Friday, January 4, 2013

There Is No Finish Line

One of the more common comments I get, right after, "How did you lose weight?" (and the "Awwww" after I tell them it's all portion control and exercise) is, "Why are you so worried? You've done it! It's over and never coming back!"

While I do appreciate the support, I can safely say that it will NEVER be over. If what all my friends words were true, any of my numerous previous dieting attempts would have stuck. No one would ever need to lose weight more than once! But weight maintenance is a lifestyle change. I will always be mindful of my condition.

And that freaks me out, only because I have failed to maintain this so many times before. I do believe I handled the lifestyle transition better this time. And I know enough to stop things from getting too far if I see myself going to the "red line" of 200 lbs. on the scale, instead of waiting until the weight got even higher up.

I also tried to set goals for myself. ("Keep it off until May and you get to strut your stuff at your 25th reunion!" "Keep it off longer and you become a more rare statistic!" )

But I know I will always be one of those folks who worries that it may happen again. I cannot relax too much about it, because I refuse to fail again. 

So just as there is no magic bullet to lose weight, there's no "final bell" when you've made goal. But I know I'm not the only person going through this. So, where to get some answers that show how to succeed?

My librarian side, of course, looked for the answer to successful maintenance the way I knew best: by doing some literature searches. A quick and dirty look in ScienceDirect, PubMed, Google Scholar and EBSCO comes up with dozens of published studies from the just the past 5 years. But even going farther back, there's not a lot of positive results. A controlled test environment, one would think, might make it easier than "real life", but the results don't always show that. 

In a 1999 study from the Netherlands,15 men were put on an diet and exercise regimen and then 6 of them were given maintenance training for 4 months. The ones on the maintenance training did regain weight, although not as much fat mass. but ultimately the study showed that "the maintenance of fat loss is extremely difficult, even with a relatively intensive exercise program."

A 2002 study from Scotland of 122 men at an industrial worksite had them go on a variety of diets. While weight was lost, weight regain "was significant and weight maintenance strategies require further development."


These are just two examples. And yes, I know they are both studies using only men. There are probably several dozen women-only studies for each one of these men-only studies. And while I did read all the studies I came across, I was admittedly looking for a bit of my own self in these tests. But the results of the women-only and mixed tests do not necessarily show any difference from these two mentioned above.


(One thing I have noticed about women weight losers/maintainers is that women tend to be better about seeking and forming support networks, which will be a subject of a later blog post).

The one place I did find some positive results was in studies done with data from the National Weight Control Registry. In order to be part of the registry, you have to be over 18 and have maintained a weight loss of 10% of your bodyweight for over a year. So naturally, the subjects in NWCR data are pretty much self-selected (I signed up for the registry on my 1st year weight loss anniversary). Then again, you have to have been successful to join, as opposed to the other studies where overweight people are found and then put on diets, which may be why virtually all the other studies show failure of maintenance. One of the many articles from NWCR on the subject (and they publish quite regularly) says that after 2 years of maintenance, subjects feel it gets easier. I can only hope so.

Some of the successful tactics they mention are things I already do (although I certainly didn't do them in "old" Ska Librarian mode):

  • Not skipping breakfast
  • Weighing myself regularly
  • Understanding 'triggers"
  • Daily exercise
  • Maintaining eating habits/calorie watching
These bullet points will also make up some future blog posts.

So I know I'm on the right track. And I guess I can take my 2 year anniversary of maintenance (and it WILL happen) as a new marker of less worry. Perhaps. 
Right now all I know is that I do not want to be part of the larger failing tests. 



References:


Pasman, Wilrike J., Wim H.M. Saris, Erik Muls, Greet Vansant, and Margriet S. Westerterp-Plantenga. “Effect of Exercise Training on Long-term Weight Maintenance in Weight-reduced Men.” Metabolism 48, no. 1 (January 1999): 15–21. 10.1016/S0026-0495(99)90004-5

 Leslie, W S, M E J Lean, H M Baillie, and C R Hankey. “Weight Management: a Comparison of Existing Dietary Approaches in a Work-site Setting.” International Journal Of Obesity And Related Metabolic Disorders: Journal Of The International Association For The Study Of Obesity 26, no. 11 (November 2002): 1469–1475. Available at http://eprints.gla.ac.uk/29/

Wing, Rena R, and Suzanne Phelan. “Long-term Weight Loss Maintenance.” The American Journal of Clinical Nutrition 82, no. 1 (July 1, 2005): 222S–225S. Available at http://ajcn.nutrition.org
 

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