Weight control behaviors of highly successful weight loss maintainers: the Portuguese Weight Control Registry

Abstract

To describe key behaviors reported by participants in the Portuguese Weight Control Registry and to determine associations between these behaviors and weight loss maintenance. A total of 388 adults participated in this cross-sectional study. Assessments included demographic information, weight history, weight loss and weight maintenance strategies, dietary intake, and physical activity. Participants lost on average 18 kg, which they had maintained for ~28 months. Their average dietary intake was 2199 kcal/day, with 33 % of energy coming from fat. About 78 % of participants engaged in levels of moderate-plus-vigorous physical activity exceeding 150 min/week (51 % above 250 min/week), with men accumulating 82 more minutes than women (p < 0.05). The most frequently reported strategies for both weight loss and maintenance were keeping healthy foods at home, consuming vegetables regularly, and having daily breakfast. Greater weight loss maintenance was associated with higher levels of physical activity, walking, weight self-monitoring, establishing specific goals, and with reduced portion size use, reduced consumption of carbohydrates, and increased consumption of protein, (p < 0.05). Results indicate that weight loss maintenance is possible through the adoption of a nutritionally-balanced diet and regular participation in physical activity, but also suggest that adopting different (and, to a degree, individualized) set of behavioral strategies is key for achieving success.

This is a preview of subscription content, log in to check access.

Fig. 1

Notes

  1. 1.

    Energy intake adjusted for initial body weight before weight loss (expressed in energy/kg/day).

References

  1. Carmo, I., Santos, O., Camolas, J., Vieira, J., Carreira, M., Medina, L., et al. (2008). Overweight and obesity in Portugal: National prevalence in 2003-2005. Obesity Reviews, 9, 11–19.

    PubMed  Google Scholar 

  2. Catenacci, V. A., Ogden, L. G., Stuht, J., Phelan, S., Wing, R. R., Hill, J. O., et al. (2008). Physical activity patterns in the National Weight Control Registry. Obesity, 16, 153–161.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Donnelly, J. E., Blair, S. N., Jakicic, J. M., Manore, M. M., Rankin, J. W., & Smith, B. K. (2009). American College of Sports Medicine Position Stand: Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Medicine and Science in Sports and Exercise, 41, 459–471.

    Article  PubMed  Google Scholar 

  4. EFSA Panel on Dietetics Products, Nutrition, and Allergies (NDA). (2010). Scientific opinion on establishing food-based dietary guidelines. EFSA Journal, 8, 1460.

    Article  Google Scholar 

  5. Feller, S., Muller, A., Mayr, A., Engeli, S., Hilbert, A., & de Zwaan, M. (2015). What distinguishes weight loss maintainers of the German Weight Control Registry from the general population? Obesity (Silver Spring), 23, 1112–1118.

    Article  Google Scholar 

  6. Heitmann, B. L., Westerterp, K. R., Loos, R. J. F., Sorensen, T. I., Dea, K. O., Mc Lean, P., et al. (2012). Obesity: Lessons from evolution and the environment. Obesity Reviews, 13, 910–922.

    CAS  Article  PubMed  Google Scholar 

  7. Institute of Medicine. (2005). Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Washington, DC: The National Academies Press.

    Google Scholar 

  8. Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., et al. (2014). 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation, 129, S102–s138.

    Article  PubMed  Google Scholar 

  9. Kiefer, I., Rathmanner, T., & Kunze, M. (2005). Eating and dieting differences in men and women. The Journal of Men’s Health and Gender, 2, 194–201.

    Article  Google Scholar 

  10. Lopes, C. (2000). Reprodutibilidade e validação de um questionário semi-quantitativo de frequência alimentar. Alimentação e enfarte agudo do miocárdio: um estudo caso-controlo de base populacional (pp. 79–115). Porto: Universidade do Porto.

    Google Scholar 

  11. Lopes, C., Aro, A., Azevedo, A., Ramos, E., & Barros, H. (2007). Intake and adipose tissue composition of fatty acids and risk of myocardial infarction in a male Portuguese community sample. Journal of the American Dietetic Association, 107, 276–286.

    CAS  Article  PubMed  Google Scholar 

  12. Ogden, L. G., Stroebele, N., Wyatt, H. R., Catenacci, V. A., Peters, J. C., Stuht, J., et al. (2012). Cluster analysis of the national weight control registry to identify distinct subgroups maintaining successful weight loss. Obesity, 20, 2039–2047.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Paddon-Jones, D., Westman, E., Mattes, R. D., Wolfe, R. R., Astrup, A., & Westerterp-Plantenga, M. (2008). Protein, weight management, and satiety. American Journal of Clinical Nutrition, 87, 1558s–1561s.

    CAS  PubMed  Google Scholar 

  14. Paffenbarger, R. S., Jr., Wing, A. L., & Hyde, R. T. (1978). Physical activity as an index of heart attack risk in college alumni. American Journal of Epidemiology, 108, 161–175.

    Article  PubMed  Google Scholar 

  15. Phelan, S., Wyatt, H. R., Hill, J. O., & Wing, R. R. (2006). Are the eating and exercise habits of successful weight losers changing? Obesity, 14, 710–716.

    Article  PubMed  Google Scholar 

  16. Powell, L. H., & Calvin, J. E. (2007). Effective obesity treatments. American Psychologist, 62, 234–246.

    Article  PubMed  Google Scholar 

  17. Sardinha, L. B., Santos, D. A., Silva, A. M., Coelho-e-Silva, M. J., Raimundo, A. M., Moreira, H., et al. (2012). Prevalence of overweight, obesity, and abdominal obesity in a representative sample of Portuguese adults. PLoS One, 7, e47883.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  18. Stevens, J., Truesdale, K. P., McClain, J. E., & Cai, J. (2006). The definition of weight maintenance. International Journal of Obesity, 30, 391–399.

    CAS  Article  PubMed  Google Scholar 

  19. Teixeira, P. J., Silva, M. N., Coutinho, S. R., Palmeira, A. L., Mata, J., Vieira, P. N., et al. (2010). Mediators of weight loss and weight loss maintenance in middle-aged women. Obesity, 18, 725–735.

    Article  PubMed  Google Scholar 

  20. Teixeira, P. J., Stubbs, R. J., King, N. A., Whybrow, S., & Blundel, J. E. (2011). Obesity. In J. M. Saxton (Ed.), Exercise and chronic disease: An evidence-based approach. London: Routledge.

    Google Scholar 

  21. Vieira, P. N., Silva, M. N., Coutinho, S. R., Santos, T. C., Santos, I., Sardinha, L. B., et al. (2012). Successful weight loss maintenance in Portugal and in the USA: Comparing results from two National Weight Control Registries [Portuguese]. Revista Portuguesa de Saúde Pública, 30, 115–124.

    Article  Google Scholar 

  22. Vieira, P. N., Teixeira, P., Sardinha, L. B., Santos, T., Coutinho, S., Mata, J., et al. (2014). Success in maintaining weight loss in Portugal: The Portuguese Weight Control Registry. Ciencia and Saude Coletiva, 19, 83–92.

    Article  PubMed  Google Scholar 

  23. Westerterp-Plantenga, M. S., Lejeune, M. P., Nijs, I., van Ooijen, M., & Kovacs, E. M. (2004). High protein intake sustains weight maintenance after body weight loss in humans. International Journal of Obesity, 28, 57–64.

    CAS  Article  PubMed  Google Scholar 

  24. Wing, R. R., & Hill, J. O. (2001). Successful weight loss maintenance. Annual Review of Nutrition, 21, 323–341.

    CAS  Article  PubMed  Google Scholar 

  25. World Health Organization. (1995). Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Commitee, WHO Technical Report Series 854. Geneva: WHO.

  26. World Health Organization. WHO Global Infobase. Retrieved February 29, 2016, from https://apps.who.int/infobase/Index.aspx

Download references

Acknowledgments

This study was funded by Grants from the Portuguese Science and Technology Foundation (PTDC/DES/72317/2008-2011 and SFRH/80739/2011 to the first author). The authors are grateful to the Oeiras City Council for its additional financial support. The authors want to acknowledge Susana Cunha for her participation in data collection.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Pedro J. Teixeira.

Ethics declarations

Conflict of interest

Authors Inês Santos, Paulo N. Vieira, Marlene N. Silva, Luís B. Sardinha, and Pedro J. Teixeira declare that they do not have any conflict of interest.

Human and animal rights and Informed consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 89 kb)

Supplementary material 2 (DOCX 114 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Santos, I., Vieira, P.N., Silva, M.N. et al. Weight control behaviors of highly successful weight loss maintainers: the Portuguese Weight Control Registry. J Behav Med 40, 366–371 (2017). https://doi.org/10.1007/s10865-016-9786-y

Download citation

Keywords

  • Weight loss
  • Weight maintenance
  • Strategies
  • Behaviors
  • Weight Control Registry