Introduction
Many people have tried to lose weight at some point in their lives. The literature reports that at least 45% of the world’s population tries to lose weight regardless of their weight at a certain time and regardless of overweight or obesity. In people who are overweight or obese, a weight loss of 5-10% of their initial weight has been associated with better health. This practically means improved blood tests, a reduced risk of developing chronic diseases, and better management of existing diseases. Despite the benefits of weight loss, few people manage to maintain this loss long-term. More specifically, it seems that 50% of people who follow weight loss programs eventually return to their original weight within 5 years.
Why is this happening?
Physiological body adaptations
Losing body fat leads to a decrease in the size of fat cells and not in the number of fat cells as many may believe. What happens is that these cells tend to remember their original size and try to regain it. It has been observed that in individuals who are in the maintenance phase, the levels of ghrelin, which is the appetite hormone, fluctuate rapidly. This results in a strong desire to consume large amounts of food in short periods of time.
Regarding satiety, leptin levels in the blood are the ones that directly affect it. Leptin secretion varies depending on the size of adipose tissue. The reduction in body weight that leads to a decrease in adipose tissue leads to a drop in leptin levels. This in turn leads to a decrease in satiety and therefore an increased need to consume more food. In addition, obese people have very high concentrations of leptin in the blood, which ultimately leads to a reduced response of the body to the feeling of satiety, a condition known as leptin resistance. Based on the above, there is much data that supports that people who start a weight loss effort with very high levels of ghrelin and a low response to leptin are more prone to regaining the lost weight.
Rate of Weight Loss
The length of time the loss took also affects the recovery of body weight. It seems that people who have resorted to easy solutions for quick weight loss, the so-called “express diets” tend to regain the lost weight more quickly. The most common dietary pattern characterized by rapid weight loss is the ketogenic diet, as well as other protein diets that exclude entire food groups. However, due to this large exclusion, the long-term adoption of such patterns is particularly difficult in practice and individuals often return to their old habits, ultimately resulting in weight regain. In fact, in some cases, overconsumption of the food groups that were excluded is common, leading to both rapid and greater weight regain. The above process is known as “yo-yo”, which is characterized by repeated large-scale weight loss in a short period of time and ultimately rapid regain. Usually such attempts are accompanied by a large loss of muscle tissue, resulting in a decrease in basal metabolism, making a subsequent weight loss attempt even more difficult.
Eating Behaviors & Lifestyle after Weight Loss
Some cases of people who are in the process of maintaining their weight change their eating habits compared to those they had during the period of trying to lose weight. There are three main changes that indirectly lead to weight regain:
- Unstable meal consumption: often leads to reduced appetite control and ultimately overeating at subsequent meals.
- Return to old habits: alcohol and soft drinks, which were on the sidelines during the weight loss phase, are usually reinstated, ultimately resulting in more calories being consumed during the day.
- More frequent consumption of foods high in energy, fat and sugar: regular consumption of sweets, packaged foods and food from outside can, due to their composition, lead to easier weight regain.
Successful Weight Maintenance
Continuous Energy Deficit
The literature suggests that weight maintenance success is easier if individuals are on a sustained hypocaloric diet, i.e. if they continue to limit the calories they consume through food relative to those they consume through exercise during their week. As in the weight loss period, it seems that in weight maintenance, more emphasis should be placed on total calorie intake relative to consumption through exercise than on the carbohydrate and fat content of the meal.
Adequate protein intake
Several studies support that increasing protein intake to a greater extent than that recommended for the general population (0.5-1g/kg BW) is associated with better maintenance of weight loss, mainly due to better control of satiety and therefore of the amount of food consumed. Therefore, basic protein sources such as dairy products, eggs, meat and legumes are important to include in all meals during the day.
Adequate intake of fruits & vegetables
Both fruits and vegetables are low in calories and therefore contribute to energy intake through food while at the same time having an increased content of fiber and flavonoids. Fiber increases the feeling of satiety, which as mentioned in the maintenance period is reduced, while flavonoids have been shown by studies to be capable of maintaining body weight in the long term when consumed in high amounts, without their mechanism of action being fully understood.
Regular Physical Activity
Systematic exercise is important both in the weight loss period and in the maintenance period. Regarding the loss period, the recommendations suggest exercise of at least 150 minutes per week. This recommendation almost doubles during the maintenance period and at least 250 minutes of exercise per week is recommended, without particular emphasis on the type of exercise. Therefore, it is advisable for people to incorporate walking, cycling, gym, running, swimming and other forms of physical activity into their daily lives in order to maintain the lost weight for a longer period of time. Finally, it should be mentioned that even in people who are active without necessarily meeting the recommendations, reducing exercise can easily lead to weight regain. Therefore, stability in exercise programs is capable of helping in long-term maintenance.
Sufficient Sleep
It is known that insufficient sleep, in quantity and quality, is associated with increased appetite, decreased feelings of satiety and increased secretion of cortisol, the stress hormone. The above leads to an increase in the amount of food consumed during the day and an increased need to consume foods with increased calories, in order to cover the energy needs that were not covered through sleep. The above processes are similar in both the period of weight loss and maintenance. Therefore, it is important for adults to sleep at least 7 hours a night, with the quality being as good as possible. Especially in the period of maintenance, when hunger and appetite hormones inevitably change, meeting sleep recommendations is very important. In fact, studies have shown that these hours are capable of maintaining weight up to 18 months after loss, compared to individuals who do not meet these recommendations.
Regular Weighing
Very often, individuals who maintain their weight are recommended to weigh themselves up to once a week and not more, under the same conditions each time. In this way, weight control will be maintained. It would be advisable not to weigh yourself after consuming large meals or during periods of the menstrual cycle in women, so that the weighing is as representative as possible.
Conclusion
In conclusion, the period of maintaining lost weight is a particularly demanding period during which individuals have to deal with adaptations that the body naturally makes. There are habits that can be incorporated into their diet and lifestyle that can positively influence their efforts to maintain their weight. Attention to portions, increased protein intake, regular physical activity and good sleep are the most important. In this way, both body weight and quality of life of individuals can be maintained in the long term.
