Author(s): Leser MS, Yanovski SZ, Yanovski JA
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Abstract OBJECTIVE: To examine the roles of diet, exercise, and lifestyle factors in determining long-term weight regain after weight loss with a very-low-calorie diet (VLCD). SUBJECTS: Twenty-seven of 38 women who lost weight with a VLCD. DESIGN: Graduates of a weight loss intervention study returned for follow-up 3 years after program completion. Percentage of initial weight loss that was regained was correlated with subjects' fat intake (assessed via 7-day food records and a Diet Habit Survey), energy intake (assessed via 7-day food records), activity level and lifestyle factors (assessed via questionnaires) that are supportive of weight loss maintenance. STATISTICAL ANALYSES PERFORMED: Regression analysis was used to assess the relationship of weight regain with fat intake, activity level, and energy intake. Contingency table analysis was used to assess the association between weight regain and lifestyle factors. RESULTS: Subjects followed experienced a -20.7kg+/-9.2kg (-19.2\%+/-7\%) (mean+/-standard deviation) weight change during the original VLCD program and a 13.9kg+/-11.3kg (76.6\%+/-52.1\%) weight change 3 years post-VLCD. Fat intake, assessed by a 7-day food diary, was positively correlated with weight regain at 3 years (r=0.66, P=.0004). Less weight regain was also seen with a lower percent fat intake as reflected by a higher Diet Habit Survey score (r=-0.55, P=.004). Women with the lowest tertile of reported fat intake (<25\% of energy) from the Diet Habit Survey regained the least amount of weight (P=.05). Activity level was negatively correlated with weight regain (r=-0.53, P=.005). After correction for multiple comparisons, there was no association between total energy intake and weight regain. Lifestyle factors were also not associated with weight regain. APPLICATIONS/CONCLUSIONS: Identifying strategies to maintain weight loss is crucial because of the negative health effects and increasing prevalence of obesity. For women who have lost weight on a VLCD, limiting dietary fat intake and maintaining physical activity are both important factors for the prevention of weight regain. To promote better weight loss outcomes, registered dietitians should help clients who have lost weight limit their fat intake to less than 30\% of energy and encourage high activity levels.
This article was published in J Am Diet Assoc
and referenced in Journal of Obesity & Weight Loss Therapy