Long-Term Maintenance


Losing weight requires commitment and effort. It is therefore disheartening both for patients and practitioners to see weight regain occur, sickness and the resulting negative feelings can lead to abandonment of weight management efforts. Research shows that the majority of those who complete weight-loss programmes lose approximately 10% of their body weight, only to then regain two-thirds of it back in one year, and almost all of it back within five years.1 The need for effective methods to ensure maintenance of weight lost has become increasingly apparent.


Read more: Introduction

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, cure 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

A number of different strategies specifically designed to achieve weight maintenance have been evaluated. These include:


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'.





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.