When it comes to weight loss, there is no shortage of diet options: low-calorie, low-carbohydrate, low-fat, juice-only fasts, meal replacements, and even medications. But, while many of these approaches can lead to initial weight loss, the real challenge lies in maintaining that loss over the long term. The key to successful, sustainable weight loss is understanding the complex factors involved and selecting a balanced, enjoyable approach tailored to your unique needs.
Why Is Long-Term Weight Loss So Difficult?
A common misconception is that losing weight is solely a matter of eating less and exercising more. However, weight regulation is far more complex. It’s not simply a behavioural issue; for many, weight gain results from genetic, hormonal, and metabolic factors. Recognizing this complexity has led to a movement toward labelling obesity as an Adiposity-Based Chronic Disease (ABCD)—emphasizing that weight regulation is a medical condition, not just a matter of willpower.
In fact, during weight loss, the body undergoes adaptations that can make it difficult to maintain new, lower weight levels:
Metabolic Slowdown: As body weight decreases, so does the metabolic rate. This means that post-weight loss, our bodies use less energy, making it easier to regain weight if eating habits don’t adapt.
Weight Set Point: Our bodies naturally resist changes in weight, often working to bring us back to our previous weight levels, sometimes increasing appetite or decreasing energy expenditure or both, to do so.
Is There a “Best” Diet for Weight Loss?
With so many diet options available, it’s natural to wonder if one is truly superior. The truth is that people can lose weight on various diets, whether they’re low-calorie, low-carb, low-fat, or even on juice cleanses or meal replacements. However, the issue with any diet isn’t so much in losing weight but in keeping it off. Studies show that most diets can work short-term, but long-term success hinges on making choices you can live with.
1. Choose Foods You Enjoy
One of the most important aspects of any diet is enjoyment. We eat food; we are not on a lifelong diet. Sustainability is key to long-term success, and enjoying our food is essential to sticking with our plan. If we force ourselves to eat food we dislike, it’s unlikely we’ll be able to maintain those habits in the long run. Instead, it is important to focus on eating various nutritious food we genuinely enjoy.
2. Increase Protein Intake
Protein intake plays a very important role in weight maintenance. It promotes satiety, reduces hunger, and preserves muscle mass, which is important for maintaining a healthy metabolic rate. Aiming for 1.2 to 1.5 grams of protein per kilogram of body weight can support these effects and help prevent weight regain. People who are more physically active require higher protein intake.
3. Adapt Carbohydrate Intake for Insulin Resistance
Managing carbohydrate intake can be especially beneficial for individuals with insulin resistance or pre-diabetes. Studies suggest that these individuals may respond well to a lower-carbohydrate diet, which can improve insulin sensitivity and stabilize blood sugar levels.
4. Consider Time-Restricted Eating and Intermittent Fasting
Many succeed with time-restricted eating (eating within a shortened window each day) or intermittent fasting (fasting for 24 hours or longer periodically). These approaches can reduce appetite, making it easier to maintain weight without constantly battling hunger. Furthermore, eating in the earlier part of the day, rather than later, may be especially beneficial for those with insulin resistance or pre-diabetes, supporting blood sugar regulation. This approach helps sustain weight loss and aligns with the body’s natural circadian rhythm.
5. Use a Continuous Glucose Monitor (CGM) for Personalized Insights
A Continuous Glucose Monitor (CGM) can provide valuable insights into how different foods impact blood sugar levels, especially for those with insulin resistance or metabolic dysfunction. A CGM wearable device tracks blood glucose levels throughout 24 hours without requiring multiple needle pricks. By observing real-time blood glucose responses, you can make more informed food choices, reducing food that cause spikes and prioritizing those that support steady glucose levels.
CGMs can also help identify hidden triggers, like certain carbohydrates or highly processed foods, that may otherwise go unnoticed. Over time, this personalized approach helps improve metabolic function, making it easier to lose weight and manage overall health.
Effective Strategies for Long-Term Weight Maintenance
While weight loss and maintenance can be challenging, research provides several evidence-backed strategies for long-term success. A behaviour design approach, especially early in the weight loss journey, can help build sustainable habits supporting maintenance.
1. Harness Initial Motivation to Build Exercise Habits: When starting a weight loss journey, motivation is often high, and this can be an ideal time to lay the foundation for long-term exercise habits. Although exercise alone has minimal impact on immediate weight loss (which is largely influenced by dietary choices), establishing an exercise routine early on can be invaluable for maintaining weight over time. Using a behaviour design approach, focus on incorporating small, achievable exercises into your routine during this period of heightened motivation. These tiny steps build consistency, helping exercise become an automatic part of your lifestyle—a key factor in successful weight maintenance.
2. Increase Physical Activity: People who maintain weight loss over the long term tend to have higher physical activity levels. Regular exercise, including both aerobic and resistance training, not only supports overall health but also helps preserve muscle mass. Muscle is metabolically active tissue, supporting a higher resting metabolic rate and aiding in weight stability.
3. Address Food Addiction: Food addiction can complicate weight management, making it difficult to maintain loss in the face of cravings. Understanding and addressing any addictive patterns around certain foods can support long-term success and reduce the likelihood of weight regain.
4. Reduce Continuous Sitting: Long hours of sitting, whether at a desk or in front of the television, can contribute to weight regain. Successful weight maintainers often limit continuous sitting to less than two to three hours per day, incorporating standing or movement breaks throughout their day to support metabolic health.
5. Frequent Weight Monitoring (If Comfortable): Regular weight monitoring, if it doesn’t induce stress or anxiety, can help catch minor weight changes early. This allows for prompt action before weight regain becomes more difficult to reverse. For those uncomfortable with the scale, alternative markers, such as clothing fit, can serve as helpful indicators of progress.
6. Keep Blood Pressure in Check: Weight loss can positively impact blood pressure, often reducing the need for medications. However, regularly monitoring blood pressure is important, as it may rise again if weight is regained. Keeping track of blood pressure readings allows you to stay proactive in your health journey, adjusting medications as needed under medical supervision.
By understanding the science of weight regulation and taking a compassionate, multi-modal approach, we can achieve weight loss and long-term success in weight maintenance.
Remember, the journey is about more than just the scale; it’s about finding a healthy, sustainable balance that works for you. Choosing enjoyable foods, incorporating adequate protein, managing carbohydrates for metabolic health, practicing regular movement, and experimenting with time-restricted eating or intermittent fasting can make weight loss maintenance achievable and rewarding.
References:
- Hall, Kevin D. “Energy compensation and metabolic adaptation:“The Biggest Loser” study reinterpreted.” Obesity 30.1 (2022): 11-13.
- Martins, Catia, Barbara A. Gower, and Gary R. Hunter. “Metabolic adaptation delays time to reach weight loss goals.” Obesity 30.2 (2022): 400-406.
- Wing, Rena R., and Suzanne Phelan. “Long-term weight loss maintenance.” The American journal of clinical nutrition 82.1 (2005): 222S-225S.
- Zeevi, David, et al. “Personalized nutrition by prediction of glycemic responses.” Cell 163.5 (2015): 1079-1094.
- Jamshed, Humaira, et al. “Effectiveness of early time-restricted eating for weight loss, fat loss, and cardiometabolic health in adults with obesity: a randomized clinical trial.” JAMA internal medicine 182.9 (2022): 953-962.
