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


METHODS
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.
Anderson
J W
JW
VA Medical Center, Graduate Center for Nutritional Sciences, University of Kentucky Health Management Resources Weight Management Program, Lexington, KY, USA. jwandersmd@aol.com
Konz
E C
EC
Frederich
R C
RC
Wood
C L
CL
D000328:Adult; D001835:Body Weight; D004038:Diet, Reducing; D002149:Energy Intake / Q000502:physiology; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D016239:MEDLINE; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000628:therapy; D016896:Treatment Outcome; D014481:United States; D015431:Weight Loss