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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”
From Diet in the management of weight loss (2006) · cites this paper as [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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Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases
Pedersen, B. K., & Saltin, B. (2015) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.12581 · Cited by 3,514
European Guidelines for Obesity Management in Adults
Yumuk, V., Tsigos, C., Fried, M., Schindler, K., Busetto, L., Micic, D., & Toplak, H. (2015) · Obesity Facts · doi:10.1159/000442721 · Cited by 3,432
Association analyses of 249,796 individuals reveal 18 new loci associated with body mass index
MAGIC, Speliotes, E. K., on behalf of Procardis Consortium, Willer, C. J., Berndt, S. I., Monda, K. L., Thorleifsson, G., Jackson, A. U., Allen, H. L., Lindgren, C. M., et al. (2010) · Nature Genetics · doi:10.1038/ng.686 · Cited by 2,912
Fuller, N. R., Colagiuri, S., SCHOFIELD, D. J., Olson, A. D., Shrestha, R. N., Holzapfel, C., Wolfenstetter, S. B., Holle, R., Ahern, A. L., Hauner, H., et al. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.139 · Cited by 2,127
Obesity Stigma: Important Considerations for Public Health
Puhl, R. M., & Heuer, C. A. (2010) · American Journal of Public Health · doi:10.2105/ajph.2009.159491 · Cited by 1,949
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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