What causes weight regain?

There are a number of factors involved in the phenomenon of weight regain. These include:

• Physiological factors e.g. the decrease in metabolic rate that occurs with weight loss
• The continued availability of tempting high-calorie foods
• The challenge of maintaining a high level of physical activity

There is also a loss of one of the most powerful reinforcers that is present during the weight loss phase of treatment, namely weight loss itself. All these factors can lead to feelings of frustration and discouragement, which can in turn lead to abandoning efforts of weight control.

Weight maintenance strategies

Read more: Weight maintenance strategies

Implications for Practice

From every viewpoint it is desirable for people who have successfully lost weight to maintain the pounds lost and prevent weight regain. Practitioners have an important role in emphasising the chronic nature of obesity and the importance of lifelong weight management. Therefore, it is much more helpful to talk about 'weight management programmes', which have a 'weight loss' and a 'weight maintenance' phase. Patients should be encouraged to make changes to diet and physical activity which they can sustain and, furthermore, they should be encouraged to continue to monitor their weight and waist, so that awareness of any weight regain can be tracked. Patients can be encouraged to return to the surgery for further support when this happens.

Read more: Implications for Practice

Is weight management worth the effort?

Undoubtedly, there are enormous benefits to be gained from weight management for the patient, the practitioner, the NHS and the economy as a whole. Many practitioners describe a high degree of job satisfaction when they can see not only the clinical benefits, but also when patients report significant improvements in their overall quality of life, levels of energy, mobility, general mood, self-confidence and physical health, which literally 'adds years to life and life to years'.

Future Challenges

There are many challenges facing those involved in the treatment and prevention of obesity. Perhaps the greatest challenge is to convince healthcare providers, overweight people and the general public that obesity is a complex, chronic condition that can only be managed effectively through lifelong care.

The aim of this package is to increase your understanding of obesity and its management. We sincerely hope that it also increases your enthusiasm and optimism, knowing that your efforts really can make a difference to those people who are struggling with their weight.

We wish you and your patients every success!

References

1. Institute of Medicine (IOM). Weighing the Option: criteria for evaluating weight-management programs. 1995. Washington, DC: National Academy Press.

2. Perri MG, Corsica JA. 2002. Improving the maintenance of weight lost in behavioural treatment of obesity. Handbook of Obesity Treatment. 2002. Guilford Press. New York.

3. Health Development Agency (HDA). The management of obesity and overweight: an analysis of reviews of diet, physical activity and behavioural approaches. 2003. HDA, London.

4. Klem ML, Wing RR, McGuire MT et al. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr 1997; 66:200–246.