- 1. Hall KD, Kahan S. Maintenance of Lost Weight and Long-Term Management of Obesity. Med Clin North Am. 2018 Jan;102(1):183-197. doi: 10.1016/j.mcna.2017.08.012. PMID: 29156185; PMCID: PMC5764193.
- 2. Huttunen-Lenz M, Hansen S, Raben A, Westerterp-Plantenga M, Macdonald I, Stratton G, Swindell N, Martinez JA, Handjieva-Darlenska T, Poppitt SD, Silvestre MP, Fogelholm M, Jalo E, Brand-Miller J, Muirhead R, Larsen TM, Vestentoft PS, Handjiev S, Schlicht W. Forming new health behavior habits during weight loss maintenance-The PREVIEW study. Health Psychol. 2022 Aug;41(8):549-558. doi: 10.1037/hea0001182. Epub 2022 Jul 4. PMID: 35787141.
- 3. Cava E, Yeat NC, Mittendorfer B. Preserving Healthy Muscle during Weight Loss. Adv Nutr. 2017 May 15;8(3):511-519. doi: 10.3945/an.116.014506. PMID: 28507015; PMCID: PMC5421125.
- 4. Ashtary-Larky D, Ghanavati M, Lamuchi-Deli N, Payami SA, Alavi-Rad S, Boustaninejad M, Afrisham R, Abbasnezhad A, Alipour M. Rapid Weight Loss vs. Slow Weight Loss: Which is More Effective on Body Composition and Metabolic Risk Factors? Int J Endocrinol Metab. 2017 May 17;15(3):e13249. doi: 10.5812/ijem.13249. PMID: 29201070; PMCID: PMC5702468.
- 5. Kase CA, Piers AD, Schaumberg K, Forman EM, Butryn ML. The relationship of alcohol use to weight loss in the context of behavioral weight loss treatment. Appetite. 2016 Apr 1;99:105-111. doi: 10.1016/j.appet.2016.01.014. Epub 2016 Jan 12. PMID: 26792773; PMCID: PMC4768732.
- 6. Taheri S, Lin L, Austin D, Young T, Mignot E (2004) Short Sleep Duration Is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index. PLOS Medicine 1(3): e62. https://doi.org/10.1371/journal.pmed.0010062
- 7. Greer SM, Goldstein AN, Walker MP. The impact of sleep deprivation on food desire in the human brain. Nat Commun. 2013;4:2259. doi: 10.1038/ncomms3259. PMID: 23922121; PMCID: PMC3763921.
- 8. Epel E, Lapidus R, McEwen B, Brownell K. Stress may add bite to appetite in women: a laboratory study of stress-induced cortisol and eating behavior. Psychoneuroendocrinology. 2001 Jan;26(1):37-49. doi: 10.1016/s0306-4530(00)00035-4. PMID: 11070333.
- 9. Dallman MF, Pecoraro N, Akana SF, La Fleur SE, Gomez F, Houshyar H, Bell ME, Bhatnagar S, Laugero KD, Manalo S. Chronic stress and obesity: a new view of 'comfort food'. Proc Natl Acad Sci U S A. 2003 Sep 30;100(20):11696-701. doi: 10.1073/pnas.1934666100. Epub 2003 Sep 15. PMID: 12975524; PMCID: PMC208820.
- 10. Institute of Medicine (US) Subcommittee on Military Weight Management. Weight Management: State of the Science and Opportunities for Military Programs. Washington (DC): National Academies Press (US); 2004. 3, Factors That Influence Body Weight. Available from here
Week 10 - How to maintain weight loss
Introduction
In the last week of our programme we talk about maintaining weight loss long term and how you can keep your new habits and lifestyle changes on track. Instead of thinking about diets as something that you start and stop again and again, we show you how turning these changes into lifetime healthy habits has a positive impact on not just your weight but your mood, motivation, and overall health.
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Welcome to week 10 from the Lifestyle Medicine team.
Welcome to Week 10, at this stage hopefully you've taken all of our Lifestyle Medicine advice on board and you’re on track to achieving your weight loss goal! Well done on your journey so far, we’re really excited for you. We understand how much effort losing weight takes, so we’re really happy you're here.
The next step in your weight loss journey, in many ways, is the most important one: maintaining the weight you've lost. For many, this could be the point in the past where you dropped the focus on managing your behaviours to support your healthy weight. It’s common to stop paying attention to what you’re eating and drop healthy habits that you've created, and then to regain some of the weight lost after achieving a weight loss goal (1). If that was you in the past, then we would love you to enjoy your achievement for the long term and to commit to making this your most successful weight loss journey ever.
The key to lasting weight loss is to hold onto the healthy habits that you've made and to turn them into long term patterns (2). Don’t worry, this section is nothing new. If you’ve been following our advice, you simply need to turn your new habits into long term healthy habits for life. By continuing to practice your new habits, your behaviour patterns will soon become automatic and this will help you stay at the weight you feel happy at and improve your long term health.
Maintaining Muscle Mass
This is essential during weight loss to help maintain your weight loss (3). This important aspect of maintaining weight loss starts while you're losing weight. Your body composition (the percentage of fat, muscle and bone in your body) is vitally important to how your body burns calories after weight loss. Slower, steady weight loss has been found to be associated with keeping a higher percentage of muscle mass following weight loss. This is helpful because your muscle tissue is more metabolically active than fat tissue, and overall, your basal metabolic rate (BMR) will be higher. When you actively work to maintain muscle mass you’re less likely to regain the weight you’ve lost because more of your body tissues are burning calories, even at rest.
Fast weight loss on the other hand has been associated with increased loss of muscle, which slows your metabolism, your BMR, making you more prone to weight regain following weight loss. It's therefore helpful to lose weight slowly to help prevent weight regain (4). Adding in a little additional resistance or strength training 2-3 times a week can also help in terms of maintaining muscle mass and reducing body fat (3).
Your “why” - Connecting with your deep seated and emotionally meaningful reason that led you on your weight loss journey is still important. It leads you to develop your grit, that combination of passion and perseverance that can really take you to your goal (1). Being clear on your “why”, your motivation to change your weight, remains vital to hold onto and to come back to if challenges appear on your way. This can help to anchor your motivation long after you've reached your goal as you establish the newer healthier you, your new weight, and your new normal. Do you have any visual prompts like before and after photos? Have you been keeping a journal that can remind you of how you felt before that you can compare to how you feel now? We recommend that you find these items because they can help you to keep your focus and remind you of where you've come from, your journey to this point. Celebrating your achievements can help to maintain your focus and success.
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How to Eat and Drink
Like we've said before, there’s no perfect diet that suits everyone. It's more important to find an eating style that you can enjoy and that will support your long term health. To help you, we've created some eating guides that are suitable for weight maintenance as well as weight loss. The most important thing is to enjoy the foods that you eat, and that your hunger is satisfied so that you don't feel tempted to reach for too many treats. Ensuring that you're eating enough protein with each meal has been found to help you to maintain your weight, as well as not eating too many sweet treats (1). Keep clear fluids as the main thing you drink - only choose higher calorie drinks as occasional treats. Drink water, black or green tea, or coffee and herbal teas.
Alcoholic drinks contain a lot of hidden calories and it can also lead to overeating so they are best enjoyed in moderation (5).
Movement - keeping active is an important part of being healthy. Work with your level of activity as it is, maintain this, or if you know you could be more active, make a plan that you can stick to. Walking for many is a great place to start - see if you can build up to 10,000 steps a day. This can be completed in bite size chunks over the course of the day, which can make it more achievable. Movement when seated can also be really beneficial, especially breaking up a sedentary day at work. You can bring movement in with arm stretches, chair yoga and even use simple household items like soup tins to add extra weight for strength building. Adding in a little additional resistance or strength training 2-3 times a week can also help in terms of maintaining muscle mass and reducing body fat (3).
Sleep - Making sure you optimise your sleep is an important step in staying at a healthy weight. Your sleep quality affects your stress levels and food choices through hormonal pathways, so it’s important to focus on sleep if yours is unsettled (6,7). Use the free gifts we have shared with you in previous weeks to support you in getting deep restful sleep.
Stress - It affects both your appetite and hormone balance. It can affect your ability to lose weight and increase your risk of weight gain (8,9). Read through the information from Week 9 about the impact of stress on weight loss to find out more.
During these 10 weeks, we have been sharing holistic lifestyle measures that you can put in place to support your personal weight loss journey. We want to acknowledge here that there is a genetic component to being overweight (10). However, the good news is that we know that our genes are switched on and off by our environment, by our behaviours, and by our lifestyle. This fascinating new area of science is called Epigenetics. What it means for you is that even if there is a strong family history of being overweight or of obesity, you have it within your power to make the changes in your environment, behaviours and lifestyle that, with consistency, will impact how your genes express themselves. Changes to your environment and lifestyle like the food you eat, the level of activity you do, the way that you manage your stress, ensuring that you get good sleep, maintaining your focus on your health, and consistency with positive changes that you make will all impact how those genes express themselves and therefore, how they will impact your body weight.
Keep in mind that when you achieve your goal weight, you must keep your good habits going to support your system to settle into your new weight for the long term for improved overall health outcomes and more energy. We encourage you to see your weight loss as a holistic process. There are many factors that contribute significantly to your weight. There is much more to it than the old fashioned, oversimplified, advice to lose weight “eat less and move more”. During this series, we hope you've learned how to use your amazing physiology to your advantage. What you eat and how much you move are important. But just as important are factors like your sleep, your stress level, how much sitting you do and your personal, strong reason for embarking on this journey to begin with, your “why”, which can help you stay on track.
Really celebrate yourself, your tenacity and determination to make this commitment to yourself and your health, and for making these changes for life. We wish you continued success in maintaining your momentum on this journey for the best possible health outcomes.
