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News Flash: Maintaining Weight Loss is Hard (There's Proof--and Hope!)

By , SparkPeople Blogger
It’s not your fault you can’t keep the weight off!

I recently got a call from my mother who told me, “I just saw something on the news about why it’s hard to maintain weight loss! I know you’ve been struggling, so will you find it and check it out?”  I told her I saw something about it already and thanks for checking in on me.  I had seen various headlines with similar titles such as “It’s not your fault that you can’t keep the weight off!”  I briefly checked them out and thought, “That doesn’t help me!” and moved on with my day.  But, later on I was thinking about the messages these headlines sent to the millions of hopeful but overweight people of America.  

Seeing a headline like that telling me, “You now have an excuse for gaining back your weight loss!” makes me cringe.  Here I am, trying to maintain a greater than 100-pound weight loss and now I’m hearing that my body is trying to sabotage my efforts?  I will get back to my take on the news after I tell you a little bit about the study

The study that prompted these headlines was published the New England Journal of Medicine in October 2011.  This study started with 50 obese non-diabetic people who were placed on a low calorie diet (500-550 calories a day!) for 10 weeks.  Hormones involved in weight regulation were measured before the diet and at 10 and 62 weeks.  During the year that they were followed, participants were counseled on how to maintain the weight loss and given calorie guidelines to follow specifically for maintenance.  It was assumed that these hormone levels would be affected at week 10 (the end of low-calorie diet)--and they were.  However, the finding that has sparked multiple headlines is that after one year of maintaining the weight loss (well, approximately 59% of it) the hormones that changed with dieting at week 10 did not return to pre-diet levels. 

Let’s highlight a few of those hormones.  Before I get into talking about specific hormones (and probably boring you) know that the hormones that I highlight, leptin and ghrelin, are just two hormones in a complex and intricate signaling system involved in regulating body weight.  Know that the scientists studying these hormones are providing the building blocks for unlocking the “hormonal” secrets of weight control and not "The Secret" to lifelong happiness and the perfect body. 

Leptin and Ghrelin
Leptin is a hormone that is produced primarily in fat cells and, when released, signals the body (through other chemicals) you are full, cueing the body to reduce food intake and expend more energy.   

Ghrelin is released from the gastrointestinal tract and pancreas and signals you through hunger that you need to seek food. 

In this study, leptin levels decreased and ghrelin increased (as expected) during the low-calorie diet phase, but failed to return to pre-diet levels at one year of maintenance.  Other hormones in the study also did not return to pre-diet levels.  So, now you’ve got less leptin (you feel less satisfied after a meal) and you’ve got more ghrelin (you’re hungrier) a year into maintaining your weight loss.  Surveys given to the study subjects after one year back this up.  The participants reported thinking about food more often and feeling less full.  No fair!  

What does this mean for you--and me?  We already knew that maintaining weight loss is not an easy task.  Most seasoned SparkPeople members know by now that the vast majority of people regain the lost pounds. (Learn 5 secrets of the 5% who keep the weight off!)  While it’s interesting to note that there are some chemical changes that occur during and probably after weight loss that signal us to gain it back, it does not change the bottom line: Weight maintenance after weight loss is a very complicated, multifactorial endeavor and is not easily accomplished. But you shouldn't give up!

Do headlines like this make you want to give it all up and return to your pre SparkPeople habits?  I hope not! I'm certainly not giving up! The number of successful maintainers is increasing, and I believe those maintenance statistics need updating.  I can tell you from experience that maintenance is difficult.  I changed my lifestyle more than four years ago, and I still struggle, maybe now more than ever.  But, I am very motivated by a desire to beat the odds, and I know that if I don’t balance my diet, exercise, and life stressors I will see 300 pounds again. 
So, read those headlines and know that you are on the right track--and you're not in this alone.  Here at SparkPeople, we don’t just talk about calories in-calories out and exercising 30 minutes most days of the week.  We stress a complete lifestyle change with the support of family and friends and the incredible community that is the heart of SparkPeople! With us, healthy living is fun and manageable!
Never give up and keep Sparking everyone!

Did you see these headlines? Do you feel demotivated by the findings, or does that push you harder to maintain your weight loss?

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A very powerful article. I wish I would have had this information before regaining nearly 85 pounds out of a 125 pound weight loss. I have kept the additional 40 pounds off for 5 years though, so I know that is a bit of an accomplishment. Report
Birdie, I respect your articles so much, because you are actually living it. I have read so many articles and interpretations about the articles about this study you talk about, and at first I WAS discouraged. When I read about the woman who had regained some of her weight, up to 195 lbs. (but still kept off a significant amount), and could only eat 1,500 calories and had to work out 90 minutes every day just to maintain that weight, I was bleak. But then I got to the point where I said, "NO....this will NOT bother me. If THIS is what it takes to maintain this loss (180 lbs. --from 328 to 148) for me, I am willing to do whatever it takes!" I think at some point we have to realize it will NEVER be easy, it will always be a STRUGGLE, but it is WORTH every last bit of effort we give to it. Sometimes I get so hungry. I just want to eat until I'm stuffed. Remember that feeling? It's been quite a while since I had that feeling. But then I think about all I have gained from losing weight: the freedom of movement, the confidence, the LOWer blood pressure, etc. etc. and I realize why would I ever want to feel uncomfortably stuffed again? I love food, but I'm learning to love healthier food. I just went and stocked up on out-of-season and very expensive fruit, so I've got lots of snack food. That 10 pounds I put on between Oct. 30 and Jan. 30 is going away! I'm reversing that upward trend on the scale and that feels good. I didn't want it to get to 15 or 20 pounds gained or worse, before I took care of it. I WILL be part of that 5%!! If that means ignoring those signals from my pancreas that I'm hungry and realizing I may never really feel full again, due to both eating less and the hormones not kicking in like they should, that's okay. It is just food. And what I am doing now is LIVING! Report
Nice job, Birdie!

Next time you want to mention the numbers of successful maintainers here at SP, you could also point to the At Goal and Maintaining team, where we've got a list of almost 100 of them!


Keep up the good fight, Chica! Report
I have not yet reached my goal weight, so I am not currently in 'maintenance mode.' I do think that I have made the lifestyle change; I'm eating a lot better, smaller meals with better ingredients, less red meat, more fish, and I've come to value exercise. I am hoping that once I do reach my goal weight, I will be able to maintain. Report
See, as someone who has taken off over 100 pounds three different times in my life, and even maintained it for awhile, only to put it all back again and more, that study does not discourage me--it reassures me! I confess I was feeling like some kind of weak-willed failure because I caved after each of those losses, specifically because diet pundits had assured me that I "should" have had it easy at that point and instead it felt like holding on was actually getting harder. But now I have confirmation that those feelings of it getting harder to maintain the loss were not just all in my head, but that I was experiencing actual biochemical changes that were truly making maintenance harder. So--now that I better understand what I'm up against, I am forewarned, and better prepared to dig in even more resolutely when I get to that point in my weight loss again. And I will get to it, again, and this time I will succeed. Report
One question I had about this study was about the severe calorie restriction that the folks in the study were subjected to... wouldn't the hormones adjust more slowly and evenly if people were put on a sensible slow diet? Report
I remember reading about this article when it was first published. Like many others who have commented, I really do wonder if the results would be the same for a 1200+ calorie diet.

I lost 60 pounds and have maintained that weight loss for almost a year and a half. Some days are harder than others. But, I weigh myself daily so that I can always see sudden spikes and I stick to a 5 pound maintenance range....this way, if I see myself creeping above that range, I can make necessary changes. So far, I've managed to stay within that range (TOM not included due to bloating).

When it comes to how I lost the weight, I never ate less than 1200 calories. As a matter of fact, I used 1200 as my net calorie marker. For instance, if I burned 500 calories worth of exercise, I would eat 1700 (1200 + 500) calories that day. It's also my formula for maintaining my weight. My base calorie amount to maintain my weight is between 1550 and 1600. To maintain, I eat 1550 plus however many calories I've burned during working out. These figures are WAY higher than the 500-550 calorie diet cited in the published study. Perhaps it's because I didn't severely restrict my calories to lose the weight that maintaining it hasn't been that tough.

I can honestly say that maintaining it, while a continuous effort, has been MUCH easier than losing it was. I notice that if I slack off on working out, my weight spikes. But as long as I keep up with working out regularly and pay attention to my portion sizes, I do fine.

For those of you who are still working to lose weight, please don't be discouraged by the report mentioned above. Maintaining your weight CAN be done. I recently joined the National Weight Control Registry. I strongly recommend looking at their site and reading the research findings of people who have lost weight and kept it off for years.

Here is the website: www.nwcr.ws /
Taken directly from their "Research Findings" page, here is information that may be encouraging to those who are still trying to lose weight, as well as to those who are in maintenance. They definitely have been for me.

Don't give up - losing and maintaining a healthy weight for life CAN be done!

NWCR Facts

"You may find it interesting to know about the people who have enrolled in the registry thus far.

80% of persons in the registry are women and 20% are men.
The "average" woman is 45 years of age and currently weighs 145 lbs, while the "average" man is 49 years of age and currently weighs 190 lbs.
Registry members have lost an average of 66 lbs and kept it off for 5.5 years.
These averages, however, hide a lot of diversity:
Weight losses have ranged from 30 to 300 lbs.
Duration of successful weight loss has ranged from 1 year to 66 years!
Some have lost the weight rapidly, while others have lost weight very slowly--over as many as 14 years.

We have also started to learn about how the weight loss was accomplished: 45% of registry participants lost the weight on their own and the other 55% lost weight with the help of some type of program.
98% of Registry participants report that they modified their food intake in some way to lose weight.
94% increased their physical activity, with the most frequently reported form of activity being walking.
There is variety in how NWCR members keep the weight off. Most report continuing to maintain a low calorie, low fat diet and doing high levels of activity.

78% eat breakfast every day.
75% weigh themselves at least once a week.
62% watch less than 10 hours of TV per week.
90% exercise, on average, about 1 hour per day." Report
I wonder what the hormone levels would be for a group who lost weight the Spark People way? You always have to look at the design of the study before you can accept the results. We all know that extreme dieting only works for the short term. But, there are people who have lost weight and maintain the loss. No one says its easy, but then, life isn't easy, so, I say, don't give up, don't quit trying. Report
Thank you for writing this!! How encouraging!!
Many people here on SP were totally freaked out about this and links to the article were posted all over at the time. So I went ahead and read the article. Actually, it made me furious. Furious at why such an article needs to be broadcast at all, obviously taking hope and motivation from many, lending an excuse to give it all up, because it can't be done. What would be the purpose of this? ..............

My achievement is not as great as many others; I have been maintaining a 40 lbs weight loss (+/- 5 lbs) over several years. I am at goal. It is still hard. There is no way you can ever go back to your pre-weightloss lifestyle, not even remotely.

What goes into maintenance is constant continued work and fine-tuning. Much the same as during weight-loss. This can only be done if we continue living our new lifestyle. Over time it does become easier, but by now I'm sure it'll take my continued daily commitment to nutrition, exercise, and emotional balance.

I'd say, get mad, get furious, get out there and fight, beat the odds, prove everybody wrong. It's your life, don't let Big Brother dictate what you think and how you feel.
I did read the results of that study as reported in a magazine recently. Rather than feeling discouraged, I felt like I couldn't really take away any clear message. The 500-550 cals/day diet the participants were put on was so extreme; I didn't learn whether the hormonal changes were applicable to more reasonable diets or specifically related to ridiculously high levels of restriction. I'm with you, though--whether or not my body's 'working against me,' I'm motivated by a desire to beat the odds and maintain my 110+ lb loss. Report
very good information! So true! Report
Surprisingly enough, this blog made me feel better. It's good to know that it's not all in my head. It really is hard.
I may still feel like a failure, but I least I don't feel alone. :-P Report
Well I believe that it's someone opinion that maintaining is hard. It you set your mind to the fact it's a life style change and not a diet I believe that you heart will follow along. I believe that maintaining can be done. It's all about the choices we make for the life that we live. Just knowing that eating healthy and working out is a way of life makes it easier for ,me. Knowing that I can do anything I set my mind to doing makes it easier. Report
I'd like to know how a diet of 1200 calories would affect hormones. Not too many people need to worry about a diet of 500 cals! Report
This is really interesting. Report
dont worry about maintaining! Just hit a plateau! Those are easy to stick with FOREVER!!!! Report
I would like to know who sponsored/proposed the study. You can learn a lot from that information. The headlines were a little misleading, I think. If I starved myself like that I am certain it would take my body quite a while to recover. If the study were done with a slow, sustained weight loss due to lifestyle changes rather than an extremely restrictive diet, I am pretty sure the results would look different. Not that maintaining won't be work once I reach my goal weight, but I sincerely doubt it is a lost cause like the headlines seemed to imply! Report
Thanks for the great article. You are very motivational and inspiring. Good luck to you and all of us who are not on a diet, but seek to follow a life changing health regimen. Report
Thank you for this article. As someone who has been on a weight loss - weight gain roller coaster my whole life, I know I need to stop making excuses for myself. I need to manage my stress instead of food managing me. And I need to have a positive image of myself, whether at 175 (my goal weight) or at 237 (my biggest). If I don't feel like I deserve to be healthy and happy, no matter what size I am, I won't be. This isn't just for today, its for tomorrow, and the rest of my life! Report
I've been thinking about that study (I saw it reported in CSM &NYT) and wonder if the degree of calorie deprivation (500-550 is very deprived!) had something to do with the refusal of the hormones to return to 'normal' levels. (And I love the level of awareness among my fellow SP-ers that I'm far from the first to think of this aspect.)

I should think a more normal rate of weight loss would sort of 'sneak up' on the hormones and they might not overreact (yes, I know they don't think, but I'm in the humanities, and tend to personify anything I can). Report
Thank you for this post. At 9 and 1/2 months of maintaining and every determination to beat the projected odds, this entry helps encourage me to stay the course. Report
Yet one more reason for not watching TV!
I agree, it's hard. I've maintained a 100 plus pound weight loss for 3 years now. But I DID change my lifestyle. And I'm still at the stage where I obsess over making sure I do everything right - I log my food throughout the day - make sure I get some form of exercise in to the point that there are days I know my body should take a rest - but I just got to do it. (I do try to go a little easier those days) I'm only now allowing myself to eat the occasional "less than healthy" food - like the french fries I had Sunday with of all people some spark friends. This is for the rest of my life and I am willing to be diligent for the rest of my life - at least now I am. Because I know how disappointed I will be with myself. And I will sense disappointment in my friends and family, although most I don't think would say anything. I like myself more and better now. I feel better now and have more energy - that is the bottom line! Report
I did read this article but was instantly alerted when it talked about a calorie intake of 500 as I thought this brought into play a whole new set of survival mechanisms in the body. A calorie intake of 1200, I thought, was much less likely to bring this into play. I did not feel that I should just give up as I have kept most of the weight off for almost four years. Report
I would like to see a scientific controlled study that used a realistic and nutritionally dense amount of food (1200+ depending on the person) and exercise, rather than the WAY too low calories the study these findings are based on. Would the results be different? That's what I would like to know. Report
Maintaining weight loss is difficult-I think all of us would agree, but hey, if I am successful, than it is 100% for me!!! I KNOW I will be a person who has to think about calories and exercise for the rest of my life-but, they pay-off is SO worth it. My life will be longer and healthier and happier-and sure, it takes work-but so do lots of other worthwhile things too! I say, keep strong-keep the path-and keep the weight off!!! Report
I'm still in the losing phase, but it's devastating to see all these people lose 100+ pounds only to regain. It's really scary that I won't be able to do it. Report
I am determined to increase that 5% of people that keep it off -- by being one more person to keep it off -- and hopefully inspire others to also lose and keep it off.
I don't put too much stock in any study that would put a person on that low of a caloric intake. We have heard in SP over and over not to eat too little -- and 500 to 550 calories has to be way too small an amount. This alone could wreck havoc with hormones and other things in your body -- like thinking we are being starved. I think slow and easy is best and it isn't that hard to maintain when it has become your new lifestyle. It's a habit to be healthy! Report
I have to wonder if the ridiculous low-calorie (500-550 Calories per day!) would have affected the hormones much more than an eating lifestyle recommended by SparkPeople! That's so incredibly low it's bound to "mess up" one's body.

I've been at maintenance for more than a decade. It's not an easy process, but a lot easier than losing weight. I'm come to the conclusion that I'll have to be careful about my food consumption and exercise for life, but that's okay because this is my new life! Report
I like your take on the article and as many of the people said, it seems a bit questionable considering the low intake amount for the initial portion of the study. However, these (possible) issues aside, I wonder if those levels ever return to normal. The reason I'm saying this is that I maintained for 3.5 years and then suddenly the weight came back. I didn't change anything in my eating or exercise (I didn't go back to my previous negative lifestyle habits) and yet the weight came back. I wonder if the body just wants to go back to that original set point, or if that set point, and those hormone levels can be reset. Report
I wish they had not done this study with such a drastic weight loss program. I personally beleive that if the study participants had lost weight in a much slower way that wasn't so shocking to their system that the results would have been much different! I hope someone does a study like that, on a much larger scale, so we can see the results! Report
I saw this study also and my first reaction was "a 500 calorie diet is not a viable diet". I question whether the research is even valid for those of us who are trying "normal" eating and lifestyle changes. The one thing the study did tell me was that you can really mess up and permanently change your hormone balances by practicing severe diet restriction. Report
I had seen this article earlier. I wish someone would do a study on people who lose weight by changing their lifestyles... you know eating good foods in reasonable portions and being physically active... sounds like Spark People. Seriously, Birdie, can you get someone to do a study with Spark people, especially those of us who are maintaining? Just imagine what we could discover. Report
I think it is important that people realize that maintaining weight loss is every bit as difficult, if not more so, than losing weight. You have the same struggles but with no reward of the satisfaction of pounds and inches dropping. That's why lifestyle changes are key to lasting success. Cold hard truth folks--your goal weight isn't the finish line! Report
Even though the news sound discouraging, the fact that this research is being done gives me hope that one day people won't be discriminated against because of their weight. The more we learn about the mechanisms in our body that make us gain or lose weight, the less people will be able to hide behind ignorant statements like "just eat less", "just take the stairs" etc. For those of us on the journey, every little bit of knowledge helps. And although I don't believe in diet pills and other "magic bullets", maybe some day there will be safe and effective medication to help regulate these and other hormones, just like there is medication for other metabolic disorders. Report
Weight loss kind of reminds me of my experience with childbirth. After 30 hours of labor my first thought was WHEW THAT'S OVER! My very next thought was...OH NO IT'S JUST BEGUN!!! I have been maintaining my weight loss for 3 years and it is STILL, to this day is just as hard as losing it! I'm happy for studies but I think less energy needs to be put in to worrying about how many calories it was based on and a WHOLE lot less on correcting one's spelling (REALLY?!) FACT IS maintenance is not for the weak! I think more emphasis needs to be put on preparing people for the maintenance obstacle course ahead of them. As long as I have breath (and celebrations and holidays and a WHOLE lot of reasons why I want to put that in my pie hole "just this time") it's a DAILY battle! Geeze after airing my feelings me thinks maybe I need to find a support group! :O :) Report
One sentence in the article says it all to me ~ "I am very motivated by a desire to beat the odds." When I set out to lose weight 3 years ago, I followed a very different path that included educating myself about nutrition, exercise and weight loss and surrounding myself with people who knew how to lose weight and keep it off. This helped me find sparkpeople, ShapeUpRI and the Weight Control and Diabetes Research Center in RI who all supported my weight loss of 33 pounds. While I may have small setbacks, I will lose the remaining 10 pounds and will not regain it. Report
The study is discouraging but also explains why I've never been able to maintain any of my many weight losses, large or small. At least research is being carried out on weight maintenance & I'm grateful for that. I'm also hopeful that this time it'll be different as I'm much more informed about weight maintenance and what it's going to take to keep the pounds off. Report
I agree w/several others below. A daily intake of 500 calories is very extreme and I this diet most likely altered the hormone levels dramatically compared to what we would see if they did a study w/a daily intake of 1200 calories. The study needs to be more realistic by having participants follow a SAFE and HEALTHY weight loss plan over a longer period of time (6 months - 1 year).

I definitely won't let this get me down! Maintenance is hard, but continuing to eat healthy, exercise (and changing it up frequently) and staying positive can overcome these types of obstacles. It won't always be easy though. Report
Thanks for this article, Dr Birdie. I know maintainers will appreciate this info. I know I do. Report
The findings explain a lot in biochemical terms, but I also think it's entirely possible to overcome their effect by implementing a variety of behavioral techniques, all of which we're learning about right here. So, I just interpret the study as more proof that it's never "laziness" that lies at the root of most people's weight problems, which I find reassuring, more than anything. Report
This type of article makes me angry. Think about it! Is it fair to do such a study based on a 500 calorie daily intake then tell the world that you are doomed? Of course you're doomed; 500 calories/day is unsustainable!!! Why don't they do one with a 1000-1200 calorie intake instead and publish their results so that we can make intelligent deductions in relation to our own situation. Report
Thanks for providing more details about the study. It makes me question its validity. No one advocates restricting calories to 500-550 a day as a good way to lose weight. I'd have more faith in the results if the study had been done with a healthy and maintainable reduction in calories and increase in exercise. There's no question that maintaining weight loss is harder than losing the weight. But we're on the right track with sites like SparkPeople. If I feel like I'm slipping, I increase my activity on the site to get the support I need. I appreciate getting good, solid information rather than hype. Report
I feel like this study is totally bogus. Eating under 1200 calories a day is considered starvation tactics. So studying the effects of eating 500 calories a day is really just a study on the effects of starvation on the body, not a study of the effects of sensible calorie restriction. Of course your body is going to go nuts, hormone-wise, after that. That's why it takes so much hard work to recover after an eating disorder. I'd be interested to see what the results would have been for a non-starvation situation. And I'm really surprised that more people haven't been pointing this out in the news. The researchers obviously knew better, if health and diet is their field of study. It's totally misleading. Report
Great article. However, we should note the study method. The subjects were on a very low-calorie diet for 10 weeks. That's quite a long time and most certainly affect the hormone and creating starvation mode the bodies. I would think that would affect the hormone interactions and gave bias results as opposed to people on SP here - which are using low calorie but healthy range to lose weight. Report
After about 18 months and having lost about 23kg (roughly 50lb) I told my Dr that for some reason I was starting to crave sugary stuff - especially chocolate - something I have never craved before. He told me it was my body trying to get me back to the weight that it knew for so long, but I would have to fight the urges. I took note. That is why now, even tho' I am at my goal weight (lost a further 4kg) I still weigh all of my food and record it all in the Nutrition Tracker. It is the only way that I can maintain, not gain! Report
Thank you!

Geez, when I first heard about this I cringed... Like it's not hard enough for people to stay motivated. This Spark Blog addresses exactly what I was thinking. I'm so glad you posted it.

Jocelyn Report
Wow - this is pretty scary. It does tell me that the feelings I've had since reaching my original goal weight are not all in my imagination - it is tougher in some ways than the original loss. And my focus on keeping to the things that got me here - tracking my eating, exercising almost every day, drinking my water - are necessary as is my daily Sparking to keeping it off. Report
I did not see the headlines but they do not demotivate me. Maintenance is hard, probably harder than weight loss but, if you adopt a lifestyle, the process is easier than if you simply "diet." And I think that may be at the root of this report. Five hundred calories? I don't know - that doesn't sound healthy to me... Right now, the one thing that's pushing me harder are the effects of menopause. Hormones! Or technically, the loss of hormones, make a huge difference in how the body responds to exercise, stores fat and also affects energy levels and stamina, at a time when you need to do more not less! It then becomes a matter of putting things in perspective after a while and making adjustments you can live with, while doing all you can not to let success slip away from you... There will never come a day when I can be less "stubborn!" Report
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