Wednesday, November 19, 2014
Here is what we had to say about the third common misconception in our paper published in Canadian Family Medicine:
Approximately two-thirds of people who lose weight will regain it within 1 year, and almost all of them will regain it within 5 years.
Although dieting (ie, caloric restriction) to lose weight is a difficult task, the maintenance of lost weight requires the patient to deploy even greater efforts.
Rather than a simple lack of willpower, the relapse of most individuals to their previous weight after otherwise successful weight loss is largely driven by the coordinated actions of metabolic, neuroendocrine, autonomic, and behavioural changes that oppose the maintenance of reduced body weight.
The few individuals successful at maintaining weight loss (at least 13.6 kg for at least 1 year) generally have common behaviour and strategies that include consuming low-energy, low-fat diets; engaging in high levels of physical activity; consistent self-monitoring of body weight and food intake; eating breakfast regularly; and demonstrating a high level of dietary restraint.
It is highly unlikely that some of this behaviour can be emulated by most of the population with excess weight.
There is also concern that unhealthy weight control methods (eg, fasting, meal skipping, laxatives, diuretics, stimulants) might ultimately lead to a larger weight regain and pose a risk to both mental and physical health.
Thus, although sustained weight loss with diet alone can be possible for some individuals, agreeing on realistic weight-loss expectations and sustainable behavioural changes is critical to avoid disappointment and nonadherence.
Weight regain (relapse) should not be framed as failure but as an expected consequence of dealing with a chronic and complex condition like obesity.