OBJECTIVE: To describe factors associated with long-term maintenance of weight loss.
DESIGN AND SUBJECTS: We identified initially overweight individuals (body mass index>27 kg/m2, n=911) from the nationwide Finnish Twin Cohort and studied those who lost at least 5% of their body weight between 1975 and 1981. Subjects who had maintained weight loss until 1990 (38 men, 17 women) were compared to both re-gainers (28 men, 26 women) and the other overweight subjects in the cohort.
MEASUREMENTS: Self-report data on weight, height, health behaviours and perceived well-being; self-report and register-based data on health status and use of medication.
RESULTS: Only 6% of all overweight individuals lost and maintained at least 5% weight loss. In men weight loss maintenance was associated with a low level of stress and health-promoting behaviours but also with medical problems. Failure to maintain weight loss seemed to be associated with stressful life and past high alcohol intake. In women weight loss maintenance was associated with low initial well-being and health-compromising behaviours that improved after weight loss.
CONCLUSION: Long-term weight loss maintenance is rare. Predictors of weight loss maintenance are different between women and men.
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Korkeila M, Kaprio J, Rissanen A, Koskenvuo M . Consistency and change of body mass index and weight. A study on 5967 adult Finnish twin pairs Int J Obes 1995 19: 310–317.
Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO . A descriptive study of individuals successful at long-term maintenance of substantial weight loss Am J Clin Nutr 1997 66: 239–246.
Coakley EH, Rimm EB, Colditz G, Kawachi I, Willet W . Predictors of weight change in men: Results from the health professionals follow-up study Int J Obes 1998 22: 89–96.
French SA, Jeffery RW, Forster JL, McGovern PG, Kelder, SH, Baxter JE . Pridictors of weight change over two years among a population of working adults: The Healthy Worker Project Int J Obes 1994 18: 145–154.
French SA, Jeffery RW, Folsom AR, McGovern P, Williamson DF . Weight loss maintenance in young adulthood: prevalence and correlations with health behavior and disease in a population-based sample of women aged 55–69 years Int J Obes 1996 20: 303–310.
Hunter GR, Weinsier RL, Bamman MM, Larson DE . A role of high intensity exercise on energy balance and weight control Int J Obes 1998 22: 489–493.
Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO . Psychological symptoms in individuals successful at long-term maintenance of weight loss Health Psychol 1998 17: 336–345.
Kahn HS, Tatham LM, Rodriguez C, Calle EE, Thun MJ, Heath CW, Jr . Stable behaviors associated with adults' 10-year change in body mass index and likelihood of gain at the waist Am J Public Health 1997 87: 747–754.
Hellerstedt WL, Jeffery RW, Murray DM . The association between alcohol intake and adiposity in the general population Am J Epidemiol 1990 132: 594–611.
WHO . Obesity: Preventing and managing the global epidemic. Report of a WHO consultation on obesity, 3–5 June 1997. World Health Organisation: Geneva 1998.
Williamson DF . “Weight cycling” and mortality: How do the epidemiologists explain he role of intentional weight loss? J Am Coll Nutr 1996 15: 6–13.
Williamson DF, Pamuk E, Thun M, Flanders D, Byers T, Heath C . Prospective study of intentional weight loss and mortality in overweight white men aged 40–64 years Am J Epidemiol 1999 149: 491–503.
French SA, Folsom AR, Jeffery RW, Williamson DF . Prospective study of intentionality of weight loss and mortality in older women: The Iowa Women's Health Study Am J Epi-demiol 1999 149: 504–514.
Korkeila M, Rissanen A, Kaprio J, Sörensen TIA, Koskenvuo M . Attempts to lose weight and risk for major weight gain. A prospective study on adult Finns Am J Clin Nutr (in press).
Tinker JE, Tucker JA . Environmental events surrounding natural recovery from obesity Addictive Behav 1997 22: 571–575.
Foreyt JP, Brunner RL, Goodrick GK, Cutter G, Brownell KD, St Jeor ST . Psychological correlates of weight fluctuation Int J Eating Disord 1995 17: 263–275.
Rumpel C, Ingram DD, Harris TB, Madans J . The association between weight change and psychological well-being in women Int J Obes 1994 18: 179–183.
Greeno CG, Wing RR . Stress-induced eating Psychol Bull 1994 115: 444–464.
Korkeila M, Kaprio J, Rissanen A, Koskenvuo M, Sörensen TIA . Predictors of major weight gain in adult Finns: Stress, life satisfaction and personality traits Int J Obes 1998 22: 949–957.
Glenny Am, O'Meara S, Melville A, Sheldon TA, Wilson C . The treatment and prevention of obesity: A systematic review of the literature Int J Obes 1997 21: 715–737.
Colvin RH, Olson SB . A descriptive analysis of men and women who have lost significant weight and are highly successful at maintaining the loss Addictive Behav 1983 8: 287–295.
Kaprio J . Lessons from twin studies in Finland Ann Med 1994 26: 135–139.
Korkeila M, Kaprio J, Rissanen A, Koskenvuo M . Effects of gender and age on the heritability of body mass index Int J Obes 1991 15: 647–654.
Kaprio J, Koskenvuo M . A prospective study of psychological and socioeconomic characteristics, health behavior and morbidity in cigarette smokers prior to quitting compared to persistent smokers and non-smokers J Clin Epidemiol 1988 41: 139–150.
Kaprio J, Koskenvuo M, Langinvainio H, Romanov K, Sarna, Rose RJ . Genetic influences on use and abuse of alcohol: A study of 5638 adult Finnish twin brothers Alcohol Clin Exp Res 1987 11: 349–356.
Kujala UM, Kaprio J, Sarna S, Koskenvuo M . Relationship of leisure-time physical activity and mortality: The Finnish twin cohort JAMA 1998 279: 440–444.
Allardt E . About dimensions of welfare. An explanatory analysis of a comparative Scandinavian survey. Research group for comparative sociology. University of Helsinki, Research Report 1 1973.
Koivumaa-Honkanen, H.-T . Life satisfaction as a health predictor. Doctoral Dissertation, D. Medical Series 143. Kuopio University Publications: Kuopio 1998.
Räiha I, Kemppainen H, Kaprio J, Koskenvuo M, Sourander . Lifestyle, stress, and genes in peptic ulcer disease: a nationwide twin cohort study Arch Intern Med 1998 158: 698–704.
Rose GA, Blackburn H, Gillum RF, Prineas RJ . Cardiovascular survey methods. World Health Organisation: Geneva 1982.
Partinen M, Putkonen PT, Kaprio J, Koskenvuo M, Hilakivi . Sleep disorders in relation to coronary heart disease Acta Med Scand 1982 660: 69–83.
Hublin C, Kaprio J, Partinen M, Heikkilä K, Koskenvuo M . Daytime sleepiness in an adult, Finnish population J Intern Med 1996 239: 417–423.
Kramer FM, Jeffery RW, Forster JL, Snell MK . Long-term follow-up of behavioral treatment for obesity: Patterns of weight regain among men and women Int J Obes 1989 13: 123–136.
Björntorp P . Endocrine abnormalities of obesity Metabolism 1995 44: 21–23.
Gemert WG van, Svereijns RM, Greve JW, Groenman N, Soeters PB . Psychological functioning of morbidly obese patients after surgical treatment Int J Obes 1998 22: 393–398.
Stunkard AJ, Sörensen TIA . Obesity and socioeconomic status—a complex relation New Engl J Med 1993 329: 1036–1037.
French SA, Jeffery RW, Folsom AR, Williamson DF, Byers T . Relation of weight variability and intentionality of weight loss to disease history and health-related variables in a population-based sample of women aged 55–69 years Am J Epidemiol 1995 142: 1306–1314.
Neumark-Sztainer D, Jeffery RW, French SA . Self-reported dieting: How should we ask? What does it mean? Associations between dieting and reported energy intake Int J Eating Disord 1997 22: 437–449.
Kuskowska-Wolk A, Bergström R, Boström G . Relationship between questionnaire data and medical records of height, weight and body mass index Int J Obes 1992 16: 1–9.
Jalkanen L, Tuomilehto J, Tanskanen A, Puska P . Accuracy of self-reported body weight compared to measured body weight. A population survey Scan J Soc Med 1987 15: 191–198.
French SA, Jeffery RW, Folsom AR, Williamson DF, Byers T . Weight variability in a population-based sample of older women: Reliability and intercorrelation of measures Int J Obes 1995 19: 22–29.
Supported in part by grants from the Academy of Finland (nos 42022 and 37800)
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Sarlio-Lähteenkorva, S., Rissanen, A. & Kaprio, J. A descriptive study of weight loss maintenance: 6 and 15 year follow-up of initially overweight adults. Int J Obes 24, 116–125 (2000). https://doi.org/10.1038/sj.ijo.0801094
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