You’ve just lost fifteen pounds. How do you keep it off?

“Anyone who has tried knows it’s not easy to lose weight,” says LIUNA General Secretary-Treasurer and LHSFNA Labor Co-Chairman Armand E. Sabitoni.  “And it’s all the more discouraging to lose 15 pounds only to gain it back. Everyone who makes the effort to shed pounds needs a realistic, practical plan to help keep the weight off.”

A new Brown Medical School study published in the New England Journal of Medicine suggests the key features of such a plan. The study is one of the first to investigate how to keep weight off.

The researchers surveyed the habits of more than 5,000 “successful losers,” people who had lost at least 30 pounds and kept it off for at least a year. Most of these “losers” lost their weight by cutting calories and increasing exercise. Some joined Weight Watchers or other weight loss programs as well. Surveys revealed some common habits that helped keep the weight off:

  • consistently eating breakfast
  • getting at least an hour of physical activity each day
  • regular weigh-ins
  • initiating corrective action when weight gain was in evidence.

Researchers then focused on the last two habits – the regular weigh-in and corrective action. Using a sample of 314 people who had lost at least ten percent of their body weight during the last two years, the researchers supplied participants with a bathroom scale, instructions to use it often, a quarterly newsletter and encouragement to report their weight weekly by telephone.

In addition, two-thirds of the participants received interventions (half through the internet and half face-to-face) emphasizing the importance of daily self-weighing and self-regulation. They were told to keep their weight within three pounds – the “green zone” – of their starting weight. If they added three or four pounds, they were cautioned that they had entered the “yellow zone” and should adjust their eating and exercise to get back to green. If they went over five pounds, they entered the “red zone” and were told to renew dieting and accept other, more active interventions proposed and supported by the study, including one-on-one weight-loss counseling to get back on track.

Over the course of the 18-month study, the proportion of participants who regained more than five pounds was significantly higher in the control group (72.4%) than in the face-to-face group (45.7%) or the internet group (54.8%). In other words, while only about a quarter of the control group maintained their starting weight, about half of those who got self-regulation guidance were successful.

Typical of the comments of the most successful participants was that of Ed Messier, quoted in the Washington Post. “[Stepping on the bathroom scale] was the single most important tool. I still weigh myself religiously, and if I am up a pound or two and see things going in the wrong direction, I am more diligent [about eating and exercise] in the next couple of days to make sure that I am not going too far off.”

“Using the scale is very objective behavior,” says the study’s lead author, Rena Wing, also quoted in the Post. “It’s a lot easier to get on the scale every day than to start writing down your calories.”

“The most successful people at weight maintenance are the ones who can stay in the green zone,” says Susan Yanovski of the National Institutes of Health, the study’s funder. “They weigh themselves every day. They have a game plan for getting back on track.”

“That seems to be the key,” says Sabitoni, summarizing the study’s lessons. “Of course, it would help if we each had a counselor or trainer to keep us on track, but that’s usually not possible. The good news is we can do it without help by stepping on the scale every day and making diet or exercise adjustments whenever we pass the three-pound barrier. After you’ve worked so hard to drop your weight, get into this habit to keep it off.”

It takes 3500 extra calories to form a pound of fat. Eating 500 fewer calories per day means losing a pound every week. Similarly, increasing physical exercise will burn more calories. A 15-minute walk burns 65 calories; 15 minutes climbing stairs burns 155. In the final analysis, getting down to and maintaining a healthy weight is all about the balance of calories in and calories expended.