More resources should go into helping people maintain their weight loss after dieting, rather than just focussing on losing weight, new research suggests.

In a paper published today in the BMJ, researchers from Newcastle University and Fuse, the centre for translational research in public health, found that most overweight / obese people regain weight after initial weight loss. Researchers also found, however, that this weight regain can be reduced through behavioural and pharmacological means.

Obesity is one of the biggest causes of early death worldwide, and weight loss can have a massive impact on prolonging life, so long as the weight is not put back on. Effective weight loss programmes are now widely available, but research has shown that weight loss usually peaks at around 6 months into a weight loss programme, followed by a slow regain. Stopping this regain is now one of the key challenges for controlling the obesity epidemic.

In a systematic review of non-surgical weight loss maintenance interventions, the largest ever completed, the team looked at 45 previous studies from around the world, involving 7,788 people.

Keeping weight off 

The team looked at interventions to support overweight / obese adults who had lost 5% or more of their body weight to keep weight off. The interventions tested involved dietary changes, physical activity, drugs, food supplements and meal replacements.

Individuals who received lifestyle interventions incorporating both regular physical activity and dietary changes regained 1.56 kg less, over a year, than individuals receiving no intervention. These favourable effects were still evident 2 years after the beginning of the maintenance intervention.

Adding the drug Orlistat to a lifestyle intervention, compared to a placebo and lifestyle intervention, helped participants avoid regain still further. Side effects involving the digestive tract should be discussed with a doctor before considering this option.

Dr Falko Sniehotta, Reader in Health Psychology at Newcastle University, and member of Fuse, said: “Many people succeed in losing weight but struggle when it comes to keeping it off. If we are going to improve public heath then maintaining weight loss is one of the key issues that we need to solve. Our findings are encouraging as they demonstrate that we can slow down weight regain. As a society we make considerable personal and financial investments in weight loss. To translate these investments into better public health we need to ensure optimal support for those who have lost weight. More effort is needed to understand the psychology and physiology of weight loss maintenance, to optimize interventions and to make evidence-based support widely available to the people who have demonstrated their determination by losing pounds.”

Weight loss trial

Drawing on these new, important findings, a team led by Newcastle University is looking to recruit people from the North East of England to take part in an innovative study into maintaining weight loss.  The research team have developed a novel intervention to help people keep weight off, which uses digital scales and internet-enabled mobile phones.  The NULevel trial will test if this new approach helps people avoid regain better than the usual weight maintenance advice. The team is looking for 288 people in the North East of England who have lost weight in the last 12 months, and who started off very overweight. These people will be randomly assigned to receive either the new programme or the usual advice.  Participants receive a set of state-of-the-art digital scales and £50 in vouchers.

For information about the NULevel trial, please visit the website. 

Dr Falko Sniehotta, Reader in Health Psychology at Newcastle University, said: “We used the best available evidence to develop this intervention. To date, there is not a single major weight loss maintenance trial completed in the UK. We want to close this gap and make the knowledge available that we need to better support people in keeping their weight off.”

published on: 14 May 2014