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Long-term weight-loss maintenance: a meta-analysis of US studies
Open accessAbstract
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; 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]
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“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]
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“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]
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“≥ 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]
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“4 mo: about 30%-40% of body weight (13-32 kg) 8,72,73,74”
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“This is exemplified by a recent meta-analysis showing that ~56% of body weight loss, as achieved through lifestyle intervention, is regained within two years, and ~79% is regained after five years9.”
From Transforming obesity: The advancement of multi-receptor drugs (2024) · cites this paper as [9]
In the citing paper
“Data from earlier long-term analyses indicate that within two years of completing a weight loss program, over 50% of individuals regain their lost weight, and within five years, this percentage exceeds 80% [11].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [11]
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Cardel, M. I., Newsome, F. A., Pearl, R. L., Ross, K. M., Dillard, J. R., Hayes, J. F., Wilfley, D. E., Keel, P. K., Dhurandhar, E. J., & Balantekin, K. N. (2022) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2022.09.017 · Cited by 7
Empfehlungen zur Ernährung von Personen mit Typ-2-Diabetes mellitus
Skurk, T., Bosy‐Westphal, A., Grünerbel, A., Kabisch, S., Keuthage, W., Kronsbein, P., Müssig, K., Nussbaumer, H., Pfeiffer, A. F. H., Simon, M., et al. (2023) · Die Diabetologie · doi:10.1007/s11428-023-01041-4 · Cited by 6
Haganes, K. L., Hawley, J. A., Lydersen, S., & Moholdt, T. T. (2025) · Scientific Reports · doi:10.1038/s41598-025-95743-y · Cited by 6
Benedé‐Ubieto, R., Estévez‐Vázquez, O., Acar, R., Leal-Lassalle, H., Gutierrez, A. H., Redondo‐Urzainqui, A., Iborra, S., Odintsova, V. E., Tyakht, A., Herranz, J. M., et al. (2026) · Gut Microbes · doi:10.1080/19490976.2026.2631834 · Cited by 7
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Clark, J. M., Smith, B. J., Juusola, J. L., & Kumar, R. B. (2025) · Obesity Science & Practice · doi:10.1002/osp4.70036 · Cited by 8
Empfehlungen zur Ernährung von Personen mit Diabetes mellitus Typ 2
Skurk, T., Bosy‐Westphal, A., Grünerbel, A., Kabisch, S., Keuthage, W., Kronsbein, P., Müssig, K., Pfeiffer, A. F. H., Simon, M., Tombek, A., et al. (2022) · Die Diabetologie · doi:10.1007/s11428-022-00908-2 · Cited by 6
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Prospective study of weight loss and all-cause-, cardiovascular-, and cancer mortality
Tolvanen, L., Ghilotti, F., Adami, H., Ye, W., Bonn, S. E., Bellocco, R., & Lagerros, Y. T. (2023) · Scientific Reports · doi:10.1038/s41598-023-32977-8 · Cited by 8
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RetractedBrown, A. C., Brosnahan, N., Khazaei, D., Wingrove, J. O., Flint, S. W., & Batterham, R. L. (2022) · Clinical Obesity · doi:10.1111/cob.12509 · Cited by 5
Metadata
- Authors
- Anderson, J. W., Konz, E. C., Frederich, R. C., & Wood, C. L.
- Affiliations
- University of Kentucky (US)
- 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)
- 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
- bronze
- doi.org
- 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 (medical) › 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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