According to high quality research on the statistics of long-term maintenance of weight loss, those who undergo weight loss tend to regain some of the weight, however, fortunately for most people, it is not back to baseline.1

While this can be rather discouraging and some may think that losing weight is a battle they cannot win, that is not true. Even a loss of 10% of weight contributes to significant improvement in blood sugar levels, blood pressure, and hormone regulation. Weight loss and maintenance is complex and much of the research recently published is just beginning to understand the physical and psychological mechanisms involved with the weight loss process. 

What makes some people more prone to keeping the weight off versus others who gain it back? Here are 5 tips to ensure that what you lose stays off forever: 

• Your mindset is everything

Weight loss isn’t just about the lower numbers on the scale. It’s what you gain from it, not what you lose. 

For instance:

• Are you lifting heavier weights?
• Are you more flexible?
• Are you sleeping better?
• Are you feeling more confident?
• Are you performing better at work and/or school?
  Thinking positively about all the great habits you’ve gained helps to stay on track and adds to a better quality of life.

• Consistency 

Maintenance is difficult for many people after they reach their “end goal” because consistency is a difficult skill to keep. Life continues to happen and plans sometimes get derailed. Remembering that the weight loss process as well as maintenance phase is a journey without end allows you to be flexible yet disciplined about your habits. While spontaneity at times is good for the soul, routine also helps with consistency because predictability allows your brain to use its energy for more important, pressing issues such as getting the car fixed or taking your kid to ballet— food should not be something to stress over! Constantly remind yourself as to why you chose to change your lifestyle, and if needed, writing it on a sticky note and placing it where you see daily will keep you motivated and consistent.

• Accountability

This is probably the biggest factor in keeping positive habits for life. Whether the accountability comes from logging your activities into a tracker app or reporting them to a health coach or group, having something or someone to keep you on track is helpful. One study found that adherence to healthy habits is best with group support and supervised attendance programs2, which explains the success of weight loss programs such as Weight Watchers. In addition, teaching others what you have accomplished is a great way of staying accountable as others look up to you for help and guidance. You do become the example to those closest to you.

• Regularly re-assess maintenance

Life happens. There’s no way around it and there’s no way to plan for mini-disasters. Meal planning and prepping, scheduling physical activity just like a doctor’s appointment, ensuring early bedtime, etc., are all ways that help minimize major derailment when life does happen, however, as life priorities change, so do goals. Perhaps working 80 hours/week doesn’t allow for daily 1 hour trips to the gym all the time, but it does allow for 20 minutes of a workout at home to keep the habit. Or a stressful life event happened and you put on some weight from stress eating, so you ensure to watch your portions and add more vegetables to your daily food intake to get back on track without beating yourself over it. Regardless of what life throws at you, and whether or not you derailed, it is okay! Re-adjust and find what works for you at that moment. This lifestyle does not have a finish line, it is a journey.

• You are not a number

With a large weight loss, comes some degree of worry about gaining the weight back, and therefore, frequent scale checking. Maybe you lost a lot of weight because of diabetes or high blood pressure and now you’re preoccupied with your blood pressure levels and what your A1C shows. You are more than a number. Focusing on how you feel and looking for those improvements mentioned earlier in this article are better ways to gauge how well your life has improved from the changes you’ve made. Some people, however, thrive on knowing numbers and use them as tangible goals without adding stress; however, for others, it can become overwhelming. Finding what helps you feel less stressed is important for the rest of your life; it may involve throwing out the scale if you’re obsessing over your weight number, or perhaps only checking your weight on a weekly basis if the number helps guide you. Either way, it should cause less stress, not more. 

In conclusion, weight loss is hard, and so is maintenance. Readjusting goals, staying accountable, and reminding yourself of your “why” regularly throughout life will allow you to make your weight loss maintenance possible forever.

**On a personal note, the bulk of my weight (85 lbs) came off in about 18 months. About 6 months into the weight loss, I became a health coach and started running my own weight loss groups virtually. That accountability was a great way for me to stay on track with my weight loss while teaching others what I was learning. At the end of those 18 months, I became a certified Insanity Life group fitness instructor and several months later I began teaching classes at a few gyms in my area during the first two years of medical school. That addition to my health and fitness routine gave me even greater accountability to be on track. Meanwhile, I have provided advice to friends and family whenever they have asked and many have approached me saying that they started changing their habits because of my example. At this time, while I no longer hold virtual groups nor do I teach at the gym, I remain accountable by tracking my food, taking my measurements and weight weekly, and providing advice to those who seek it, including occasionally teaching healthy lifestyle classes in my county to various audiences. My daily reminder as to why I choose to keep living a healthy life comes from knowing I will soon be preaching this to my patients on a daily basis. Exercising regularly is a habit I no longer think about because I enjoy the stress relief it gives me. I believe that regardless of what your schedule may be or what your goals are, weight loss and maintenance are achievable and rewarding. 

References

1. Franz, Marion J., et al. “Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up.” Journal of the American Dietetic Association 107.10 (2007): 1755-1767.
2. Lemstra, Mark, et al. “Weight loss intervention adherence and factors promoting adherence: a meta-analysis.” Patient preference and adherence 10 (2016): 1547.