Abstract
To analyse determinants of long-term weight maintenance we studied energy expenditure, dietary intake, eating behaviour and psychological symptoms of 9 women (SS BMI=26.6) who reached their ideal weight during 1985-86 and were still an average 16.2 kg below their original weight in 1993. Controls were 42 obese, non-reducing females (OC BMI=34.8). Dietary intake was calculated from four-day food records. Dietary restraint was assessed by the Three-Factor Eating Questionnaire (TFEQ) and symptoms of bulimia or binge eating by Bulimic Investigatory Test, Edinburgh (BITE). Physical exercise was estimat ed by open interviews, resting metabolic rate (RMR) by indirect calorimetry and body com position by bioelectrical impedance. Psychological characteristics were studied using the Defense Style Questionnaire (DSQ), Beck Depression Inventory (BDI) and Symptom Check list (SCL-90). SS had lower RMR (1320 kcal vs. 1540 kcal, p=0.004), lower daily energy intake (1208 kcal vs. 1525 kcal, p=0.020) and higher scores for dietary restraint (14.6 vs. 8.4, p=0.002 than OC. Restraint scores correlated negatively with energy intake and RMR in both groups especially in SS (r= −0.75, p=0.021 and r=−0.87, p=0.002, respectively). Attempts to incorpo rate habitual physical activities to daily life (89% vs. 39%, p=0.011) and weekly sports hobbies (67% vs. 13%, p=0.002) were more often reported by SS. The scores of BITE, DSQ, BDI and SCL-90 were within normal range in both groups but SS had higher scores in most mea sures, especially for anxiety (16.4 vs. 14.3, p=0.045). In conclusion, long-term maintenance o weight loss was associated with highly restrained eating, regular physical activity, and per haps with increased anxiety.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Klem M.L., Wing R.R., McGuire M.T., Seagle H.M., Hill J.O.: A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am. J. Clin. Nutr., 66, 239–446, 1997.
Rosenbaum M., Leibel R.L., Hirch J.: Obesity. N. Engl. J. Med., 337, 396–407, 1997.
Leibel R.L., Michael R., Hirch J.: Changes in energy expenditure resulting from altered body weight. N. Engl. J. Med., 332, 621–628, 1995.
Astrup A., Gotzsche P., Toubo S., Ranneries C., van der Werken K., Raben A., Buemann B.: Low resting metabolic rate in formerly obese: a meta-analysis. Int. J. Obes., 21, suppl 2, 1997 (Abstract)
Björvell H., Aly A., Langius A., Norström G.: Indicators of changes in weight and eating behaviour in severely obese patients treated in a nursing behavioural program. Int. J. Obes., 18, 521–525, 1994.
Pekkarinen T., Takala I., Mustajoki P.: Twoyear maintenance of weight loss after VLCD and behavioural therapy for obesity correlation to the scores of questionnaires measuring eating behaviour. Int. J. Obes., 20, 332–337, 1996.
Westerterp-Plantenga M.S., Kempen K.P.G., Saris W.H.M.: Determinants of weight maintenance in women after diet-induced weight reduction. Int. J. Obes., 22, 1–6, 1998.
Klem M.L, Wing R.R., Seagle H.M., Hill J.O., McGuire M.T.: Psychological symptoms in individuals successful at long-term maintenance of weight loss. Health Psychol., 17, 336–345, 1998.
Ewbank P.P., Darga L.L., Lucas C.P.: Physical activity as a predictor of weight maintenance in previously obese subjects. Obes. Res., 3, 257–263, 1995.
Hensrud D.D., Weinsier R.L., Darnell B.E., Hunter G.R.: Relationship of co-morbidities of obesity to weight loss and four-year weight maintenance/rebound. Obes. Res., 3, suppl, 217s–222s, 1995.
Kayman S., Bruvold W., Stern J.S.: Mainte — nance and relapse after weight loss in women: behavioral aspects. Am. J. Clin. Nutr., 52, 800–807, 1990.
Deurenberg P., Weststrate J.A., van der Kooy K.: Body composition changes assessed by bioelectrical impedance measurements. Am. J. Clin. Nutr., 49, 401–403, 1989.
Stunkard A.J., Messick S.: The Three-Factor Eating Questionnaire to measure dietary restraint, disinhibition and hunger. J. Psychosom. Res., 29, 71–83, 1985.
Henderson M., Freeman C.P.L.: A self-rating scale for bulimia: the BITE. Br. J. Psychol., 150, 18–24, 1987.
Mishler E.G.: Research interviewing. Cambrigde, Harward University Press, 1986.
Bond M.P., Vaillant J.S.: An empirical study of the relationship between diagnosis and defense style. Arch. Gen. Psychiatry, 43, 285–288, 1983.
Beck A.T., Ward C.H., Mendelson M., Mock J., Erbaugh J.: An inventory for measuring depression. Arch. Gen. Psychiatry, 4, 561–571, 1961.
Derogatis R.L., Lipman R.S., Covi L.: SCL- 90: An outpatient psychiatric rating scale — preliminary report. Psychopharmacol. Bull., 9, 13–28, 1974.
Black A.E., Prentice A.M., Goldberg G.R., Jebb S.A., Bingham S.A., Livingstone M.B.E., Coward W.A.: Measurements of total energy expenditure provide insights into the validity of dietary measurements of energy intake. J. Am. Diet. Assoc., 93, 572–579, 1993.
Heitmann B.L., Lissner L.: Dietary underreporting by obese individuals — is it specific or non-specific? Br. Med. J., 311, 986–989, 1995.
Amatruda J.M., Statt M.C., Welle S.L.: Total and resting energy expenditure in obese women reduced to ideal body weight. J. Clin. Invest., 92, 1236–1242, 1993.
Van Dale D., Saris W.H.M., Hoor F.T.: Weight maintenance and resting metabolic rate 18–40 months after a diet/exercise treatment. Int. J. Obes., 14, 347–359, 1990.
Polivy J.: Psychological consequences of food restriction. J. Am. Diet. Assoc., 6, 589–592, 1996.
Holi M.M., Sammallahti P., Aalberg V.: A Finnish validation study of the SCL-90. Acta Psychiatr. Scand., 97, 42–46, 1998.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sarlio-Lähteenkorva, S., Rissanen, A. Weight loss maintenance: Determinants of long-term success. Eat Weight Disord 3, 131–135 (1998). https://doi.org/10.1007/BF03340000
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03340000