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Weight-Loss Maintenance for 10 Years in the National Weight Control Registry

  • J. Graham Thomas
    Correspondence
    Address correspondence to: J. Graham Thomas, PhD, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital Weight Control and Diabetes Research Center, 196 Richmond Street, Providence RI 02903.
    Affiliations
    Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island
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  • Dale S. Bond
    Affiliations
    Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island
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  • Suzanne Phelan
    Affiliations
    Kinesiology Department, California Polytechnic State University, San Luis Obispo, California
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  • James O. Hill
    Affiliations
    Anschutz Health & Wellness Center, University of Colorado School of Medicine, Aurora, Colorado
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  • Rena R. Wing
    Affiliations
    Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island
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      Background

      The challenge of weight-loss maintenance is well known, but few studies have followed successful weight losers over an extended period or evaluated the effect of behavior change on weight trajectories.

      Purpose

      To study the weight-loss trajectories of successful weight losers in the National Weight Control Registry (NWCR) over a 10-year period, and to evaluate the effect of behavior change on weight-loss trajectories.

      Methods

      A 10-year observational study of self-reported weight loss and behavior change in 2886 participants (78% female; mean age 48 years) in the NWCR who at entry had lost at least 30 lbs (13.6 kg) and kept it off for at least one year. Data were collected in 1993–2010; analysis was conducted in 2012.

      Main outcome measures

      Weight loss (kilograms; percent weight loss from maximum weight).

      Results

      Mean weight loss was 31.3 kg (95% CI=30.8, 31.9) at baseline, 23.8 kg (95% CI=23.2, 24.4) at 5 years and 23.1±0.4 kg (95% CI=22.3, 23.9) at 10 years. More than 87% of participants were estimated to be still maintaining at least a 10% weight loss at Years 5 and 10. Larger initial weight losses and longer duration of maintenance were associated with better long-term outcomes. Decreases in leisure-time physical activity, dietary restraint, and frequency of self-weighing and increases in percentage of energy intake from fat and disinhibition were associated with greater weight regain.

      Conclusions

      The majority of weight lost by NWCR members is maintained over 10 years. Long-term weight-loss maintenance is possible and requires sustained behavior change.
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