Anyone who has tried to lose a substantial amount of weight knows that the true challenge often lies in keeping those shed pounds from creeping back on. The good news is that weight regain is not a foregone conclusion — there are strategies you can use to make your weight loss permanent.

Metabolic adaptation 

Several factors impact your ability to keep weight off for good, says endocrinologist Bartolome Burguera, MD, PhD.  One of the main factors is your basic metabolic rate, or how many calories your body burns while at rest.

“You start losing weight and the basic metabolic rate goes down from 2,000 to 1,600, so unless you burn 400 more calories by exercising or you eat 400 calories less, you will not be able to continue to lose weight,” Dr. Burguera says.

The human brain is wired to protect the body from starvation, Dr. Burguera says. So when you decrease the amount of calories you consume, your brain’s natural reaction is to try to stop your body from losing more weight.  This is called metabolic adaptation.

A recent study followed the progress of contestants who lost a substantial amount of weight on a popular weight-loss reality television show. Researchers wanted to see if the contestants would be able to keep the pounds off.

At the beginning of the show, the contestants had normal metabolisms for their size. When the show ended, however, the contestants’ metabolisms had slowed dramatically. Their slimmed-down bodies were not burning enough calories to maintain their smaller sizes. This often happens at the end of an intense dieting period.

But the researchers were surprised to find that the contestants’ resting metabolic rates did not return to a normal rate even six years later.

As a result most of the contestants had re-gained weight — some of them gained back every pound that was lost on the show, and then some.

Keeping it off for good

Metabolic adaptation is important, but it’s merely one indicator of why it is so difficult for people to keep weight off, says Dr. Burguera. He did not take part in the study.

Anyone who is trying to lose weight will have better success if they treat their weight as a chronic health condition, and not a one-and-done approach, he says.

“We need to understand that obesity is a chronic disease. In order to treat a chronic condition, you have to offer chronic therapies,” Dr. Burguera says. “So trying to become very physically active, eat a very little amount of calories — that’s short term.  You cannot do that long term.”

Dr. Burguera recommends a five-pronged approach to lose weight for good:

  • Appetite control
  • Physical activity
  • Healthy diet
  • Stress management
  • Adequate sleep


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