Greater improvement in medical risk factors with greater weight loss/maintenance compared to recommended 5–10%.

Objective: A weight loss of 5% to 10% of initial body weight has been shown to confer significant health benefits and is used as a benchmark for “successful” weight loss. Maintenance of the weight loss long-term is necessary for continued health benefits. There is still some question whether weight losses of greater than 5–10% should be recommended and whether maintaining greater losses is possible.

Method: We performed a retrospective analysis of the weight and medical risk factors of 1,219 maintenance patients from 42 clinics participating in the HMR Program for Weight Management™. All maintenance patients who completed both an initial health risk appraisal (HRA) prior to weight loss on a very low-, low-calorie, or moderately restricted diet and a follow-up HRA in 1997 through 1999 were included (those with missing biometric values or not indicating current status as maintenance were excluded).

Results: The average length of time between the initial and follow-up HRA was 113 weeks. The majority of patients (85.6%) were maintaining at least 5% of initial body weight and 71.8% were maintaining 11% of initial body weight or greater. The average weight change for the entire sample was 43.1 lbs (16.95% of initial body weight). When patients were analyzed according to the percent of initial body weight being maintained, a dose-response relationship was evident. Compared to the standard of 5–10%, those maintaining 21–30% of initial body weight and >30% demonstrated significantly improved changes in medical risk factors. Average point changes between HRA surveys indicated significant decreases (p< .01) in total cholesterol (10 mg/dl for 5–10% vs. 24 mg/dl for 21–30% vs. 38 mg/dl for >30% group), triglycerides (19 vs. 61, 67 mg/dl), systolic (3 vs. 10, 17 mmHg) and diastolic blood pressure (5 vs. 8, 12 mmHg). Changes in glucose were: 5 vs. 10 (p<.05) and 18 mg/dl (p<.01).

Conclusion: In summary, patients who continue in a structured maintenance program can maintain losses greater than the recommended 5–10% of initial body weight along with substantial improvements in biometric values. Patients should be encouraged to lose as much weight as possible and participate in a structured long-term maintenance program in order to prevent weight regain and maintain improvements in medical risk factors.