A new study says that the key to long-term weight loss and maintenance is to lose weight quickly, not gradually, in the initial stages of obesity treatment.
As part of the study, Lisa Nackers and colleagues, from the University of Florida in the US, and her team examined the association between rate of initial weight loss and long-term maintenance of lost weight, by looking specifically at whether losing weight at a slow initial rate results in larger long-term weight reduction and less weight regain than losing weight at a fast initial rate.
The authors analyzed data for 262 middle-aged obese women who took part in the Treatment of Obesity in Underserved Rural Settings (TOURS) trial.
These women followed a six-month lifestyle program encouraging them to reduce their calorie intake and increase their moderate intensity physical activity to achieve an average weight loss of 0.45kg per week.
They were then supported for a further year with an extended care program involving contact twice a month in the form of group sessions, telephone contact or newsletters.
Nackers and team split the women into three groups according to how much weight they lost in the first month of the intervention. Women in the FAST group lost over 0.68kg per week; those in the MODERATE group lost between 0.23 and 0.68kg per week; women in the SLOW group lost less than 0.23kg per week in that first month.
The authors then looked at the womens' weight loss at 6 and 18 months, as well as any weight regain.
They found that there were long-term advantages to fast initial weight loss.
Fast weight losers lost more weight overall, maintained their weight loss for longer and were not more likely to put weight back on than the more gradual weight losers.
In particular, women in the FAST group were five times more likely to achieve the clinically significant 10 percent weight loss at 18 months than those in the SLOW group and those in the MODERATE group were nearly three times more likely to achieve this milestone than women in the SLOW group.
"Our study provides further evidence that, within the context of lifestyle treatment, losing weight at a fast initial rate leads to greater short-term weight reductions, does not result in increased susceptibility to weight regain, and is associated with larger weight losses and overall long-term success in weight management. We suggest that, within lifestyle weight control programs, substantial efforts should be focused on promoting large rather than small behavioral changes during the initial weeks of treatment," the authors said.
Their findings are published online in International Journal of Behavioural Medicine.