Weight Maintenance at Lower
Once the goals of weight loss
have been successfully achieved, maintenance of a lower body weight becomes a
major challenge. In the past, obtaining the goal of weight loss has been
considered the end of weight loss therapy. Unfortunately, once patients are
dismissed from clinical therapy, they frequently regain the lost weight. This
report recommends that observation, monitoring, and encouragement of patients
who have successfully lost weight be continued on a long-term basis.
After 6 months of weight loss treatment, efforts to maintain weight loss
through diet, physical activity, and behavior therapy are important. Evidence
Rationale: After 6
months of weight loss, the rate of weight loss usually declines and plateaus
(395, 507, 555). The primary care
practitioner and patient should recognize that at this point, weight
maintenance, the second phase of the weight loss effort, should take priority.
Successful weight maintenance is defined as a weight regain of 3 kg (6.6 lb) in
2 years and a sustained reduction in waist circumference at at least 4 cm. If a
patient wishes to lose more weight after a period of weight maintenance, the
procedure for weight loss outlined above can be repeated.
|Recommendation: A weight maintenance program should be a
priority after the initial 6 months of weight loss therapy. Evidence Category
Lost weight usually will be regained unless a weight maintenance program
consisting of dietary therapy, physical activity, and behavioral therapy is
continued indefinitely. Drug therapy can also be used; however, drug safety and
efficacy beyond 1 year of total treatment have not been established. Evidence
Rationale: After a
patient has achieved the goals of weight loss, the combined modalities of
therapy (dietary therapy, physical activity, and behavior therapy) must be
continued indefinitely; otherwise excess weight will likely be regained.
Numerous strategies are
available for motivating the patient; all of these require that the
practitioner continue to communicate frequently with the patient. Long-term
monitoring and encouragement can be accomplished in several ways: by regular
clinic visits, at group meetings, or via telephone or E-mail. The longer the
weight maintenance phase can be sustained, the better the prospects for
long-term success in weight reduction. Drug therapy may also be helpful during
the weight maintenance phase.