Long-term weight-loss maintenance: a meta-analysis of US studies.
Level 1 - systematic review of randomized trials
Meta-analysis of clinical intervention studies
PubMed 11684524 · doi:10.1093/ajcn/74.5.579
What was done
A meta-analysis of 29 US studies evaluated long-term weight-loss maintenance in individuals completing structured weight-loss programs with at least 2 years of follow-up. The meta-analysis examined weight-loss maintenance across very-low-energy diets (VLEDs) and hypoenergetic balanced diets (HBDs). Primary outcomes were weight loss maintained (kg), percentage of initial weight loss maintained, and reduced weight as a percentage of initial body weight.
What was found
At 4 to 5 years of follow-up, 55.4% of VLED participants and 79.7% of HBD participants were assessed. VLEDs resulted in significantly greater long-term weight-loss maintenance compared to HBDs: - Weight-loss maintenance: 7.1 kg (95% CI: 6.1, 8.1) for VLEDs vs 2.0 kg (95% CI: 1.5, 2.5) for HBDs. - Percentage of initial weight loss maintained: 29% (95% CI: 25%, 33%) for VLEDs vs 17% (95% CI: 13%, 22%) for HBDs. - Reduced weight: 6.6% (95% CI: 5.7%, 7.5%) for VLEDs vs 2.1% (95% CI: 1.6%, 2.7%) for HBDs. Maintenance did not differ significantly by sex. Six studies noted significantly greater maintenance with higher exercise. Overall, average individuals maintained >3 kg and >3% reduced weight at 5 years.
Why it matters
This study refutes the common perception that all weight lost in structured programs is regained within 5 years, demonstrating modest sustained weight loss that is greater with initial very-low-energy diets.
Limits
The analysis was limited to US studies and restricted to program completers, introducing selection bias. Significant participant attrition occurred by year 5 (especially in the VLED group at 55.4% follow-up). The abstract does not report total participant n or study randomization details.
Cited by
- supports Meta-analyses and research studies show that individuals who exercise during a weight-loss program are consistently better at maintaining long-term fat loss over weeks to years.