Study examines strategies to recover from weight regain

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Science shows that weight regain over time is common, but a new study—co-authored by a Cal Poly faculty member—has gathered new data on effective strategies to recover from weight regain.

Suzanne Phelan—director of Cal Poly’s Center for Health Research and a professor of kinesiology and public health in the College of Science and Mathematics—assisted in the article published Oct. 25 in Obesity. Phelan’s team surveyed thousands of participants in the WW (WeightWatchers) program.

The study used data from extensive questionnaires, distributed to participants from 2019-2020, that surveyed behaviors, goals, successes and setbacks.

“This asks the very question: ‘How do people who have successfully maintained weight loss over the long-term do it?'” said Phelan, whose body of research is focused on discovering ways to promote weight loss and weight gain prevention in a variety of settings. “What can we learn from them to help others going through a similar journey be more successful?”

Key study findings revealed individuals who successfully maintained weight loss: resumed weight loss efforts responsively after showing limited gains; frequently self-monitored; and used coping and problem-solving skills to get back on track.

The research was led by Jacqueline F. Hayes, an assistant professor (research) and clinical psychologist in the Department of Psychiatry and Human Behavior at the Warren Alpert Medical School of Brown University, and the Weight Control and Diabetes Research Center, both in Providence, Rhode Island.

Aiding Hayes and Phelan were Gary Foster, WW’s chief scientific officer, and an adjunct professor of psychology in psychiatry at the Perelman School of Medicine at the University of Pennsylvania; Rena Wing, a professor in psychiatry and human behavior at the Warren Alpert Medical School; and Noemi Alarcon, a Cal Poly Corporation project coordinator and research associate.

The study evaluated 2,457 WW members who lost an average of 57.9 pounds and kept it off for more than 3.5 years. Participants were part of the growing Center for Health Research’s WeightWatchers Global Success Registry who have lost 20 or more pounds and kept it off for at least a year. This study is part of ongoing research among this cohort to evaluate long-term weight loss maintenance behaviors.

Long-term weight-loss maintainers who responded to the survey were designated in three groups: 48% who maintained weight loss (described as “Stable”); 29% reported gains and losses (“Gain-Lose”); and 23% reported gradual regain (“Gain”). The majority of participants (94.9%) were female with an average age of 60 years. Participants ranged from 49 to 71 years old.

Survey questions included: “What is the largest amount of weight you have regained before restarting weight-loss efforts?” and “When you tried to re-lose this larger amount of weight, what was your primary strategy?”

Respondents successfully used strategies such as: “recording calories; setting a calorie goal; self-weighing and tracking weight; and tracking exercise.” In comparison to those in the Gain group, the Gain-Lose participants engaged in the following behaviors:

  • Resumed weight-loss efforts after a smaller amount of regain (less than 8 pounds)
  • Sustained weight-loss efforts longer (16 weeks in Gain-Lose versus 10 weeks among Gain group)
  • Engaged in more frequent self-weighing, self-monitoring and healthy dietary choices
  • Used more psychological coping mechanisms, such as self-reinforcement, problem-solving and restructuring negative thoughts

Setbacks are inevitable along the journey, researchers said, but implementing helpful thinking styles can help people get back on track.

“If the number goes up on the scale, a negative thought would be “Oh, this is hopeless; here I go again,'” Phelan said. “Instead, this group of weight-loss maintainers are saying, “I’ve got this. This is a setback, but it’s temporary.'”

The study expanded upon Phelan’s previous work, including research into weight regain and the benefits of self-monitoring referenced in the New York Times article “How to Lose Weight and Keep it Off,” based on her January 2020 study in Obesity that used validated questionnaires to identify novel behavioral and psychological strategies among weight loss maintainers in a commercial weight management program.

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