International Journal of Behavioral Medicine

, Volume 17, Issue 3, pp 161–167 | Cite as

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

  • Lisa M. NackersEmail author
  • Kathryn M. Ross
  • Michael G. Perri



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.


Obesity Weight loss Lifestyle modification 



This research was supported by grant R18HL073326 from the National Heart, Lung, and Blood Institute.


The authors declare no conflict of interest.


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Copyright information

© International Society of Behavioral Medicine 2010

Authors and Affiliations

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

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