Is Long-Term Weight Loss Possible?

I’m working on a conference presentation for health care providers on helping adolescents lose weight. I called my husband the other day a little frustrated that I didn’t have the solution to the world-wide obesity epidemic to share with the audience. Obviously, I have some delusions of grandeur. 

Throughout the week, combing through the research really depressed me. There are so many articles that talk about the obstacles to long-term weight loss and so few that provide promising solutions. No one really has the answer to this question. A lot of diet books claim to know, but the authors are just trying to make a buck. Decoding the mystery to long-term weight loss is a little like figuring out why Arnold Schwarzenegger would cheat on Maria Shriver with the housekeeper--totally baffling. 

An article that was just published by Marc-Andre Cornier (2011) adds a layer of frustration to the problem. Dr. Cornier writes about how, as people lose weight, their bodies fight to regain it. The person’s metabolic rate slows. (This makes sense as smaller people burn less calories than bigger people.) After weight loss people also feel hungrier, aren’t satisfied after a meal, and tend to fidget less. The human body doesn’t like weight loss and fights tooth and nail to get back to its previous chubby state.

Long-term weight loss is so rare that scientists are able to keep track of people who have managed this in the National Weight Control Registry (NWCR). In fact, less than 10% of people who lose weight are able to keep it off for 5 years (Cornier, 2011). The 5,000 or so people in the NWCR all have some things in common; they maintain a low-fat, low-calorie diet; eat breakfast every day; weigh themselves at least once a week; watch less than 10 hours of TV per week; and exercise about an hour a day (NWCR, 2011). All of this is well and good, but it doesn't show what motivates them to do all of these things, when 90% of weight losers aren't able to stay motivated.

Just when I was ready to throw in the towel, I had a little glimmer of hope. Researchers at the Urban Policy Institute discovered some stark differences in obese teens who lost weight over the course of time and obese teens who gained weight during the same time. They found that all of the teens who lost weight had an a-ha moment. There was a tipping point that changed their path. 

One teen had a track coach who complimented her running, but told her that she would be even faster if she ate better. Another teen had been worried about his grandmother's diabetes around the same time his doctor brought up his weight and risk of diabetes. Another teen had an a-ha moment at the neighborhood basketball court saying, “I sat there, and I watched other people play…. They sweat a lot, but they don’t get tired, and I get tired… I was like, I don’t wanna be like that for the rest of my life.” (Lieberman, 2009) After these a-ha moments, these teens made significant lifestyle changes. In contrast, there were few life-altering moments in the group of teens that continued to gain weight. 

I had a turning point like this when I quit smoking 10 years ago. I was at a drag queen Abba concert even though I had a head cold. I had been trying to quit smoking for a while and had been resisting buying packs of cigarettes. I really wanted a cigarette that night and I bummed one off some guy. The cigarette tasted awful, as any of you who have smoked a cigarette with a cold could have predicted. I had the epiphany that smoking was a disgusting habit that night and that was my last drag of a cigarette.
  
Unfortunately, none of these a-ha moments occurred during unique situations. Every smoker brakes down and has a cigarette when sick and the cigarette, no matter how much the smoker is craving it, tastes repulsive. Why don't all smokers quit when this happens? Many overweight people have a health scare or a moment where they feel bad about their weight. What was different about the teens in the article?


What do you think? Stay tuned for part two.


Cornier, M-A. (2011). Is your brain to blame for weight regain? Physiology and Behavior. E-pub ahead of print.

Lieberman, A., et al. (2009) Why some adolescents lose weight and others do not: A qualitative study. 101(5); 439-447.