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Original Research Communication |
1 From the VA Medical Center, Graduate Center for Nutritional Sciences, University of Kentucky Health Management Resources Weight Management Program, Lexington, and the Departments of Internal Medicine and Biostatistics, University of Kentucky, Lexington.
Background: Current perception is that participants of a structured weight-loss program regain all of their weight loss within 5 y.
Objective: The objective was to examine the long-term weight-loss maintenance of individuals completing a structured weight-loss program.
Design: Studies were required to 1) have been conducted in the United States, 2) have included participants in a structured weight-loss program, 3) have provided follow-up data with variance estimates for 
2 y. Primary outcome variables were weight-loss maintenance in kilograms, weight-loss maintenance as a percentage of initial weight loss, and weight loss as a percentage of initial body weight (reduced weight).
Results: Twenty-nine studies met the inclusion criteria. Successful very-low-energy diets (VLEDs) were associated with significantly greater weight-loss maintenance than were successful hypoenergetic balanced diets (HBDs) at all years of follow-up. The percentage of individuals at 4 or 5 y of follow-up for VLEDs and HBDs were 55.4% and 79.7%, respectively. The results for VLEDs and HBDs, respectively, were as follows: weight-loss maintenance, 7.1 kg (95% CI: 6.1, 8.1 kg) and 2.0 (1.5, 2.5) kg; percentage weight-loss maintenance, 29% (25%, 33%) and 17% (13%, 22%); and reduced weight, 6.6% (5.7%, 7.5%) and 2.1% (1.6%, 2.7%). Weight-loss maintenance did not differ significantly between women and men. Six studies reported that groups who exercised more had significantly greater weight-loss maintenance than did those who exercised less.
Conclusions: Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3 kg and a reduced weight of >3% of initial body weight. After VLEDs or weight loss of 20 kg, individuals maintained significantly more weight loss than after HBDs or weight losses of <10 kg.
Key Words: Weight maintenance • weight loss • meta-analysis • very-low-energy diet • hypoenergetic balanced diet
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