Taking Off Pounds Sensibly Works For Those Who Stick With It



TOPS_logoAlthough the same can probably said for most ethical weight management programs, actual data on the long-term benefits of sticking with a structured weight management program are hard to come by.

This is why the recent paper by Nia Mitchell and colleagues from the University of Colorado, published in the American Journal of Preventive Medicine is of considerable interest.

The study looks at long-term weight loss of participants who joined Take Off Pounds Sensibly (TOPS), a US nonprofit, low-cost, peer-led weight-loss program between 2005-2011 (207,469 individuals) and consecutively renewed their annual membership at least once 74,629 (35.9%).

Mean weight loss for those who renewed their membership at least once was 6% and 8% for the 2,289 participants with 7 years of consecutive annual renewal.

Three points are probably worth emphasizing: for one, as with most weight loss programs, only a small proportion of individuals stick with it even for just a year (in this case about 35% which is still probably better than for most programs that I am aware of). Long-term members (in this case about 10%, who manage to stick with the program for at least 7 years) are even a greater minority.

Secondly, those who stick with the program in the long-term are able to sustain their benefit – of course it is hard to prove that this long-term benefit is actually causally related to the program – after all, the kind of people who make long-term commitments to a weight management program may well differ from the general public in other ways that may be important for their success.

Thirdly, the study illustrates that the average weight loss even for those who stick with the program over 7 years manage to keep off only about half of what is generally seen in long-term studies with bariatric surgery (about 20% weight loss over 15-20 years).

None of this takes away from the success of the TOPS approach to long-term weight management – it does however illustrate that even one of the best and longest running “lifestyle” management approaches to weight management, faces the usual challenges of attrition and plateauing weight loss at a level that may be less than what many living with severe obesity would consider a satisfactory outcome.

Kudos to TOPS for allowing this public analysis of their data – few other weight loss programs would dare to do the same.

@DrSharma
Edmonton, AB