Evidence Based Maintenance FAQ

Here are some questions that are answered by National Weight Control Registry Predictors

1.  What is the NWCR, and what do you mean by Predictor?

    The NWCR is a voluntary survey of people who have lost at least 30 pounds and maintained it for over 12 months.  They may or may not have attained goal weight.

    A Predictor is a behavior or feature that is suggested by evidence to predict successful maintenance.

2.  Is there a particular diet that works well for maintenance?

    There is not a particular diet in the sense of particular foods to eat or avoid. One predictor is eating breakfast.  A commonly reported calorie average is around 1,400 but this is inaccurate because it is based on a tool known to underestimate calories 20-30%.  The average is closer to 1,800 calories per day in a survey that is 77% women with an average BMI of 25.1 (down from average BMI 36.7).  (Wing and Phelan 2005)

3.  Do maintainers exercise, and how much?

    Maintainers burned about 2500 calories/week for women and 3300/week for men, equivalent to about 1 hour a day of brisk walking.  Walking is a popular form of exercise for the maintainers, many of whom workout from home.  Fitness levels are best worked up to gradually.

4.  What else do maintainers do differently from average Americans?

    10 hours of TV per week rather than 24

    Eat out 3x per week, and fast food 1x per week rather than 7x

    Avoid situations that encourage overeating

5.  Why do people regain weight?

Length of time in maintenance, only 2 years or more predicts continued maintenance

Disinhibited eating (periodic loss of control)

Depression

6.  Has anything been shown to decrease chances of regain?

Identification of a triggering event, or reason that a lifestyle change was undertaken.  People with medical triggers lost more weight and regained less weight than those with no triggering event or non medical triggers.

Dietary consistency (eating in the same way throughout the week including special occasions) is correlated with about 50% better odds of continued maintenance.

NWCR findings were used to design a program for a Study called STOP Regain, which indicated that active support and self monitoring (interpretation of daily weight and calorie numbers) produced a 47% rate of successful maintenance in the first year after weight loss.  (Other NWCR data is on people who have already maintained for one year.)

To sum up:

1. Continued modification of food intake

2. Daily fitness equivalent to 1 hour walking

3. Eat breakfast

4. Self monitoring (understand weight, fitness and food interactions)

5. Less than 10 hours of TV per week (average is 24)

6. Utilize support and continuing education

7. Eat out less than 3x week, fast food 1x week

8. Be vigilant of conditions that encourage overeating

9. Develop emotional regulation, especially resilience to setbacks

10.  Keep in mind why the weight was lost (triggering event)

Sources:

NWCR Facts: http://www.nwcr.ws/Research/default.htm

Wing and Phelan 2005 http://ajcn.nutrition.org/content/82/1/222S.long

STOP Regain http://www.brown.edu/Administration/News_Bureau/2006-07/06-035.html

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