The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race?
Open accessAbstract
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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“In subjects with obesity, more rapid initial weight loss has been associated with greater long-term weight loss [41–43]”
From International Society of Sports Nutrition position stand: diets for body weight reduction (2026) · cites this paper as [41]
In the citing paper
“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]
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“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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Cites
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S UCCESSFUL W EIGHT L OSS M AINTENANCE
Wing, R. R., & Hill, J. O. (2001) · Annual Review of Nutrition · doi:10.1146/annurev.nutr.21.1.323 · Cited by 1,382
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“Conversely, reviews of weight loss patterns have concluded that the greater the initial weight loss in obese patients, the larger the total weight loss observed at longterm follow-up [10, 21].”
BackgroundLong-term maintenance of weight loss: Current status.
Jeffery, R. W., Epstein, L. H., Wilson, G. T., Drewnowski, A., Stunkard, A. J., & Wing, R. R. (2000) · Health Psychology · doi:10.1037/0278-6133.19.suppl1.5 · Cited by 1,093
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“Losing weight at a slow initial rate has been shown to result in continued weight loss, reduced risk for weight regain, and successful long-term weight loss maintenance [16–20].”
BackgroundRandomized Trial of Lifestyle Modification and Pharmacotherapy for Obesity
Wadden, T. A., Berkowitz, R. I., Womble, L. G., Sarwer, D. B., Phelan, S., Cato, R. K., Hesson, L. A., Osei, S. Y., Kaplan, R., & Stunkard, A. J. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa050156 · Cited by 794
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Efficacy of Lifestyle Modification for Long‐Term Weight Control
Wadden, T. A., Butryn, M. L., & Byrne, K. J. (2004) · Obesity Research · doi:10.1038/oby.2004.282 · Cited by 511
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- Jeffery RW, Drewnowski A, Epstein LH, et al. Long-term maintenance of weight loss: current status. Health Psychol. 2008;19:5–16. · DOI · Paper page
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NIH working group report: Innovative research to improve maintenance of weight loss
MacLean, P. S., Wing, R. R., Davidson, T. L., Epstein, L. H., Goodpaster, B. H., Hall, K. D., Levin, B. E., Perri, M. G., Rolls, B. J., ROSENBAUM, M. S., et al. (2014) · Obesity · doi:10.1002/oby.20967 · Cited by 575
Self-citationAlmirall, D., Nahum-Shani, I., Sherwood, N. E., & Murphy, S. A. (2014) · Translational Behavioral Medicine · doi:10.1007/s13142-014-0265-0 · Cited by 453
Four-year weight losses in the Look AHEAD study: factors associated with long-term success
Wadden, T. A., Neiberg, R. H., Wing, R. R., Clark, J. M., Delahanty, L. M., Hill, J. O., Krakoff, J., Otto, A., Ryan, D. H., Vitolins, M. Z., et al. (2011) · Obesity · doi:10.1038/oby.2011.230 · Cited by 465
Myths, Presumptions, and Facts about Obesity
Casazza, K., Fontaine, K. R., Astrup, A., Birch, L. L., Brown, A. W., Bohan Brown, M. M., Durant, N., Dutton, G., Foster, E. M., Heymsfield, S. B., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmsa1208051 · Cited by 442
Metadata
- Authors
- Nackers, L. M., Ross, K. M., & Perri, M. G.
- Affiliations
- University of Florida Health (US)
- Corresponding author
- Nackers, Lisa M.
- Venue
- International Journal of Behavioral Medicine
- Published
- 2010-05-05
- Volume
- 17
- Issue
- 3
- Pages
- 161-167
- ISSN
- 1070-5503 (ISSN-L)
- 1532-7558
- 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
- green
- www.ncbi.nlm.nih.gov
- 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 (medical) › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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