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The challenge of weight loss maintenance

The challenge of weight loss maintenance - What can we learn from the National Weight Control Registry?”. C á tia Martins Associate Professor Medical Faculty , IKM NTNU Researcher RSSO St. Olavs Hospital. Weight loss maintenance. Anderson et al, 2001 (AJCN).

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The challenge of weight loss maintenance

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  1. The challenge of weight loss maintenance - What can we learn from the National Weight Control Registry?” Cátia Martins Associate Professor Medical Faculty, IKM NTNU Researcher RSSO St. Olavs Hospital

  2. Weight loss maintenance Anderson et al, 2001 (AJCN)

  3. Weight loss maintenance

  4. Weight loss maintenance • National Weight Control Registry (NWCR) • American registrywhichprovidesinformationaboutthestrategies used by successful WL maintainers (started in 1994) • Self-selectedpopulationrecruitedmainlythroughnewspapers and magazinearticles • Eligibilityrequirements: • - Having lost at least 13.6kg • - Maintaining it for at least 1 year • - >18 yearsof age • Individualsareasked to complete a bateryofquestionnaresdetailinghowtheyoriginatly lost theirweight and whichstrategiestheyuse to maintaintheir WL • Subsequently (annually) followed to determinechanges in weight and weight-relatedbehaviours overtime Hill et al, 2005 (J Nutr Educ Behav)

  5. Weight loss maintenance • National Weight Control Registry (NWCR) • The average WL among registrants was (in 2004) 32 kg, maintained for almost 6 years, a decrease from a maximumweightof 104.7 kg to a currentaverageweightof 71.8kg • The vast majority of members had tried previously to lose weight, unsuccessfully • These individuals used different approaches for WL/WL maintenance : • - The majority used both diet and exercise • - <10% lost weightwith diet alone • - None lost weightwithexercisealone • - Different types of dietary approaches were used Hill et al, 2005 (J Nutr Educ Behav)

  6. Weight loss maintenance National Weight Control Registry (NWCR) Klem et al, 1997 (AJCN)

  7. Weight loss maintenance National Weight Control Registry (NWCR) Klem et al, 1997 (AJCN)

  8. Weight loss maintenance National Weight Control Registry (NWCR) ~1400kcal/day ~400kcal/day ~ 1h/day Klem et al, 1997 (AJCN)

  9. Weight loss maintenance National Weight Control Registry (NWCR) Catenacci et al, 2008 (Obesity)

  10. Weight loss maintenance National Weight Control Registry (NWCR) Catenacci et al, 2011 (Obesity)

  11. Catenacci et al, 2011 (Obesity)

  12. Weight loss maintenance National Weight Control Registry (NWCR) 78.7% 42.5% 36.2% Butryn et al, 2007 (Obesity)

  13. Weight loss maintenance National Weight Control Registry (NWCR) Butryn et al, 2007 (Obesity)

  14. Weight loss maintenance National Weight Control Registry (NWCR) Typical breakfast: cereal + fruit Wyatt et al, 2002 (Obes Res)

  15. Weight loss maintenance National Weight Control Registry (NWCR) Diet consistency is associated with WL maintenance Allowing for flexibility in the diet may increase exposure to high-risk situations creating more opportunities for loss of control Gorin et al, 2004 (IJO)

  16. Weight loss maintenance II National Weight Control Registry Phelan et al, 2007 (Obesity)

  17. Weight loss maintenance II National Weight Control Registry (NWCR) Phelan et al, 2007 (Obesity)

  18. Weight loss maintenance II National Weight Control Registry Phelan et al, 2006 (Obesity)

  19. Weight loss maintenance National Weight Control Registry There has been a shift in the macronutrient composition of the diet of NWCR members over the past decade Only a minority consumes a low-CHO diet Phelan et al, 2006 (Obesity)

  20. Weight loss maintenance Bond et al, 2009 (IJO)

  21. Weight loss maintenance Bond et al, 2009 (IJO)

  22. Weight loss maintenance National Weight Control Registry After 1 year: • 35% gained ≥2.3 kg • 59% maintained their weight • 6% continued to lose weight Several years of successful WL maintenance increase the probability of further weight maintenance McGuire etal, 1999 (JCCP)

  23. Weight loss maintenance National Weight Control Registry (NWCR) McGuire etal, 1999 (JCCP)

  24. Weight loss maintenance National Weight Control Registry (NWCR) Phelan et al, 2003 (Am J Clin Nutr)

  25. Weight loss maintenance Conclusions: • The following strategies are consistently associated with long-term WL maintenance: - Consuming a low-calorie, low- to moderate-fat diet - Doing high levels of PA (~ 1h/day) - Self-monitoring weight on a regular basis - Maintaining a consistent eating pattern - Consuming breakfast daily - Catching ”slips” before they turn into large regains • However, it is possible to be successfull at long-term WL with a variety of dietary approaches and PA programs • The longer one has maintained WL, the better the chances of continuing to maintain it!

  26. Weight loss maintenance References: • Klem et al, Am J Clin Nutr, 1997; 66:236-46 *** • Catenacci et al, Obesity, 2008; 16:153-61 • Wyatt et al, Obes Res, 2002;10(2):78-82 • Gorin et al, IJO, 2004;28:278-81 • McGuire et al, J Consult Clin Psychol, 1999; 67:177-85 • Phelan et al, Am J Clin Nutr, 2003;78:1079-84 • Butryn et al, Obesity, 2007;15(12):3091-6 • Hill et al, J Nutr Educ Behav, 2005; 37:206-10*** • Phelan et al, Obesity, 2007; 15(19):2470-7 • Phelan et al, Obesity, 2006; 14(4):710-6 • Bond et al, IJO, 2009; 33(1):173-80***

  27. Weight loss maintenance QUESTIONS?

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