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Cited by 166Obesity, Physical Activity, DietPharmacology and Obesity TreatmentObesity and Health Practices

The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race?

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Nackers, Lisa M., Ross, Kathryn M., Perri, Michael G.·2010·International Journal of Behavioral Medicine
DOI 10.1007/s12529-010-9092-yPMC PMC3780395
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Abstract

Background Controversy exists regarding the optimal rate of weight loss for long-term weight management success.Purpose This study examined whether gradual initial weight loss was associated with greater long-term weight reduction than rapid initial loss.Methods Groups were drawn from participants in the TOURS trial, which included a sample of middle-aged (mean = 59.3 years) obese women (mean BMI = 36.8) who received a 6-month lifestyle intervention followed by a 1-year extended care program. Participants were encouraged to reduce caloric intake to achieve weight losses of 0.45 kg/week. Groups were categorized as "FAST" (> or =0.68 kg/week, n = 69), "MODERATE" (> or =0.23 and <0.68 kg/week, n = 104), and "SLOW" (<0.23 kg/week, n = 89) based on rate of weight loss during first month of treatment.Results The FAST, MODERATE, and SLOW groups differed significantly in mean weight changes at 6 months (-13.5, -8.9, and -5.1 kg, respectively, ps < 0.001), and the FAST and SLOW groups differed significantly at 18 months (-10.9, -7.1, and -3.7 kg, respectively, ps < 0.001). No significant group differences were found in weight regain between 6 and 18 months (2.6, 1.8, and 1.3 kg, respectively, ps < 0.9). The FAST and MODERATE groups were 5.1 and 2.7 times more likely to achieve 10% weight losses at 18 months than the SLOW group.Conclusion Collectively, findings indicate both short- and long-term advantages to fast initial weight loss. Fast weight losers obtained greater weight reduction and long-term maintenance, and were not more susceptible to weight regain than gradual weight losers.

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  • Research suggests that individuals who will not respond to weight loss treatment can be identified early, during treatment.

    “Further, research suggests that it may be possible to identify such individuals early, i.e., during treatment [16].”

    From Introduction to SMART designs for the development of adaptive interventions: with application to weight loss research (2014) · cites this paper as [16]

  • The 5-lb nonresponse cutoff comes from prior research and clinical experience indicating that a loss below 5 lbs by week 5 of behavioral therapy predicts inadequate longer-term weight loss (<5-10% of body weight at 26 weeks) and thus a need to change or augment treatment.

    “In this example, the 5 lbs cutoff is based on previous research [16], which is corroborated by clinical experience, suggesting that weight loss of less than 5 lbs during the first 5 weeks of behavioral therapy treatment is associated with longer-term insufficient weight loss (<5-10 % of body weight at the end of 26 weeks), thereby indicating a need for subsequent (changes or”

    From Introduction to SMART designs for the development of adaptive interventions: with application to weight loss research (2014) · cites this paper as [16]

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Research works printed but not linked: 1

  1. [27]Jeffery RW Drewnowski A Epstein LH Long-term maintenance of weight loss: current status Health Psychol 2008 19 5 16 10709944

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Authors
Nackers, L. M., Ross, K. M., & Perri, M. G.
Affiliations
University of Florida Health (US)
Corresponding author
Nackers, Lisa M.
ORCID
Venue
International Journal of Behavioral Medicine
Publisher
Springer Science and Business Media LLC
Published
2010-05-05
Volume
17
Issue
3
Pages
161-167
ISSN
  • 1070-5503 (ISSN-L)
  • 1532-7558
DOI
10.1007/s12529-010-9092-y
PMC
PMC3780395
OpenAlex
W2158253734
Cited by
166
References
34
Citations by year
2026: 7 · 2025: 8 · 2024: 7 · 2023: 10 · 2022: 7 · 2021: 12 · 2020: 18 · 2019: 16 · 2018: 14 · 2017: 11 · 2016: 12 · 2015: 10 · 2014: 14 · 2013: 7 · 2012: 6
FWCI
6.34
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • International Journal of Behavioral Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Aging (P30AG028740)
  • National Heart, Lung, and Blood Institute (R18HL073326)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
Keywords
obesity treatment, rapid weight loss, long-term weight maintenance, weight regain, lifestyle intervention, caloric restriction, middle-aged women
MeSH terms
Aged, Energy Intake, Diet, Reducing, Female, Humans, Middle Aged, Motor Activity, Obesity, Patient Compliance, Time Factors, Weight Loss, Body Mass Index, Risk Reduction Behavior

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