Certain Factors Predict Weight Regain After Big Losses

— But even “regainers” still kept off most of the weight

by
Kristen Monaco, Senior Staff Writer, MedPage Today
October 17, 2023

DALLAS — Certain factors predicted who kept the weight off after successful losses with a commercially available weight-management program, a researcher reported here.

Among nearly 3,000 people who participated in WeightWatchers, 57.4% had maintained their weight loss at 1 year, while 42.6% gained back 2.3 kg (5.1 lb) or more, reported Suzanne Phelan, PhD, of California Polytechnic State University in San Luis Obispo, during the ObesityWeek annual meeting.

The average 1-year weight gain among maintainers was 0.4 kg (0.9 lb) compared with 7.2 kg (15.9 lb) among regainers, Phelan and team noted in the study, which was simultaneously published in the journal Obesity.

“Modest weight regain was relatively common among weight loss maintainers,” Phelan said during her presentation. “Yet the gainers remain 18% below their starting weight. So, [they were] largely successful at weight loss.”

Few baseline characteristics were predictive of maintaining weight loss at 1 year, she noted. Those who did maintain weight loss tended to be older (58 vs 52 years), have a lower initial body mass index (BMI; 34.8 vs 37.4), and a longer duration since weight loss. However, sex, race/ethnicity, income, education, marital status, and home environment weren’t predictive of who maintained or regained weight.

Behavioral characteristics were more predictive of maintaining weight loss, she added, as those who did tended to score higher on scales measuring psychological coping, self-monitoring, physical activity, dietary choices, not eating in the absence of hunger, and stronger diet and exercise habits. Only total weekly energy expenditure and time spent sedentary were not significantly different between the two groups.

It was somewhat surprising, Phelan said, that these patients maintained at least an 18% weight loss across the board, even among those deemed regainers. All were engaging in high levels of physical activity to sustain losses, she added.

When it came to eating patterns, maintainers scored lower on hunger and disinhibition scales. However, both groups scored similarly on eating restraint. Those who maintained weight loss scored higher on two measures of body image: appearance and body satisfaction, while those who experienced more pain tended to fall into the weight regain category. Maintainers also tended to score higher when it came to self-compassion, but this wasn’t significantly different.

“Future weight-maintenance interventions may emphasize improvements in body function and pain rather than appearance as a motivator of long-term weight control and incorporate behavioral (e.g., physical activity) and psychological strategies to promote body function and minimize bodily pain,” the authors wrote.

The almost all white and female participant pool included 1,632 weight loss maintainers and 1,211 regainers. Mean age was 56.

At 1 year, BMI was 25.9 among maintainers and 30.5 among regainers after weight losses of 25.1% and 24.8%, respectively. The average weight loss among regainers 3.5 years after starting the program was still 25% of their starting weight (average of 26 kg [57 lb]).

When discussing limitations of the study, Phelan noted that they only assessed these individuals at the 1-year mark, and over half of the original program participants didn’t respond to this follow-up questionnaire.