It’s Hard to Maintain Weight Loss, But Not Impossible

You’ve whittled your weight down to a desirable number. Congratulations! Enjoy the extra room in those jeans, the validating compliments you get from friends, and the new energy you’re likely enjoying. 

When the post-diet glow wears off, you may wonder what to do next. Real talk: Many people who lose weight successfully often regain some or all of it back. Weight loss changes your body and simply reverting back to your old habits (you know, the ones that led to you gaining weight in the first place) after achieving your weight loss goal will eventually take you back to square one. 

We’ll explore the reasons why keeping weight off is a lifelong journey. Then, we’ll reveal five dietitian-recommended strategies to maintain weight loss instead of falling back to your old habits. Let’s get to it.

Set Point Theory

Think of set-point theory as your body’s internal temperature. This theory implies that weight loss is hard to maintain because your body makes adjustments to your metabolism to keep you within a specific weight range. When weight is lost, your metabolism plummets to prevent you from dropping below your body’s preferred weight range. 

A small study of 31 adults with obesity found that the reduced metabolism seen with weight loss occurs once a person has lost about 5% of their weight. Exercising more to burn extra calories doesn't appear to help, either. The study found a drop in the amount of calories people burned at rest (while not exercising) once they lost 10% of their body weight. The authors note the drop in metabolism may contribute to weight regain. 

While the change in metabolism related to food restriction can occur early in a weight loss program, this doesn’t mean you can’t lose weight after it happens. One study found a drop in the amount of calories people burned while resting after one week of reducing calories. But, this didn’t predict weight loss success or failure at the end of the 20-week study. 

Some of the strategies I give to clients who struggle with weight loss:

• Change your environment to make it less “obesogenic” — that’s a fancy way of saying things that prompt you to act in ways that promote weight gain. For example, if you always eat too many cookies or chips and that makes you feel guilty, sick (to your tummy), and more prone to overeat other foods, don’t keep those foods in your house for a little while. When you’re ready to eat chips or cookies again, try limiting yourself to one cookie or one serving of chips (single-serving chip bags or one cookie bought at a bakery can help) and see how that makes you feel.

• Cut back on high-calorie foods and drinks. Sugar is empty calories.

• Increase physical activity — this doesn’t have to mean planned workouts. Walking the dog, gardening, cleaning the house, and taking the stairs all count.

• Spend time sleeping. You read that right. Lack of sleep disrupts hormones that impact appetite and weight regulation. I tell my clients, “sleep is good food.”

What’s Your Gut Say?

The brain gut axis means your gastrointestinal and nervous systems are connected. Impulses from the gut can be transferred back and forth to the brain, some of which could impact your risk of weight gain. 

Highly processed food (think Cheez-Its and Pop-Tarts) may be part of the problem. Super tasty and high in calories, ultra-processed food may change your microbiome, which could impact the risk of food addiction. These types of food interfere with the brain’s dopaminergic pathways (“feel good” vibes), intestinal function, and desire to eat. 

In one study of overweight adults given a diet of ultra-processed foods versus unprocessed foods, participants were told to eat as much or as little as they wanted. Calorie intake was higher with the ultra-processed food diet, resulting in weight gain. 

Your gut also contains the hormones ghrelin and leptin, which impact hunger cues. Ghrelin is made in your stomach and tells your brain to eat while leptin says, “slow down.” Ghrelin levels are low after you’ve eaten and higher when you’re hungry. 

Managing ghrelin may be important to weight loss success. Ghrelin manages normal caloric balance as well as “hedonic” eating, or the desire to eat yummy foods. One study found that ghrelin was 23% higher after weight loss in obese men. Medications that target ghrelin might be of use for weight loss success.

The hormone leptin is also involved in appetite regulation. When leptin levels are high (after meals), the urge to eat disappears. Weight change impacts leptin. Leptin levels drop when fat is lost, encouraging you to eat to regain the weight. 

In experiments where leptin resistance is imposed on mice, the rodents are less satisfied and eat extra calories, resulting in weight gain. One study in diet-induced obese mice shows promise that amylin (a pancreatic hormone) used along with leptin may aid in weight loss. Continuous use of amylin reduced food intake, raised calories burned, and reduced body weight.

The Impact of Metabolic Syndrome

Metabolic syndrome is a cluster of symptoms including insulin resistance, high blood pressure, elevated lipids, and a large waistline. Taken together, this condition raises the risk of heart disease. Individuals with metabolic syndrome could have trouble losing weight as insulin sensitivity is decreased.

With insulin resistance, your body does not use insulin effectively, so your pancreas produces more. While this sounds like a fix, the excess insulin floating around in your blood results in fat storage.

Individuals with metabolic syndrome may respond well to a Mediterranean diet. A research review indicates a lower-fat diet with moderate amounts of fruits, vegetables, whole grains, and plant-based proteins can improve metabolic functioning for these people.

A lower-carb diet is beneficial for those with pre-diabetes, though studies have conflicting results. A meta-analysis of 12 studies shows that both low-carb (<40% carbs) or low-fat (less than 30% fat) diets may result in weight loss and improved markers of metabolic syndrome. A lower-carb diet appears to improve HDL levels better than a low-fat diet.

Dietitian’s Advice for Weight Loss Maintenance

Modify what goes into your mouth, and think about what other habits you have that may impact your weight. 

Get Adequate Sleep 

Poor sleep or too much sleep (over 10 hours per night) has been linked with food cravings, insulin resistance, and weight gain. Most experts advise seven to eight hours each night. 

Tune in to Your Hunger Cues 

What’s eating you that’s making you eat? Are you hungry or is it just a habit? One study found that combining intuitive eating with a chewing strategy resulted in better weight loss compared to more traditional weight loss techniques. Those in the chewing group also maintained the weight they lost after four weeks.

Eat Enough Protein 

Protein spares lean muscle mass during weight loss and helps regulate your appetite. While plant-based proteins may aid in weight loss, animal protein helps people under age 50 maintain lean body mass. Consume both if you’re not vegan, as plant-based protein also contains fiber.

A surprising side effect of fiber was noted in a weight loss maintenance study. It found that as carbohydrate and fiber intake increased, so did appetite. This is not to say, “go eat more processed foods,” as these are more detrimental to your waistline. But, rather, pay attention to serving sizes of food, including high-fiber foods.

Move Your Muscles 

Diet and exercise go hand in hand, but it’s true that you can’t outrun a bad diet. Regular exercise burns calories and maintains lean muscle mass. It also reduces stress and improves sleep, which in turn may reduce stress eating and cravings. Find something you enjoy doing and keep doing it. Both behavior modification (eating less) and exercise are effective for losing weight and maintaining the loss. 

Both aerobic and HIIT (high-intensity interval training) are beneficial for weight loss as long as calorie expense is equal, according to a large systematic review. More research is needed on which exercises are most effective for maintaining weight loss.

Get Support 

Whether it’s a formal group, your book club, a personal trainer or dietitian, or a handful of co-workers, having a sounding board during weight loss is beneficial. A study found that individuals who joined a self-help group lost over four times as much weight (13.2 pounds versus 3.08 pounds). 

Weight loss is a journey. Habits don’t change overnight, but gradual shifts in behavior can make a difference. Whatever you do, don’t give up! You can find more support and expert guidance when you sign up for Kickoff.