How to Maintain Weight Loss After Working So Hard to Lose the Pounds

“The challenge of losing weight is very different from the challenge of maintaining the loss,” notes James Hill, PhD, associate professor of Physiological Psychology at the University of Colorado in Denver. “Most Americans trying to lose weight think, ‘okay, I’ll subject myself to this program for 12 weeks. I can put up with anything for that long.’ But they don’t give a lot of thought to the changes in behaviors that will help them maintain the loss.”

Until recently, this way of thinking was aided and abetted by the diet industry, which also devoted more attention to weight loss than to maintenance. A section on maintenance is tacked on to most diet books and programs mostly as a “post script” that basically says “keep it up.” The traditional assumption was that the nuts and bolts of an intense weight-loss program—counting fat grams and calories or weighing portions—could easily become a permanent part of life. But the reality is that weight maintenance involves switching from a restricted reducing diet to a more flexible set of eating patterns that will keep you at your desired weight. By their nature, those new habits are harder to set down as a simple set of rules.

A wake-up call to focus on weight maintenance was sounded in 1994, when dieting guidelines published by the National Academy of Sciences revealed that the average dieter regains two-thirds of lost weight within one year and almost all within five years. The report noted that although different weight-loss programs use different diets and strategies, none have been able to overcome this basic pattern. “My impression is that the success people have in maintaining their weight loss appears to be entirely unrelated to how they lost the weight,” says Dr. Arthur Frank, medical director of the George Washington University Obesity Management Program. “Most weight-loss diets do work in the short term. The problem is, we have not yet evolved good techniques for maintenance.”

Happily, this is beginning to change, and there are now a lot of clues as to how and why some people succeed at “keeping it off,” while others seem to return to their old weights just as soon as they’ve purchased a smaller-sized wardrobe. Here we look first at the success stories—the characteristics and approaches of people who manage to control their weight long-term. Then we explores how to cope with the psychological implications of having a healthier, slimmer body; and, how to develop weight maintenance techniques that fit your own personality and lifestyle.

Principles of Success

What can we learn from the few people who DO succeed at long-term weight control? A number of researchers have begun to answer this question through innovative efforts such as the National Weight Control Registry. This program keeps track of over 3,000 people from around the country who have succeeded at long-term weight maintenance. Other research has compared groups of dieters who regain their weight to those who are able to maintain their new, lower weight for several years or more.

Perhaps the most heartening finding is that, despite extensive histories of overweight and failed dieting attempts, nearly half (42 percent) the registry members report that maintaining their weight loss is less difficult than the effort involved in initially losing the weight. Less heartening is the fact that the majority aren’t quite as lucky. Indeed, when asked how difficult it was for them to maintain their weight, their answers ranged from “moderately hard” to “very hard.” Even people who have never had to lose weight often report that they have to work hard to avoid gaining.

Accepting the fact that weight maintenance is a difficult task may be an important first step towards success. The triumph of losing weight makes it easy to develop illusions of invulnerability—“I’ll never backslide; I’m going to stick to this diet for the rest of my life.” Recognizing that the task is hard, and that some degree of failure is inevitable, will prepare you to cope with the obstacles ahead. You can set aside the notion that now that you’ve lost weight, your problems are solved and you can go back to being spontaneous, forgetful, and unconscious about what you eat. People who do acknowledge the difficulty of weight maintenance seem to be able to rise to the challenge and formulate realistic goals that they can take pleasure in meeting.

Overcoming the Body’s Inertia

“There seems to be a powerful but elusive signal that makes people return to their original weight,” endocrinologist F. Xavier Pi-Sunyer, director of the Obesity Research Center at St. Luke’s-Roosevelt Hospital Center in New York told the New York Times. “We now know that it is unrealistic to expect a very heavy person to be thin.”

Indeed, research at Rockefeller University has revealed a “self-adjusting” mechanism at work in the body’s metabolism. When you lose weight, your metabolism slows down, burning fewer calories than before, and making calorie control all the more imperative. This seems especially true in the months immediately following the start of a diet. However, the metabolic slowdown doesn’t seem to be permanent. Researchers at the National Weight Control Registry found no evidence of a sluggish metabolism when comparing 40 long-term weight-loss winners with a group of non-dieters, suggesting that metabolism eventually returns to normal.

For many people, maintaining modest weight loss is a more appropriate goal than struggling to remake themselves completely. Very heavy people can often substantially improve hypertension, cholesterol, and blood sugar levels, and sometimes even decrease their risk of cardiovascular disease, by losing just 10 percent of their body weight, said Dr. Pi-Sunyer. If they can keep this weight off for a year, they can then try for another 10 percent, he suggests.

Studies comparing weight maintainers to regainers have yielded some interesting insights that may help you devise a weight maintenance program to suit your needs and abilities.

Weight History

The ease of maintaining dietary changes that produce weight loss seems to be related to individual weight history. In a worksite study at a large Midwestern university campus, the dieters involved had been overweight since they were anywhere from 5 to 60 years old. But researchers found that the problem had begun earlier among those who regained weight—on average, at age 26, compared to age 33 for those who succeeded in maintaining their weight loss. Only one of the weight maintainers—but seven of the regainers—reported being overweight as a child.

If you have a long history of being overweight, you should recognize that maintenance may be especially challenging. You may need to seek long-term medical and/or social support to help you create and stay with a maintenance program. A study from the Annals of Internal Medicine found that physician advice and encouragement helped individuals both lose weight and maintain the loss.

Weight Cycling

A history of dieting and regaining weight may also make it more difficult to finally become a maintainer. In one study, subjects averaged six cycles of losing and regaining weight within the past 5 years. Dieters who had been through fewer weight “yo-yos” had an easier time maintaining weight than those who had lost and regained many times. Though some reports now insist that past weight cycling does not make future maintenance more difficult, a tendency to yo-yo is, if nothing else, a signal that you really need to make weight maintenance a serious, long-term priority. Trying to lose weight may actually be a mistake during periods in life when more urgent needs, such as coping with a personal, family, or career crisis, demand your attention. A strong effort to lose and then maintain your weight when other conditions in your life are more settled may allow for greater success. This is bound to be better than the frustration of many half-hearted attempts at inopportune moments.

Education

Dieters who keep their weight off tend to have more years of education than those who regain weight, according to a study in the Journal of the American Dietetic Association—(a mean of 14.2 years of education for regainers, compared to 15.8 years among maintainers).

This finding seems to reinforce the notion that learned skills are the key to weight maintenance. It doesn’t mean that if you have less education, you are bound to fail, but you may need to mount a deliberate effort to learn necessary maintenance skills. If “book learning” is not your style, you can try videos or an audio tape behavior modification program.

Food Awareness

Successful maintainers report that they use a variety of approaches, including reducing calorie and fat content of their food, and increasing activity. Most often, maintainers alter their lifestyles and food choices but don’t completely deny themselves favorite foods. Unlike regainers, maintainers are always aware of their food consumption and quickly respond to weight gain with changes in habits. Relapsers, on the other hand, tend to rely on diet foods or formulas, attend weight-control groups—and continually feel deprived.

Taking a positive approach to weight maintenance means making sure that your eating plan is both pleasurable and fun. And keeping track of your results allows you to nip an incipient gain in the bud.

Activity Levels

The amount of leisure time devoted to physical activity is among the key differences between weight maintainers and regainers found in every study thus far. The differences are dramatic. A large study at Kaiser Permanente Health Care group in Freemont, California found that 90 percent of maintainers—but only 34 percent of relapsers—exercised regularly. Interestingly, most maintainers (90 percent) chose walking as their exercise. The fact that they liked this form of exercise helped them stay with it. Exercise helps weight maintenance by burning excess calories, squelching appetite, and increasing lean muscle tissue, which in turn increases your metabolism.

The type of exercise you choose could also affect your weight maintenance efforts. According to research published in the June 2001 issue of Medicine and Science in Sports and Exercise, a combination of aerobic exercise (such as walking or bike riding) and weight training provides the biggest bang for your buck. Many dieters already do aerobic exercise, but lifting weights to build muscle can be just as important. In fact, scientists say that while aerobic exercise burns more calories as you’re doing it, the metabolism slows back to normal within half an hour. Women who lift weights, on the other hand, burn more calories for 2 hours after their workouts.

The message here goes beyond the obvious (and important) recommendation to make exercise or some kind of physical activity an integral part of your life. It’s also a warning that you can be especially vulnerable to weight gain during periods when you cannot exercise. Bad weather, minor illnesses or injuries, and a stretch of intense busyness or personal crises can all interfere with your exercise schedule. While it may not be possible to overcome these barriers immediately, watching what you eat during these times can help you maintain your weight until you’re able to exercise again.

Skills and Support

Research shows that people who maintain weight loss generally get more help from others and attack problems more easily than those who do not. “Maintainers had a better social support network; most had three or more people they could turn to,” according to a study published in the American Journal of Clinical Nutrition, by Judith S. Stern, Sc., professor of Nutrition and Internal Medicine at University of California, Davis. “Maintainers also had better problem-solving skills. When faced with a relapse, regainers more often used escape-avoidance—‘I’ll deal with this problem tomorrow’—while maintainers knuckled down and tried to analyze and solve the problem.”

It may be helpful, therefore, to view stabilizing your weight loss as a difficult set of puzzles to solve. As soon as you get one puzzle figured out—for example, devising a shopping schedule to keep fresh fruits and vegetables in the house—another one crops up. Holiday dinners, business luncheons, travel, a sprained knee that keeps you from exercising, a new office mate who brings in your favorite butter cookies, your mate giving up and gaining 10 pounds, a personal crisis … . The list is endless. But you can develop skills for solving each dilemma and find help in this effort by seeking out support from smart and sympathetic friends. “Continued contact with formal weight- loss programs is a predictor of maintenance success,” notes Stern.

Personalization

One of the most interesting research findings is that weight maintainers choose from a wide variety of strategies, personalizing their weight-loss programs to reflect their own needs, tastes, and lifestyles. In the Kaiser study, both those who maintained and those who relapsed used many of the same strategies to lose weight, but those who maintained their weight loss adapted these strategies in ways that were specific to their own lifestyle. Maintainers were more likely than relapsers to devise a personal eating plan and to make attempts to avoid feelings of deprivation when changing their eating patterns.

The Psychology of Weight Maintenance

A weight-loss diet is comparable to a sprint to the finish line: exciting, fast-paced, goal-oriented, and all-consuming. But maintenance is more like a long distance run: It requires pacing, picking yourself up after a fall, and nurturing your own motivation and enthusiasm.

Along with the nuts and bolts of staying nutritionally aware and active, maintenance also involves a subtle process of adjusting to and accepting your new, thinner self. Some people regain weight because they can’t get comfortable in their slimmer bodies. Significant weight loss often requires people to adjust to changes in their relationships, and to manage the excitement and pressures that their trim new look can provoke.

In our weight-obsessed society, the successful pound loser is apt to receive a lot of attention. While lapping up compliments might seem like an easy task, you may also face jealousy and subtle put-downs. Unexpected reactions may make you feel insecure and even overwhelmed at first. The repercussions of changing any long-standing pattern of self-destructive behavior, such as overeating, can throw you and your self-esteem into a psychological tailspin.

Dealing With Jealousy

“When people notice you slimming down, it can be threatening at first,” says Helen Singer Kaplan, MD, PhD, director of the human sexuality program at New York Hospital-Cornell Medical Center. The king-size reactions you’re likely to get from friends and family can be disconcerting, ranging from “Wow, you look great;” to such backhanded compliments as “You should have done this ten years ago;” to the outright hostility of “I hate you—I wish I could lose 20 pounds.” There may also be frequent demands to know your “secret” and “how you did it,” which can lead you into long, dull conversations about dieting.

A good way to deal with these reactions is to be prepared. Try role playing with family or a trusted friend, or just with yourself, in the mirror. Think of what people are likely to say and prepare your replies in advance. Often a casual “thank you” and a swift change of subject is best. One woman decided to answer the “how did you do it?” question with “the usual way, less eating and more exercise.” Also, find comfortable responses to jealous reactions from a spouse or friends. Explaining that keeping the weight off isn’t easy is one way to counteract the implication that some special ability is allowing you to succeed easily where others have failed. Directly asking for the other person’s support (“It would help me stick to my plan if you didn’t insist that I try your dessert,”) may also help temper envious responses.

Making Friends with Your Slimmer Self Incredibly, many weight losers have trouble accepting as "real" the body they've worked so hard to create. After years of living with excess pounds, their new physique doesn't quite seem natural—as though it belongs to someone else. If you find yourself succumbing to this feeling, you must take steps to get over it. The idea that somehow you really should be heavier can easily become a self-fulfilling prophecy. Make a deliberate effort to get used to your new appearance as quickly as possible. Study yourself on a daily basis. Get new clothes that fit your body to its best advantage. Spend more time on grooming and beauty care. This all may seem rather self-absorbed, but it's a necessary psychological step towards your goal of maintaining a healthy weight long-term.

Dealing with Sex

Increased attention from the opposite sex, including flirtation from co-workers and glances and comments from strangers, may be an unexpected (or desired) result of weight loss. If this occurs, it’s a good idea to examine how you feel about it. While the attention may be flattering, it can also be disconcerting and inappropriate. For some people, the loss of weight means a loss of protective covering that must be replaced with new ways of handling people. Don’t fall into the trap of regaining weight to retreat to more comfortable and familiar social relationships. Learn to politely but firmly discourage unwanted attention. If sexual harassment becomes a genuine danger and you can’t seem to cope, don’t hesitate to seek counsel from an appropriate therapist.

Accepting Your New Self

Along with dealing with others in a new way, you may have to talk with yourself about the “new you.” The weight comes off your body first, but you need to give your mind time to get used to it. Most people find they need to accept both who they are now, and who they were when they were heavier—rather than demonize their old self as “fat” or “disgusting.” Some feel an odd sense of disloyalty to their former, heavier self when they enjoy their new shape. They may also face a sense of unreality, or image anxiety, and need to remind themselves that “I’m still the same person, though others may not see it that way.”

You can help yourself accept your new appearance with a number of simple steps. One is to look at yourself naked in the mirror every day—to get used to the way your body has changed and acknowledge it as your own. Try to avoid being critical about what you see and instead view yourself as kindly as you would a good friend. It helps to remember that “you are what you think you are,” and to feed yourself positive thoughts.

Learning to claim and enjoy your new body is a good way to hold on to it. Some people “show off” in the privacy of their own home, wearing attractive, form-fitting clothing or lingerie around the house to get used to seeing a positive reflection. Body-nurturing, grooming, and beauty rituals also promote a healthy body image. Try some simple acts of kindness to yourself, such as soaking in an aromatic bath, applying body lotion, and taking special care of your hair, nails, and skin.

While laying claim to your new body, cultivate a positive self-image, as well. The following exercises can help you reinforce self-esteem:

Weight Maintenance Skills

Once you’ve lost the weight and have come to accept your new appearance, you have to develop new skills to hold onto your hard-won gains. While there is no simple formula for keeping weight off, there are skills you can develop that will help you maintain your desired weight and make maintaining it more automatic.

The “C” Word

Long-term weight management requires a conscious commitment—one just as strong, or stronger than the one you made in deciding to lose weight. Permanent commitments can seem daunting; “for the rest of my life,” has a tone of finality that may evoke a rebellious spirit—“how do I know, at this point, what I want to do for the rest of my life?”

So with maintenance, as with any large project, it’s a good idea to break the task down into smaller, doable segments. Many people find it easier to make a commitment to maintain their current weight for one year. Your maintenance pledge can be made on a memorable day—New Year’s, Valentine’s Day, your birthday—and be up for reconsideration and renewal 12 months later (after a suitable celebration of your first year’s success).

The commitment should be specific—something like: “I will continue to go to exercise class 3 times a week. I will continue to use vegetables for my snacks. I will continue to restructure the way I think and act about food so that I can maintain a healthy weight. I know this is a major challenge and that I may occasionally slip up, but I can do this. It’s my responsibility and although I may ask others for help, I understand this is something no one can do for me.”

Once the commitment is made, keep visualizing your success. Imagine yourself a year from today, still able to get into your current sized jeans. Imagine yourself relaxed and happy, eating foods you like that are also good for you.

Create New Habits

Habits are an economical use of our mental energy. Most of us develop a set morning routine, for example, so that we don’t waste time when we wake up wondering whether or not to brush our teeth today. Years ago you decided to brush your teeth every morning and now you just do it without thinking.

In the same way, weight maintenance becomes a much easier proposition once you’ve established good nutritional habits. Simplification and preparation are the key to getting new habits in place. For example, if you don’t habitually eat breakfast but have decided to do so to boost your morning energy and prevent overeating at lunch, start with a simple approach. Dr. Stern suggests eating the same breakfast every day until the habit is firmly embedded. Prepare by keeping the things you want for breakfast always on hand.

In times of stress, notes Dr. Stern, your old poor eating habits and non-nutritional lifestyle may prove stronger than newly learned habits. To avoid falling back into old habits, you need to trigger your new habits on a daily basis. For example, put a note on the mirror reminding yourself to eat breakfast, and set out dishes and some ingredients the night before.

Simplifying your approach to food makes it easier to form new habits. Choose a nutritional plan that feels comfortable and doable. If possible, reduce your plan to a simple-to-remember formula. For example, plan to eat a fruit or vegetable with each meal or snack, or set a fixed number of portions from each food group to eat every day. Keep your plan in your wallet and look at it before you buy your lunch. Also remember to drink plenty of fluids. Dehydration causes you to feel weak, tired, and light-headed. These symptoms also mimic hunger and may lead you to snack when all you really needed was water or juice. Drinking eight glasses of water a day will also help you feel more energetic and fit.

And finally, be sure to get enough shut-eye. Researchers at the University of Chicago report that chronic sleep loss can reduce the body’s ability to perform basic metabolic functions such as processing and storing carbohydrates or regulating hormones. The scientists found that cutting sleep time from the standard 8 hours down to 4 hours produced striking changes in glucose tolerance and hormonal levels that mimicked the early stages of diabetes. Such changes could potentially derail your weight maintenance program.

Connect with Hunger

People who have never had a weight problem tend to eat when their body says “I’m hungry.” But hunger signals may be a mystery to those of us who have been through various deprivation diets. Judith Matz, co-director of the Chicago Center for Overcoming Overeating, suggests it’s possible to relearn to identify and respond to hunger signals and to eat when they occur. “With practice you can reconnect your eating with internal cues,” she says. “Doing so helps you distinguish between a bodily urge for nourishment and the desire for emotional comfort from food.” This doesn’t mean you should never reach for food out of emotional hunger, but that you should know it when you do. Sometimes you may choose to satisfy an emotional hunger with food, but other times you may decide to fill it with a phone call to a good friend or another more direct satisfaction of your emotional needs.

If you often feel hungry between meals, consider adjusting your food choices. Some foods have “staying power,” notes Sybil Ferguson of The Diet Center Program. They stay longer in your system, helping you feel more satisfied and energetic. Many foods low in calories, such as prepackaged convenience diet foods, are also low in “staying power” because they’re digested quickly. Natural foods with lots of fiber, such as oatmeal, vegetables, and fruits—are helpful for maintenance because they take longer to chew and to digest, and they create a full feeling in your stomach.

Skipping meals, either because of time crunches or out of guilt from previous overeating, interferes with the steady state of satisfaction that makes maintenance easier. When the body has been deprived of food for many hours, your blood sugar level drops, leading to cravings for immediate energy boosts. Eating a balanced selection of foods on a consistent schedule helps stabilize your blood sugar level and hunger sensations, so you can continue to make intelligent decisions about eating.

Avoid Deprivation

A sense of deprivation (“oh, I wish I could eat that,” “you’re lucky, you can eat anything,” “I used to be able to finish a whole cake at one sitting”) is a prime enemy of long-term weight maintenance. Tyrannical diet programs do work well for short-term weight loss, but over the long haul, we all need to eat for pleasure as well as nourishment. Meals are among the most pleasurable social events in life, and it pays to learn to take pleasure in the foods that are good for you.

Keep a list of foods or dishes you particularly like that also fit in with weight maintenance. One man’s list includes: pancakes with fresh strawberries, grilled mushrooms, mussels marinara, linguine with tomato sauce, crusty Italian bread, and sorbet. When he finds himself missing his old bacon, eggs, and steak diet, he treats himself to all of his favorite nutritious foods in the same day. It keeps his spirits up without expanding his waistline.

Whenever you feel hungry, there’s always something you can eat that will be satisfying without threatening your weight stability. Try keeping the refrigerator stocked with fresh fruits and vegetables—especially when you’ll be spending a lot of time at home for a few days. Treat yourself to exotic and out of season fruits and vegetables when they look inviting in the market. You’re probably spending a lot less than you used to on meat and sweets, so this is not such an extravagance. Nibble on red peppers, fresh young carrots, and cucumbers dipped in a low-fat sauce (no-fat salad dressing makes a quickie dip).

Monitor Your Weight

Some people use the scale. Others keep a food journal. Still others check in with a certain skirt or pair of pants. But most successful weight maintainers use some kind of daily weight checkup. If they find they’ve put on a pound or two, they quickly try to ease themselves back on track. This may involve relaxation efforts, visualizing more nutritional eating, or being extra careful for a few days. But once a 5-pound gain has occurred, you should consider it a “weight emergency” and construct a relapse recovery plan.

Return from Relapse

“Everyone should expect to have slips from their weight maintenance program,” says Professor James Hill. “The trick is not to let it go on too long. After you’ve gone off a routine for several days, it’s easy to slip into complete relapse. The most important thing is to recover as soon as possible.”

The first step in recovery is to identify the problem(s). List all possible reasons to finish the sentence, “I’ve started gaining weight again because … .” Your list may include: “I’ve been unable to exercise,” “I’ve been too busy to grocery shop and cook,” “I have the winter blahs,” “I’ve been under a lot of stress,” “I got tired of eating sensible foods.”

Then adopt an optimistic stance about your ability to bounce back from hard times. Assume responsibility for your actions and beliefs—this puts you firmly in control of your future. Come up with some solutions for each of the stresses that undercut your program. For example, a new low-fat cookbook or cooking class can help you combat food boredom. If grocery shopping is the sore point, perhaps you can enlist a family member to help out.

When you’ve patched together a recovery plan to meet your needs, gather strength for the new change by tapping into your support network. Everyone needs at least one person to talk to about weight maintenance—someone who is positive and reinforces your decisions. If you were part of a formal weight-loss program, check in with the support group whenever you need to recover from a lapse.

Relapses can be a bit humiliating. After all, you may have spent 18 months carefully keeping yourself in nutritional balance, and now, in what seems like a short time, you’ve gained 10 pounds. But focusing on your own strengths, remembering previous accomplishments, and setting realistic goals for the future can soon have you back on the maintenance track.

Most of all, keep in mind that it won’t always be this hard. An article in Obesity Research reports that the risk of regaining weight seems to decrease over time, and those who’ve maintained weight loss for an extended period don’t need as much effort to keep the weight off.

Feed Your Emotional Needs

The trick to avoiding relapses—and coping with those that occur—is to remember that you’re a capable, lovable human being who can accomplish your goals. Nurturing your own self-esteem can help you cope with the stress and burnout that so often lead to overeating. When you feel tired, bored, quick to anger, withdrawn, rigid and ineffective, you’re most apt to abandon your nutritional program. It helps to remember the positive side of your weight-loss experience: feelings of being in control, reaching goals, making peace with your appetite, taking care of yourself. It’s easy to believe in yourself when things are going well. It’s when the going gets tough that you need to reinforce your self-confidence.

Making positive life changes that improve your body and mind are a good way to foster self-esteem. Consider taking a stimulating class or workshop, or try a new exercise program, such as fencing, basketball, or power walking. Developing a relaxation ritual, which may involve breathing exercises, chanting, or muscle tension and relaxation, is another excellent technique for caring for yourself.

The Maintenance Mantra

Why do you want to maintain your weight loss? What’s the most important factor for you? The reasons vary from person to person. For some, lowering blood pressure or a high cholesterol level is most important. For others, cosmetic concerns loom largest. Naming your motivation proudly and loudly, at least to yourself, can help you stay on track.

“Usually people go out and lose as much weight as they can, then see how much they can keep off,” notes Professor Hill. “Maybe we should do the reverse. First, make the right nutritional changes, then, based on our ability to stick with them, accept the resulting weight.”

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