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Cited by 1,351Obesity, Physical Activity, DietBariatric Surgery and OutcomesDiet and metabolism studies

Long-term weight-loss maintenance: a meta-analysis of US studies

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Anderson, James W, Konz, Elizabeth C, Frederich, Robert C, Wood, Constance L·2001·The American Journal of Clinical Nutrition
DOI 10.1093/ajcn/74.5.579
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Abstract

Background Current perception is that participants of a structured weight-loss program regain all of their weight loss within 5 y.Objective The objective was to examine the long-term weight-loss maintenance of individuals completing a structured weight-loss program.Design Studies were required to 1) have been conducted in the United States, 2) have included participants in a structured weight-loss program, 3) have provided follow-up data with variance estimates for > or =2 y. Primary outcome variables were weight-loss maintenance in kilograms, weight-loss maintenance as a percentage of initial weight loss, and weight loss as a percentage of initial body weight (reduced weight).Results Twenty-nine studies met the inclusion criteria. Successful very-low-energy diets (VLEDs) were associated with significantly greater weight-loss maintenance than were successful hypoenergetic balanced diets (HBDs) at all years of follow-up. The percentage of individuals at 4 or 5 y of follow-up for VLEDs and HBDs were 55.4% and 79.7%, respectively. The results for VLEDs and HBDs, respectively, were as follows: weight-loss maintenance, 7.1 kg (95% CI: 6.1, 8.1 kg) and 2.0 (1.5, 2.5) kg; percentage weight-loss maintenance, 29% (25%, 33%) and 17% (13%, 22%); and reduced weight, 6.6% (5.7%, 7.5%) and 2.1% (1.6%, 2.7%). Weight-loss maintenance did not differ significantly between women and men. Six studies reported that groups who exercised more had significantly greater weight-loss maintenance than did those who exercised less.Conclusions Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3 kg and a reduced weight of >3% of initial body weight. After VLEDs or weight loss of > or =20 kg, individuals maintained significantly more weight loss than after HBDs or weight losses of <10 kg.

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  • Use of very-low-calorie diets does not improve weight-loss maintenance.

    “Use of very-low-calorie diets does not improve weight-loss maintenance; 8 however, there is some disagreement on this issue.73,74”

    From Diet in the management of weight loss (2006) · cites this paper as [74]

    The discussion (under Figure 1) says use of very-low-energy diets was strongly related to successful long-term weight-loss maintenance. Its conclusion reports 7 kg of maintenance at 4–5 years among participants who used such a diet or lost at least 20 kg. This is contrary to the claim that these diets do not improve maintenance, though the paper cautions that its observational design limits causal conclusions. (LLM, conf=0.91)

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  • In a meta-analysis of 29 long-term weight loss studies, more than half of lost weight was regained within two years and more than 80% by five years.

    “In a meta-analysis of 29 long-term weight loss studies, more than half of the lost weight was regained within two years, and by five years more than 80% of lost weight was regained (Figure 1)4.”

    From Maintenance of Lost Weight and Long-Term Management of Obesity (2018) · cites this paper as [4]

    The Abstract reports 29 included studies. The Results report that participants maintained 44% of their initial weight loss at two years, meaning 56% was regained. At five years they maintained 21%, meaning 79%—not more than 80%—was regained. (LLM, conf=0.91)

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  • Very-low-calorie diets present a number of medical risks but offer rapid weight loss.

    “Overall, very-low-calorie diets present a number of medical risks but offer rapid weight loss.”

    From Diet in the management of weight loss (2006) · cites this paper as [74]

    The Introduction (page not provided) says very-low-energy diets combined with behavior modification enable substantial initial weight loss, typically 20–25 kg; the Results also report significantly greater initial loss than with balanced diets. Our copy does not substantiate the claim that these diets present a number of medical risks. A reference title mentions benefits and risks, but gives no findings about those risks. (LLM, conf=0.86)

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  • Very-low-calorie diets followed by a low-calorie diet lead to about 30% of body weight loss (7-20 kg) at ≥1 year.

    “≥ 1 yr: VLCD + LCD about 30% of body weight (7-20 kg) 8,72,73,74”

    From Diet in the management of weight loss (2006) · cites this paper as [74]

    The Results (page not specified) report that participants in very-low-energy diet studies maintained about 7 kg of weight loss at 4–5 years. The approximately 29–30% figure is the proportion of initial weight loss maintained, not the proportion of body weight lost; the reported body-weight reduction was 6.6% at 4–5 years. The paper compares very-low-energy and hypoenergetic balanced diets rather than establishing the claimed sequence of one followed by the other. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Very-low-calorie diets lead to about 30%-40% of body weight loss (13-32 kg) at 4 months.

    “4 mo: about 30%-40% of body weight (13-32 kg) 8,72,73,74”

    From Diet in the management of weight loss (2006) · cites this paper as [74]

    The Introduction reports that very-low-energy diets typically produce an initial loss of 20–25 kg, which falls within the claimed 13–32 kg range. But the Results report a median VLED treatment duration of 22 weeks, not four months, and neither that section nor Table 2 supports a loss of 30%–40% of initial body weight. (LLM, conf=0.87)

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Cites

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3 of the 69 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. [1]1. Bjorntorp P. Obesity. Lancet 1997;350:423-6.
  2. [48]48. Wang MC, Bushman BJ. Fixed-effects models in meta-analysis. In: Wang M, Bushman B, eds. Integrating results through meta-analytic review using SAS software. Cary, NC: SAS Institute Inc, 1999: 224-72.
  3. [51]51. Williamson DF. Descriptive epidemiology of body weight and weight changes in US adults. Ann Intern Med 1993;119:646-9.
  4. [56]56. Andersen RE, Wadden TA, Barlett SJ, Zemel B, Verde TJ, Frankckowiak S. Effects of lifestyle activity vs structured aerobic exercise in obese women. JAMA 1999;281:335-40.

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Authors
Anderson, J. W., Konz, E. C., Frederich, R. C., & Wood, C. L.
Affiliations
University of Kentucky (US)
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2001-11
Volume
74
Issue
5
Pages
579-584
ISSN
0002-9165 (ISSN-L)
DOI
10.1093/ajcn/74.5.579
OpenAlex
W2097309757
Semantic Scholar
93e83f33e0a0e57bebd19c0201f6f49724341278
Cited by
1,351
References
69
Citations by year
2026: 30 · 2025: 61 · 2024: 78 · 2023: 66 · 2022: 76 · 2021: 94 · 2020: 50 · 2019: 62 · 2018: 52 · 2017: 62 · 2016: 67 · 2015: 65 · 2014: 73 · 2013: 77 · 2012: 42
FWCI
4.29
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
Keywords
weight loss maintenance, very low calorie diet, weight regain, long-term follow-up, physical activity, sex differences, obesity
MeSH terms
Adult, Body Weight, Energy Intake, Diet, Reducing, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Obesity, United States, Weight Loss, Exercise, MEDLINE, Treatment Outcome

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