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Does The Rate Of Weight Loss Predict Your Rate of Weight Regain?



scaleThe conventional wisdom, as reflected in almost all dietary recommendations for weight loss, is that it is best to lose weight slowly – the hope is that this will allow time for both your body to adjust to the change in caloric intake as well establishing new “habits”.

Now a study by Katrina Purcell and colleagues from the University of Melbourne, published in The Lancet Diabetes & Endocrinology challenges this dogma.

The researchers enrolled 204 participants (51 men and 153 women) aged 18—70 years with a BMI between 30 and 45 kg/m2 into a two phase, randomised, non-masked, dietary intervention trial.

During Phase 1, participants were randomly assigned to either a 12-week rapid weight loss or a 36-week gradual programme, both aimed at 15% weight loss. At the end of this phase, 51 (50%) participants in the gradual weight loss group and 76 (81%) in the rapid weight loss group achieved 12·5% or more weight loss in the allocated time and were then switched to Phase 2, which consisted of a weight maintenance diet for 144 weeks.

By the end of Phase 2, about 70% of both the rapid and gradual gainers had regained all their weight.

Thus, in this first randomised controlled trial of its kind, there does not appear to be any relevant benefit of losing weight faster or slower – in the end (about 2.5 years later), the vast majority of participants in either group will have regained any weight lost.

On a positive note, the study dismisses the dogma that weight lost quickly is regained just as fast.

On a negative note, the study also confirms just how dismal the results of dietary attempts to lose weight and keep it off really are.

I may sound like a broken record – but we do need better treatments for weight-loss maintenance!

@DrSharma
Kingston, ON

3 Comments

  1. Actually the fair way to describe this unexciting study is to report that regardless of how fast subjects lost the same amount of weight assigning them to the exact same (crappy) diet to keep it off, leads both groups to gain it back just as quickly. Go figure. Could/should have been published in the Journal of Duh.

    Not a helpful study, and definitely doesn’t speak to the losing fast/slow question one way or the other.

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  2. I would be interested to see what these scientists think constitutes a maintenance diet is. I would bet you $5 US that it reflects the common wisdom (cultural mythology) that a maintenance phase is less restrictive than a weight-loss diet phase. If so, then everyone was set up for failure.

    The truth of the matter is that whatever a person is doing in the final week that he or she loses a pound is the bar that must be jumped for the remainder of his or her life, both with regard to food restriction and rigorousness of exercise. The bar never gets lower, and with menopause may become even more challenging.

    Grrr.

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  3. You can’t maintain weightloss if you go back to eating the way you ate hen you gained weight in the first place, and you can’t starve yourself permanently. This is the ironic (rather pathetic) logic used by the average dietitian as “weight loss advice”: Do everything to put yourself in starvation and stay that way for life. Oh, you can’t do that? Well, that’s because you are glutonous, not because our advice is idiotic.

    Sustained weight loss that can be maintained comes from eliminating crappy foods (filled with sugar and processed grains usually), increasing fats (especially saturated) and protein, and ensuring adequate sleep. Exercise is great for health but nearly meaningless for weight loss.

    Take Sweden for example: they’ve accepted a low-carb, high-fat (LCHF) diet as a good treatment for obesity, but continue to espouse the standard grain-filled, industrial-oil-drizzled garbage diet as the “normal” recommended diet, so those people who successfully lose weight on a LCHF diet will then be told to re-introduce the carbs that made them fat, and will subsequently regain their weight. Shocking.

    (As a side note: a LCHF diet will not be sufficient for everybody to lose weight, but significantly reducing carb consumption is likely an important step for most, if not all, people to lose weight. Weight management: it’s about the hormones more than the calories.)

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