European Journal of Nutrition

, Volume 56, Issue 3, pp 991–1002 | Cite as

Dietary patterns in weight loss maintenance: results from the MedWeight study

  • Eleni Karfopoulou
  • Dora Brikou
  • Eirini Mamalaki
  • Fragiskos Bersimis
  • Costas A. Anastasiou
  • James O. Hill
  • Mary YannakouliaEmail author
Original Contribution



The dietary habits contributing to weight loss maintenance are not sufficiently understood. We studied weight loss maintainers in comparison with regainers, to identify the differentiating behaviors.


The MedWeight study is a Greek registry of weight loss maintainers and regainers. Participants had intentionally lost ≥10 % of their weight and either had maintained this loss for over a year, or had regained weight. Questionnaires on demographics and lifestyle habits were completed online. Dietary assessment was carried out by two telephone 24-h recalls.


Present analysis focused on 361 participants (32 years old, 39 % men): 264 maintainers and 97 regainers. Energy and macronutrient intake did not differ by maintenance status (1770 ± 651 kcal in maintainers vs. 1845 ± 678 kcal in regainers, p = 0.338), although protein intake per kg of body weight was higher in maintainers (1.02 ± 0.39 vs. 0.83 ± 0.28 g/kg in regainers, p < 0.001). Physical activity energy expenditure was greater for maintainers in men (by 1380 kcal per week, p = 0.016), but not women. Salty snacks, alcohol and regular soda were more frequently consumed by men regainers. Principal component analysis identified a healthy dietary pattern featuring mainly unprocessed cereal, fruit, vegetables, olive oil and low-fat dairy. Male maintainers were 4.6 times more likely to follow this healthy pattern compared to regainers (OR 4.6, 95 % CI 2.0–11.0). No similar finding was revealed in women. Other characteristics of maintainers but not of regainers were: involvement in meal preparation and eating at home for men, and a higher eating frequency and slower eating rate for women.


Men maintaining weight loss were much more likely to adhere to a healthy eating pattern. Eating at home, involvement in meal preparation, higher eating frequency and slower eating rate were also associated with maintenance. These lifestyle habits of successful maintainers provide target behaviors to improve obesity treatment.


Weight loss maintenance Maintainers Regainers Dietary patterns 



We sincerely thank the volunteers for participating in the study. Eleni Karfopoulou has received financial support from the Greek State Scholarships Foundation. Eirini Mamalaki has received financial support from the IKY fellowships of excellence for postgraduate studies in Greece-Siemens program.

Compliance with ethical standards

Conflict of interest

The MedWeight study is financially supported by the Coca-Cola Foundation. Eleni Karfopoulou, Dora Brikou, Eirini Mamalaki and Costas A. Anastasiou have received stipends from this grant. The funding body had no involvement in the design of the study, collection and analysis of data or the decision to publish. James O. Hill is in the advisory boards of General Mills, McDonalds and Curves, is a consultant for Coca-Cola and Novo Nordisk, and has received grants from Coca-Cola and the American Beverage Association.

Ethical standards

The study was approved by the Harokopio University Ethics Committee and performed in accordance with the ethical standards in the Declaration of Helsinki. All participants provided informed consent prior to inclusion in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Eleni Karfopoulou
    • 1
  • Dora Brikou
    • 1
  • Eirini Mamalaki
    • 1
  • Fragiskos Bersimis
    • 2
  • Costas A. Anastasiou
    • 1
  • James O. Hill
    • 3
  • Mary Yannakoulia
    • 1
    Email author
  1. 1.Department of Nutrition and DieteticsHarokopio UniversityAthensGreece
  2. 2.Department of Informatics and TelematicsHarokopio UniversityAthensGreece
  3. 3.Anschutz Health and Wellness CenterUniversity of ColoradoAuroraUSA

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