There’s been a lot of research on what diets and exercise programs help with weight loss but not so much about how to maintain the new weight. At least until now. Researchers at the University of Copenhagen and the Hvidovre Hospital have completed a new, sensational study on this topic. By testing four different types of treatment, the researchers demonstrated for the first time how to maintain long-term weight loss.
Why is it hard to stay slim after weight loss?
The researchers explained that hormonal changes caused by weight loss are the biggest issue when it comes to keeping weight off. Whenever people lose weight, their hormones make them that much hungrier.
“The problem is that people are fighting against strong biological forces when losing weight. The appetite increases simultaneously with decreased energy consumption, and this counteracts weight-loss maintenance. We have an appetite-stimulating hormone, which increases dramatically when we lose weight and, simultaneously, the level of appetite-suppressing hormones drops dramatically. In addition, weight loss can provoke loss of muscle mass while the body reduces energy consumption. Thus, when the focus in obesity treatment has been on how to obtain weight loss – rather than how to maintain a weight loss – it is really difficult to do something about your situation,” says co-author of the study Professor Signe Torekov.
A new study tested a combination of treatments
The new study included 215 people with obesity and low fitness. The participants first followed a low-calorie diet over 8 weeks where they each lost approximately 13 kg. After that they were randomly divided into 4 groups for the experiment. The groups received the following treatments:
- Exercise group: placebo medication + 150 min. of activity per week
- Medication group: obesity medication + their usual activity
- Combination group: obesity medication + 150 min. of activity per week
- Placebo group: placebo medication + their usual activity
The activity prescribed could be made up of 150 minutes of moderate-intensity activities or 75 minutes of vigorous-intensity activities or a mix of both. All participants in the study were then weighed monthly and received regular nutritional and diet counselling.
Weight loss results after 1 year were not surprising
The combination group did the best, participants were able to further improve their weight loss to 16 kg. The placebo group, on the other hand, was only able to maintain half of the initial weight loss. The other two groups were able to just about maintain the 13 kg of weight loss.
- Exercise group: maintained the initial 13 kg weight loss
- Medication group: maintained the initial 13 kg weight loss
- Combination group: Improved weight loss to 16 kg
- Placebo group: Maintained only 6,5 kg weight loss
“It is great news for public health that significant weight loss can be maintained with exercise for approximately 115 minutes per week, performed mostly at a vigorous intensity, such as cycling. And that by combining exercise with obesity medication, the effect is twice as good as each of the individual treatments,” says Signe Torekov.
Exercise makes weight loss healthier
The researchers observed a few other effects of the treatment. The two groups that exercised increased their fitness rating, lost fat mass, and gained muscle mass. The combination group was also able to reduce blood sugar and improve the quality of life. On the other hand, the placebo group showed worsening signs of type 2 diabetes and cardiovascular disease.
“It is an important aspect to highlight, as you do not necessarily get a healthier body from losing weight if, at the same time, you lose a lot of muscle mass,” says Signe Torekov.
An ongoing treatment plan and support is crucial to maintain weight loss
This study highlights that losing weight might not even be half the battle. To succeed in the long term, it’s crucial to have ongoing support and a treatment plan that stretches far beyond the initial weight-loss period.
“Without a follow-up on whether people actually have support to perform the exercise, the treatment will not be enough. Therefore, we also followed up with the participants on an ongoing basis to ensure that they received the support they needed in order to exercise. That is necessary because maintaining weight loss is extremely hard. People need to understand this. Once you have lost weight, you are not ‘cured.’ The ongoing exercise and effort will likely need to continue for many years,” concludes Signe Torekov.