Prevalence and predictors of weight loss maintenance: a retrospective population‐based survey of European adults with overweight and obesity

Abstract

2019) Prevalence and predictors of weight loss maintenance: a retrospective population-based survey of European adults with overweight and obesity J Hum Nutr Diet. 32, 745-753 https://doi.org/10.1111/jhn.12666 † These authors contributed equally to the present study. AbstractBackground: The prevalence of weight loss attempts has increased worldwide, although the extent to which sustained weight loss is achieved is unknown. There is insufficient research into weight loss maintenance (WLM) in individuals with overweight or obesity who have recently lost clinically significant amounts of weight (≥5%), particularly in the European general population. The present study aimed to determine the prevalence and retrospective predictors of WLM in population-based samples of European adults with overweight or obesity who had made a recently completed weight loss attempt. Methods: Participants (N = 2000) in UK, Denmark and Portugal completed an online survey about loss and regain in their most recent completed weight loss attempt, features of their attempt (duration, self-weighing, lapses, strategies), as well as loss of control and binge eating. Multiple regression analysis was used to determine factors retrospectively associated with WLM in those who achieved clinically significant weight loss (n = 1272). Results: Mean (SD) self-reported weight loss was 9% (8%) and mean (SD) regain was 96.3% (9%) of participants' start weight. Twenty-three percent of the total sample had maintained weight loss of ≥5% for at least 1 month. Controlling for weight loss and time since attempt, predictors of better WLM were avoidance of a temporary lapse, infrequent/absent loss of control and binge eating, and use of a greater number of dietary strategies for WLM (r 2 = 0.338, P < 0.001). Principal conclusions: Factors associated with recent successful WLM indicate the importance of the continued use of dietary and other strategies for WLM, particularly in the face of a lapse, as well as the need to manage dysfunctional eating behaviours. 745

Food Liking but Not Wanting Decreases after Controlled Intermittent or Continuous Energy Restriction to ≥5% Weight Loss in Women with Overweight/Obesity

“…Detailed data analysis showed apparent inter-individual variability in food reward variables but was not able to provide information about the mechanism of changes. It could be proposed that dietary strategies to maintain healthy eating habits would help to sustain appetite control after WL and possibly prevent weight regain [ 61 ]. Further studies with larger sample sizes are needed to elucidate the role of liking and wanting during WL and weight maintenance.…”

Evidence-Based Digital Tools for Weight Loss Maintenance: The NoHoW Project

“…We determined how many of these efforts are successful as defined by a WL of ≥5% sustained for at least 12 months. These data informed the design of the digital TK for weight management [14,107].…”

“…To design a digital offering that addresses the needs of European citizens, the project initially examined why a representative sample of European citizens make WL efforts, how often these efforts are made over a year, and the specific methods people use for WL. Information was gained from international surveys of 2,000 consumers in 3 countries, from longitudinal analysis of weight management experience in an existing cohort of 2,000 successful WL maintainers, and from qualitative studies of those engaged in WLM attempts [107]. Because information technology offers cost-effective, scalable, and attractive tools for teaching and supporting these techniques, some of which are currently delivered through resource-intensive face-to-face therapies, the project has developed a digital toolkit (TK) using theoretically informed, evidence-based behaviour change approaches.…”

“…To engage citizens in longer-term weight management, and design evidence-based tools to support them, we characterised weight management practices across Europe. This has established when and how a representative sample of 2,000 Europeans make WL efforts over a year [14,107]. We also followed an existing cohort of 2,000 successful WL maintainers in a commercial weight management programme longitudinally over 12 months to identify the factors that contribute to successful WLM and collected qualitative insights into self-regulatory behaviours in WLM.…”

“…The NoHoW project has gathered an evidence base of weight management practices across Europe and around the world [11] and longitudinally tracked psychological predictors of WLM in a large cohort of commercial weight management participants who have achieved a significant amount of WL and are explicitly seeking to maintain that loss [14,107].…”