Some diets promise rapid weight loss. Others aim for a slower pace. Does the rate at which we lose weight have any bearing on whether we keep it off? This is a great question. Conventional wisdom has long held that slow, gradual weight loss is more sustainable. However, a new study questions that wisdom: regardless of how fast the weight comes off, what really matters is the long-term effort to keep it off. In fact, 85% of the people who lost weight gained it back. But when we look at the details of the study, we find it was the perspective of the researchers that led to the low long term success rate. Let’s take a closer look.
Rapid weight loss is not considered to be healthy except under the close supervision of a qualified medical professional, so it is not something I recommend. Slow, gradual weight loss is generally considered to be safer (and my preference). However, in this study it didn’t seem to correlate with long-term maintenance, which was noteworthy because conventional wisdom suggests that gradual weight loss allows for habit change to become more permanent.
The study did not address why both fast and slow dieters did not maintain their weight loss, other than to point out that “intensive effort” is required. It also did not address damage to one’s metabolism that results from prolonged caloric restriction.
Nevertheless, this is an interesting study, mostly due to the emphasis on the importance of what happens after the diet.
I have a few observations about this study in light of our Mindful Life program.
It does not appear that long-term habit change was an aim, but rather losing weight via calorie restriction. In both cases participants used diet alone supplemented by liquid meal replacements. Even the slow group replaced one to two meals per day with liquid. Few people would opt to replace some meals with a shake forever. So during the duration of their diet, they were not working toward sustainable habit change. They were following a “diet” (which no one wants to stay on for one minute longer than necessary). People get into the “on a diet/off a diet” mentality, understandably. If they were actually targeting habit change, a gradual approach would be more sustainable. Also, the quality of the foods with regard to metabolism didn’t seem to be an issue. Processed foods vs. whole foods makes all the difference.
To answer the question of whether slow and steady wins the race, it may be appropriate to adjust the metaphor. A “race” is something with a start line and a finish line. The race is the amount of weight you need to lose: 20 pounds, 50 pounds, 100 pounds. Whether you lose it by sprinting or by strolling, you will ultimately cross the finish line. This is the “medical model” which simply targets the amount of weight that needs to be lost. According to Steve, “When you change your lifestyle to a path that makes you happier and includes unprocessed, healthy food choices, your chances of success are a great deal better. The medical model does not consider this possibility.”