Weight loss maintenance: keeping off pounds.

Introduction

The world is in the grip of an obesity epidemic. In my post, Is obesity a disease or risk factor for other conditions? I had discussed the magnitude of obesity and had also highlighted that today most of the major international and national health organisations, including the World Health Organization (WHO), World Obesity Federation, and American Medical Association recognise obesity as a disease. However, rather than considering obesity in a conventional way, one aspect that needs serious consideration is that normal weight doesn’t always equal healthy weight. In my post ‘What is obesity – is it merely about BMI?‘ obesity had been defined as “excessive body fat accumulation (not weighing too much), which is associated with clear risks to health.” In my post ‘Normal Weight Obesity – a myth or a reality? I had described individuals who have weight within normal limits according to the BMI but have a high body fat percentage and are predisposed to the same health risks as in obesity. Lifestyle modifications encompassing dieting, physical activity and behavioural modifications often lead to weight loss. However, over the long term, the vast majority of individuals regain the weight they have lost. Thus, long-term weight loss maintenance remains the main challenge of obesity treatment. Various studies have shown that this relapse has a strong physiological basis and is not simply the result of the voluntary resumption of old habits.

Long-term weight loss maintenance remains the main challenge of obesity treatment. The image depicts an obese women on a weighing scale.
An obese women on a weighing scale

What is the successful maintenance of weight loss?

To assess the population of individuals who successfully maintain weight loss, it is pertinent to lay down objective criteria to define ‘successful maintenance of weight loss’. The most commonly followed definition of successful maintenance of weight loss was proposed by Wing and Hill; they define successful maintenance of weight loss as “intentionally losing at least 10 per cent of the initial body weight and keeping it off for at least one year.” Rossner proposed that sustained weight loss of about 5% to 10% of baseline body weight represents a definite degree of success. This goal for weight loss is in accordance with the recommendation of various health and nutrition organisations for reducing the risk of various disease conditions associated with obesity.

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