int J Obes 23: pp. 203-10 CrossRef
- Jeffery, RW, Wing, RR, Mayer, RR (1998) Are smaller weight losses or more achievable weight loss goals better in the long term for obese patients?. J Consult Clin Psychol 66: pp. 641-5 CrossRef
- Lutes, LD, Winett, RA, Barger, SD (2008) Small changes in nutrition and physical activity promote weight loss and maintenance: 3-month evidence from the ASPIRE randomized trial. Ann Behav Med 35: pp. 351-7 CrossRef
- Sbrocco, T, Nedegaard, RC, Stone, JM, Lewis, EL (1999) Behavioral choice treatment promotes continuing weight loss: preliminary results of a cognitive-behavioral decision-based treatment for obesity. J Consult Clin Psychol 67: pp. 260-6 CrossRef
- Kumanyika, SK, Espeland, MA, Bahnson, JL (2002) Ethnic comparison of weight loss in the trial of nonpharmacologic interventions in the elderly. Obes Res 10: pp. 96-106 CrossRef
- Stevens, VJ, Obarzanek, E, Cook, NR (2001) Long-term weight loss and changes in blood pressure: results of the trials of hypertension prevention, phase II. Ann Intern Med 134: pp. 1-11
- Wassertheil-Smoller, S, Langford, HG, Blaufox, MD (1985) Effective dietary intervention in hypertensives: sodium restriction and weight reduction. J Am Diet Assoc 85: pp. 423-30
- Astrup, A, Rössner, S (2000) Lessons from obesity management programmes: greater initial weight loss improves long-term maintenance. Obes Rev 1: pp. 17-9 CrossRef
- Wadden, TA, Foster, GD, Letizia, KA (1994) One-year behavioral treatment of obesity: comparison of moderate and severe caloric restriction and the effects of weight maintenance therapy. J Consult Clin Psychol 62: pp. 165-71 CrossRef
- McGuire, MT, Wing, RR, Klem, ML, Lang, W, Hill, JO (1999) What predicts weight regain in a group of successful weight losers?. J Consult Clin Psychol 67: pp. 177-85 CrossRef
- Weiss, EC, Galuska, DA, Kettel Khan, L, Gillespie, C, Serdula, MK (2007) Weight regain in U.S. adults who experienced substantial weight loss; 1999–2002. Am J Prev Med 33: pp. 34-40 CrossRef
- Perri, MG, Limacher, MC, Durning, PE (2008) Extended-care programs for weight management in rural communities: the treatment of obesity in underserved rural settings (TOURS) randomized trial. Arch Intern Med 168: pp. 2347-54 CrossRef
- Perri, MG, Corsica, JA Improving the maintenance of weight lost in behavioral treatment of obesity. In: Wadden, TA, Stunkard, AJ eds. (2001) Handbook of obesity treatment. Guilford Press, New York, pp. 357-79
- Jeffery, RW, Drewnowski, A, Epstein, LH (2008) Long-term maintenance of weight loss: current status. Health Psychol 19: pp. 5-16 CrossRef
- Wadden, TA, Berkowitz, RJ, Sarwer, DB, Prus-Wisniewski, R, Steinberg, C (2001) Benefits of lifestyle modification in the pharmacologic treatment of obesity. Arch Intern Med 161: pp. 218-27 CrossRef
- Wadden, TA, Berkowitz, RI, Womble, LG (2005) Randomized trial of lifestyle modification and pharmacotherapy for obesity. N Engl J Med 353: pp. 2111-20 CrossRef
- Stotland, SC, Larocque, M (2005) Early treatment response as a predictor of ongoing weight loss in obesity treatment. Br J Health Psychol 10: pp. 601-14 CrossRef
- Latner, JD, Stunkard, AJ, Wilson, GT, Jackson, ML, Zelitch, DS, Labouvie, E (2000) Effective long-term treatment of obesity: a continuing care model. Int J Obes 24: pp. 893-8 CrossRef
- Toubro, S, Astrup, A (1997) Randomised comparison of diets for maintaining obese subjects’ weight after major weight loss: ad lib, low fat, high carbohydrate diet v fixed energy intake. Br Med J 4: pp. 314-29
- The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race?
International Journal of Behavioral Medicine
Volume 17, Issue 3 , pp 161-167
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Weight loss
- Lifestyle modification