What Is the Main Idea?

If you are losing weight for personal or medical reasons, it could be important to talk to your primary care physician about your approach. They might be able to help you define different behaviors for weight loss and weight loss maintenance as well as showing you how to more objectively monitor your progress. They might be interested in “The H2020 ‘NoHoW Project’: A Position Statement on Behavioural Approaches to Longer-Term Weight Management” published in the journal Obesity Facts. It explains the current understanding of this complex area.

What Else Can You Learn?

Consider looking for emotional or therapeutic support if you’re losing weight. There is considerable emotional cost in weight loss, especially if goals are not reached. It’s also important to understand that as you lose weight, your body’s structure and energy needs may change. You’ll need to compensate for such changes in your behavior.

The Emotional Cost of Weight Loss

Weight loss is a sensitive subject. Despite the increased visibility of body positivity movements and a better understanding of the range of healthy body shapes, being heavier than average is still stigmatized in most parts of the world. There is considerable societal and personal pressure on “larger” people to slim down by changing their diet and lifestyle or even by seeking medical intervention.

This pressure has a huge impact. People who feel that they have “the wrong” body shape are more likely to develop low self-esteem, depression and anxiety. They may make frequent attempts to diet. If they don’t succeed — or they succeed and then regain some weight — this results in further emotional cost. Emotional or therapeutic support is advisable, especially if you have plans for major changes.

Is Regaining Weight Inevitable?

Studies have shown that some degree of weight regain generally happens in the long term, regardless of whether behavioral, surgical or pharmaceutical approaches were applied. Even when people have medical reasons for slimming down, maintaining the target weight proves challenging.

Weight loss maintenance depends on changing behaviors in the long term. Although many techniques exist to help people change their behavior, it’s still unclear which of these techniques would work best for maintaining the desired weight. Furthermore, physiological, psychological and environmental factors influence our behaviors: These are powerful influences that can overwhelm our efforts.

 What Is the NoHoW Consortium?

Discovering how to help people with weight loss maintenance is the goal of the NoHoW Consortium. This inter-institutional research group aims to create evidence-based approaches to help people reach their desired weight and maintain it. You can learn more about their work here.

What Has the NoHoW Consortium Found?

This open access paper details six position statements that were discussed in a workshop at the 2019 European Congress on Obesity. The hope is that these concepts can form the foundation for better long-term weight maintenance practice.

The position statements can be summed up as follows:

  • Behavioral approaches must take into account that we have different motivations and methods for losing weight than those for maintaining the desired weight. Similarly, the factors that disrupt weight loss are different from those that disrupt weight loss maintenance.
  • Weight management interventions need to dynamically align behavior (diet, lifestyle, exercise) with changes in the body’s energy balance. Weight loss has an impact on body structure, which affects energy requirements. More sophisticated methods of measuring energy intake and energy expenditure would help to understand what’s happening so behaviors could be adjusted over time.
  • Objectively tracking how the energy balance changes over time could help personalize approaches to weight management. There is considerable evidence that weight loss maintenance would respond well to such personalization.
  • More long-term, structured studies are needed to better understand the relationship between behavioral changes and the factors that disrupt weight loss maintenance.
  • Weight loss attempts carry the risk of disappointment and other negative emotions, which can make longer-term weight management more difficult. It’s essential to develop a more comprehensive understanding of the factors that promote and disrupt weight loss maintenance, including personal experiences.
  • Evidence-based, standardized, longitudinal studies are essential for a better understanding of how to compensate for the physiological and emotional factors that undermine weight loss maintenance. They will also give a better sense of who is likely to succeed in their longer-term weight goals.

Can I Apply These Ideas in My Weight Loss Journey?

You could certainly start to consider weight loss and weight maintenance as two separate phases of your journey. Thinking of them separately might help you find different approaches for each. You should also bear in mind that as you lose weight, your body will undergo some changes. Consider talking to a professional about what this means. Finally, finding objective ways to measure your energy intake and energy expenditure would be valuable.

And most importantly of all, if you’re trying to lose weight for personal or medical reasons, ensure that you’re not pushing your body too hard. Talk to your primary care physician before you take any major steps.

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