Get There and Stay There

I’m sure most of you know some person or maybe several people who lose weight, gain it back, lose weight again, gain it back and so the cycle goes.  Well they certainly aren’t alone as weight loss is challenging, and as you’ll see maintaining weight loss may be even more challenging.  Only 20% of people are successful at long-term weight maintenance [8] and 30% of people who lose weight through dieting gain it back within one year.  The figure goes up to 95% of people when the time span stretches to five years [1].  Worse yet, the crazier the dieting approach (think Grapefruit diet or Peanut Butter diet), the more the lost weight comes from valuable hard-to-build (and get back) lean (muscle) tissue.  Even with reasonable long-term dieting-only approaches, anywhere from 14 – 23% of weight loss comes from lean tissue [3].  For example, a recent study in the American Journal of Clinical Nutrition had older women follow a five month diet program that required them to restrict their daily caloric intake by 400 calories (a candy bar and a bottle of soda) and follow a simple exercise program three days per week [9].  On average, the 78 women in this study lost around 25 pounds of body weight.  Impressively, 18 pounds or 72% of the lost weight was from fat while 8 pounds or 30% of the lost weight came from muscle.  The take home message at this point is that weight loss doesn’t have to feel like an impossible task if an adequate time frame is allowed and daily, consistent effort is applied.  So instead of setting a goal to lose 20 pounds in two months, say you are going to lose a little more than one pound per week when averaged over the next six months.

The next step of this study was the most telling aspect, however.  After completing the five month program, the research participants were on their own with no help from the researchers.  Six and twelve months after completing the program they were tested again for changes in body mass and body composition.  After six months, the women, on average, gained back almost four pounds and right at eight pounds of weight was gained back after 12 weeks [2].  As we discussed before and unfortunately, this is somewhat expected.  Even more frustrating is that when the weight was initially lost around 30% of the weight came from muscle, but when it was gained back only 12% of the weight came back as lean tissue.  When you consider that bone, lean tissue and fat tissue make up almost the entire body, this is a troubling situation.  Last time I checked, bone size in adults doesn’t change that quickly so that leaves either lean tissue or fat tissue, which means that more fat is gained back when weight is lost and then gained back again.

Surely, some means exists for this cycle to be interrupted, right?  The first aspect is to not fall of the wagon after busting your hump for several months and finally achieving your goals only to gain the weight back.  For many people, dieting and exercising to lose weight is hard work and takes significant sacrifice, life changes and is both physically and emotionally taxing.  When the goal is reached, you want to stop!  Unfortunately, your body’s physiology will still bring back the pounds if you stop your exercise program and start eating like you did before the weight loss began.  In this respect, it’s critically important to mentally approach a new diet and exercise program as something that won’t go away or you won’t stop doing…ever.  Sure, you’ll have good days and bad days, but doing a little something each day will keep things from getting out of control.  The next thing you can do to keep from losing too much muscle and gaining back too much fat is to follow a resistance training program.  I’m not saying you need to train like a mad man (or woman) or need to resemble one of those grizzly looking guys at the gym.  You know the guy tripping over himself when he stares at himself too much in the gym.  I’m talking about a simple weight training program that hits every body part using optimal intensity and volume each week.  Most women I know gravitate to cardio machines, but weight training is where you’ll build muscle, build bone, and build strength (and probably a little bit of confidence as well).

Finally, the next thing you can do is add some extra protein in your diet.  A number of studies repeatedly show that when a low-calorie diet has an increased proportion of protein, weight loss is improved, body composition changes are better and many common markers of your health are improved as well [4-7].  Add a weight training program and this type of diet and you get the best of both worlds.  And YES, studies do show that there is a combination effect where greater results are seen when a higher protein diet and resistance training program is added together [7].

REFERENCES

1. Methods for voluntary weight loss control. NIH Technology Assessment Conference Panel. Consensus Development Conference, 30 March to 1 April 1992. 1993. 119: p. 764-70.
2. Beavers, KM, et al. Is lost lean mass from intentional weight loss recovered during weight regain in postmenopausal women? Am J Clin Nutr, 2011. 94(3): p. 767-74.
3. Chaston, TB, et al. Changes in fat-free mass during significant weight loss: a systematic review. Int J Obes (Lond), 2007. 31(5): p. 743-50.
4. Kerksick, C, et al. Effects of a popular exercise and weight loss program on weight loss, body composition, energy expenditure and health in obese women. 2009. 6: p. 23.
5. Layman, DK. Protein quantity and quality at levels above the RDA improves adult weight loss. 2004. 23(6 Suppl): p. 631S-636S.
6. Layman, DK, et al. A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. 2003. 133(2): p. 411-7.
7. Layman, DK, et al. Dietary protein and exercise have additive effects on body composition during weight loss in adult women. 2005. 135(8): p. 1903-10.
8. McGuire, MT, et al. The prevalence of weight loss maintenance among American adults. Int J Obes Relat Metab Disord, 1999. 23(12): p. 1314-9.
9. Nicklas, BJ, et al. Effect of exercise intensity on abdominal fat loss during calorie restriction in overweight and obese postmenopausal women: a randomized, controlled trial. Am J Clin Nutr, 2009. 89(4): p. 1043-52.