International Journal of Behavioral Medicine

, Volume 17, Issue 3, pp 161–167

The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race?

  • Lisa M. Nackers
  • Kathryn M. Ross
  • Michael G. Perri

DOI: 10.1007/s12529-010-9092-y

Cite this article as:
Nackers, L.M., Ross, K.M. & Perri, M.G. Int.J. Behav. Med. (2010) 17: 161. doi:10.1007/s12529-010-9092-y



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.


ObesityWeight lossLifestyle modification

Copyright information

© International Society of Behavioral Medicine 2010

Authors and Affiliations

  • Lisa M. Nackers
    • 1
  • Kathryn M. Ross
    • 1
  • Michael G. Perri
    • 1
  1. 1.Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleUSA