Top ten tips to achieve weight maintenance after weight loss

"Often people who lose weight report a surge in appetite more than the drop in metabolism that can lead to weight regain. The increase in appetite can be three time stronger" . Kevin Hall PhD who studied how the body responds to weight loss at the National Institutes of health in Bethesda MD

The following top ten tips maybe the answer to avoid weight regain once you have achieved your target weight :

1. Increase your calories by 100 -When a person loses weight their basal metabolic rate drops. To maintain their new weight, they need to consume fewer calories. That person must continue to have a calorie deficit, which varies individually but is often 500kcal/day. When a person achieves goal weight, increase intake by 100kcal/day in nutritious food until they start to gain weight. When they start to gain weight, advice is given to decrease by 100kcal/day until they do not gain any longer. This requires weekly weight monitoring.

2. Adding a serving a day of non-starchy fruit and vegetables was associated with less weight gain E.g berries, apples, pear, cauliflower, green leafy vegetables, soy, and tofu. the order in which food is eaten might be important -eating vegetables first, protein second and grain third reduced fluctuations in blood glucose levels and improve insulin sensitivity

3. Eat at home and avoid processed foods which although cheaper is higher in calories. Eating at home compared to eating out whether fast food or full-service restaurant can also avoid consumption of excess calorie intake

4. Have breakfast especially increasing lean protein intake can help with weight maintenance. This can also result in more satisfaction and less snacking. Successful maintainers had daily breakfast, a lower fat diet and fewer calories e.g nuts, pulses, beans and tofu, probiotic yoghurt. Aim 25-30g protein at each meal, 1 serving of whole grain

5. Self-monitor – weighing weekly same time same place same scale same day of the week can produce more accurate reading, monitoring intake e.g using online calorie counter my fitness pal

6. Spend time exercising – moving an hour a day 5 days per week. Combination of strengthening and endurance is recommended. This has been shown improve blood fats levels, insulin resistance and blood pressure. It also has been shown to increase lean muscle mass which can raise basal metabolic rate

7. Ensure sound sleep -short sleep < 6 hours. Those who are successful with weight loss and long-term weight maintenance are known to get up early, have longer sleep duration and better quality of asleep also fall asleep more quickly. Aim for 7-8 hours’ sleep. Go to bed and get up same time every day

8. Address mental health challenges – being a good problem solver, having hope and a more positive mood are personal traits that have been shown to help weight maintenance. Addressing depression with antidepressants not associated with weight gain is important.

9. Modify old habits and adapt new ones – restructuring daily routines and increasing mindfulness, using distraction techniques to move away from emotional eating has been shown to achieve successful weight maintenance e.g taking a different driving route, keeping busy with a new activity. Such small changes help improve weight maintenance. Focus on healthy eating, eating based on cues of hunger and recognising fullness, eating slowly, and savouring every bite are intuitive eating methods which help. Techniques such as sipping water or resting fork between bites of food may help. Allowing yourself less restrictions in the weekend may help weight maintenance than restrict diet every day

10. Attend a support group -being accountable is important. Monthly meeting seems to help with weight maintenance

Summary Keep up activity, add 100 calories per day and chart your weekly weight to see if it’s stopped decreasing and achieving maintenance, keep up healthy balanced meals and snacks, keep up regular meals, keep up fruit and vegetables as a large part of meals, keep up hydration, keep up managing stress and boredom and keep up sleeping well. Remember there can be several factors that influence weight regain including food , reduced activity, environmental, Genetics, medication, mood , hormones. While you can't fully control some , work on the factors that you can control like food and drink , mood ,sleep and activity.

Reference: Ten proven strategies to help patients maintain weight loss-Mari Jane Hynes MD J of family practice February 20 vol 69 No1

For Specialised Diet and Nutrition advice seek the advice of a Professional Dietitian and Nutritionist Tabby Kabeer

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