Most dieters know the cycle all too well: You lose a substantial amount of weight. Your clothes start hanging on your slimmed-down body, so you go out and buy new outfits in smaller sizes.
You proudly show off your new body and updated wardrobe, but then one day, you notice your jeans aren’t buttoning as easily as they used to. Reluctantly, you start bringing out your “fat clothes” because all your “skinny clothes” are becoming uncomfortably tight.
Before you know it, you’re back at your original weight — or even higher. You’re discouraged, depressed and frustrated. How did this happen yet again?
How is it that some dieters are able to keep their weight off, while other dieters (by some accounts, the majority) struggle to maintain their weight loss and usually gain all of it — and often more — back?
This is the million-dollar question. And researchers in Philadelphia attempted to find out the answer. Their goal was to learn about the similarities and differences between “maintainers” and “regainers” and what qualitative (not quantitative) factors promoted or prevented the maintenance of weight loss efforts.
Researchers conducted a focus group with 29 participants — 19 regainers and 10 maintainers. Regainers were defined as people who regained 33 percent or more of their weight loss at enrollment. Maintainers were defined as those who had sustained their initial weight loss for at least one year or regained 15 percent or less at enrollment.
Researchers developed questions for the focus group and divided them into five domains: weight loss; transition from weight loss to maintenance; maintenance/regain; acceptability of various diet approaches; and physical activity.
How Maintainers and Regainers are Alike
After analyzing participants’ answers, they narrowed down responses into eight themes, four similarities and four differences between the maintainers and regainers.
As for similarities, both groups:
1. Experienced challenges or setbacks
2. Used the fit of their clothing as the primary indicator of weight status
3. Desired greater support from family and friends during their weight loss maintenance period
4. Decreased self-monitoring of food intake over time
And How They are Different
There were also four differences between the groups. Compared to the regainers, the maintainers:
1. Continued food and activity habits established while they were losing weight (i.e., exercise, portion control, avoidance of specific foods, limited splurges, etc.)
2. Weighed themselves regularly (many regainers actually avoided the scale out of shame or denial, while others just didn’t want to see the number potentially go up)
3. Applied more productive problem-solving techniques, such as adjusting their lifestyle to continue their diet and exercise regimen
4. Used positive self-talk during their weight-loss maintenance period
It’s All About Attitude and Action
The differences between the maintainers and regainers are what eventually lead to success or failure in long-term weight loss.
According to researchers, the first three differences listed above are “consistent with the continued vigilance reported in the National Weight Control Registry.” (The National Weight Control Registry is the largest prospective investigation of long-term successful weight loss maintenance.)
And they stated that, in particular, weighing yourself daily is associated with long-term weight loss success.
Researchers also noted that positive self-talk, good problem-solving skills and adaptability suggest cognitive styles that “provide a partial explanation of how maintainers are able to effectively swim upstream in an obesogenic environment.” (This is an environment that comprises factors that support obesity — like fast food restaurants at every corner, for instance.)
In short, maintainers have the right attitude and take appropriate actions to keep up with their weight loss. This is not to say they don’t experience challenges along the way, as was noted in the similarities between maintainers and regainers. But maintainers were able to adapt their lifestyles to accommodate changes and setbacks that might otherwise cause them to “fall off the weight loss wagon.”
Become a Maintainer
If you’re one of the millions of people who have yo-yo dieted, only to get more and more frustrated with regaining the weight, this study should help give you some insight into what changes you can make to become a maintainer.
One thing you can do right away is find a person (like a personal trainer or weight loss buddy) or an organization (such as Weight Watchers) to hold you accountable for your diet, exercise and weight management.
You also might want to have a consultation with a dietician, trainer, or other fitness/lifestyle expert to learn creative ways to deal with challenges and setbacks successfully.
Remember, weight loss and management is a lifelong journey and commitment. So take the steps now that are necessary to become a maintainer. You’ll be glad you did!
 Reyes N et al. Similarities and differences between weight loss maintainers and regainers: a qualitative analysis. Journal of the Academy of Nutrition and Dietetics. 2012;112(4):499-505.