For weight loss, slow and steady loses the race

For obese patients, fast initial weight loss might be better than more gradual weight loss for long term weight maintenance.

Lisa Nackers and her team from the University of Florida used data from the Treatment of Obesity in Underserved Rural Settings (TOURS) study to reach their conclusions. The TOURS study was conducted from 2003 to 2008 by the National Heart, Lung and Blood Institute on obese women aged 50 to 75. Participants were encouraged to achieve weight losses of 0.45 kg/week through diet and exercise, and were enrolled in lifestyle intervention programs for eighteen months.

Nackers and her colleagues divided the data from 262 TOURS participants into three categories, depending on how much weight the women had actually lost in the first month. The fast group lost at least 0.68 kg/week, the slow group lost less than 0.23 kg/week, and the moderate group fell in the middle.

When compared at both six months and again at eighteen months, the fast group lost more weight overall than the other groups. Contrary to conventional wisdom, the fast weight losers were not more likely to regain weight.

The authors concluded:

Losing weight at a fast initial rate leads to greater short-term weight reductions, does not result in increased susceptibility to weight regain, and is associated with larger weight losses and overall long-term success in weight management. We suggest that, within lifestyle weight control programs, substantial efforts should be focused on promoting large rather than small behavioral changes during the initial weeks of treatment.