Improved long-term maintenance of weight loss with ongoing involvement in weight management program.

Objective: Long-term maintenance of weight loss, even after significant weight loss, is difficult and often is not achieved. The reported 4.5 and 5-year maintenance of weight loss, as % of loss, after very-low-energy diets is 29% and 20% respectively (Am J Clin Nutr 74:579,2001; J Am Coll Nutr 18:620,1999).

Method: We examined weight maintenance in 73 patients who have lost >100 pounds (#) in the Health Management Resources™ Program at the University of Kentucky. Clinic weights were available for 54 (74%) patients at 52–520 weeks after achieving an initial weight loss of > 100#. No weights were available for 19 patients at 70–468 weeks after 100# weight loss; we used our previous polynomial fit (JACN 18:620,’99) to estimate weight maintenance for these patients.

Results: The 54 patients who were seen in our clinic at >52 weeks lost an average of 140# and were maintaining an average weight loss of 100# (sem, 8.9#) or 70% (sem, 7.2%) of weight loss at an average of 161 weeks. Most of these patients had been active in the maintenance program, many had participated in Restart™ weight-loss sessions and a small percentage used adjunctive pharmacotherapy for obesity. We estimated the weight maintenance of the 19 patients for whom we had no follow-up weights based on previous data from our clinic; this probably underestimates success at weight maintenance for this group. The estimated weight maintenance of these 19 patients was 27% of weight loss at an average of 233 weeks. The average measured and estimated weight maintenance for the entire 73 patients was 59% (sem, 15.4%) of weight loss at an average of 180 weeks. Long-term participation in maintenance program, periodic restarts, and possible use of adjunctive pharmacotherapy probably contribute to the maintenance of 100# or 70% of weight loss for an average of >3 years in the 54 patients.

Conclusion: These observations suggest that active maintenance programs are substantially enhancing long-term maintenance of weight losses for severely obese individuals.