Long-term weight-loss maintenance: a meta-analysis of US studies

Background: Current perception is that participants of a structured weight- loss program regain all of their weight loss within 5 y. Objective: The objective was to examine the long-term weight-loss maintenan ce of individuals completing a structured weight-loss program. Design: Studies were required to 1) have been conducted in the United State s, 2) have included participants in a structured weight-loss program, 3) ha ve provided follow-up data with variance estimates for greater than or equa l to2 y. Primary outcome variables were weightloss maintenance in kilograms , weight-loss maintenance as a percentage of initial weight loss, and weigh t loss as a percentage of initial body weight (reduced weight). Results: Twenty-nine studies met the inclusion criteria. Successful very-lo w-energy diets (VLEDs) were associated with significantly greater weight-lo ss maintenance than were successful hypoenergetic balanced diets (HBDs) at all years of follow-up. The percentage of individuals at 4 or 5 y of follow up for VLEDs and HBDs were 55.4% and 79.7%, respectively. The results for V LEDs and HBDs, respectively, were as follows: weight-loss maintenance, 7.1 kg (95% Cl: 6.1, 8.1 kg) and 2.0 (1.5, 2.5) kg; percentage weight-loss main tenance, 29% (25%, 33%) and 17% (13%, 22%); and reduced weight, 6.6% (5.7%, 7.5%) and 2.1% (1.6%, 2.7%). Weight-loss maintenance did not differ signif icantly between women and men. Six studies reported that groups who exercis ed more had significantly greater weight-loss maintenance than did those wh o exercised less. Conclusions: Five years after completing structured weight-loss programs, t he average individual maintained a weight loss of >3 kg and a reduced weigh t of >3% of initial body weight. After VLEDs or weight loss of greater than or equal to 20 kg, individuals maintained significantly more weight loss t han after HBDs or weight losses of < 10 kg.