Can losing weight lead to gaining weight??!!

If there is one major negative thing that has emerged from recent research on weight loss is that it often leads to weight regain. If done in an unhealthy, unbalanced way, regaining the weight along with a few extra pounds is also a big possibility. This weight regain is not only frustrating but makes any subsequent attempts at weight loss even harder.

So, if losing weight often leads to weight regain, wouldn't weight maintenance be perhaps the better option for some people? Yes. Also, it is important to note, that if you are gaining weight over time, stabilizing your weight (or stopping the gain) is, in itself, weight loss. To read more on maintaining weight, read my last post.

Another consideration is the idea of preventing weight gain rather than actively trying to lose weight (especially in an unhealthy way). Preventing weight gain has been the focus of much research recently. One reason is because it is easier for people to prevent gaining weight then to try to lose it.

Keeping the weight off after losing it requires most people to be vigilant with their eating and exercise- more so then they did before they lost the weight. Consider that for a moment- to keep off the weight, you cannot merely return to your "usual" way of living. You have to have learnt about healthy eating, made sustainable changes to food and exercise AND found a way to continue this new lifestyle for life. No wonder most people put weight back on especially if short term solutions are used. If done in a healthy way, "watching" what you eat can be an easy thing (if you have practiced mindful eating). It could also be a constant struggle if you have just followed a diet plan and never reconnected with hunger and fullness cues.

One study in particular that focused on weight gain prevention is the "Strategies to prevent weight gain in adults". I think the name of the review says it all! Their main conclusions were that (although the strength of evidence is low for all the strategies) effective approaches may be: low fat diets (where 20% of calories is coming from fat. So if you eat 2000cal per day, 400cal are from fat or 44g per day), eating fewer meals prepared away from home, eating more fruits and vegetables, monitoring heart rate during exercise and participating in group sessions that deal with lifestyle change  (that includes text message reminders). Some of these approaches sound more fun and interesting than others. It's also important to note that other strategies may work but have not been studied (such as mindful or intuitive eating).

One interesting quote from this systematic review paper is :

"The lack of rigorously conducted long term trials to inform those who aim to prevent weight gain may be indirectly contributing to the obesity epidemic"

Interesting. If we are relying on old-school techniques to prevent weight gain we may in fact be pushing people in the wrong direction?! I feel this is another reason why "losing weight at any cost" or "losing weight any way possible" are both bad ideas.

So, be prudent when deciding what strategies to use for losing weight. Consider the possibility of maintaining your weight, at least for a little while before taking on weight loss.

Saying what no one wants to hear.....weight maintenance

As a dietitian most, if not all of my clients want to lose weight. I would even guess that most people I know want to lose weight. It does not matter the reason, nor does it really matter how much they actually weigh- many people want to change it, regardless of the healthiness of their weight. So, how do I go about suggesting that they should abandon their goals/dreams/hopes? Very carefully.
For some people, maintaining their weight rather than losing weight may be the healthiest option- both for the mind and for the body. This applies both to healthy weight people and - yes- people who are labelled as overweight or obese. Many studies over the last 10 years have shown a weak link between being a fit heavy person and development of diseases. So the age old statement of "I want to lose weight to be healthier" is no longer relevant. The act of losing weight may not have an impact on health if blood pressure, blood sugar, cholesterol levels, etc do not actually improve. This may happen if these risk factors are already in the normal range or if an unhealthy approach to weight loss is taken. Not to mention any psychological issues that can arise from dieting! (guilt, deprivation and shame do not help anyone eat healthier!)
So, how does a dietitian broach the subject that weight maintenance may be the best bet for a client? I have had this discussion a few times recently and despite their differences, each client's situation was eerily similar. My first client was a gentleman who has been struggling to lose weight through exercising more and calorie counting to try to eat less. He has found a nice balance between feeling hungry and eating just enough so that his cravings for certain foods has decreased. With less hunger, he can focus less on eating and more on work/life/family. He has been maintaining his weight for the last 2 months. He feels he cannot dedicate more time to exercising nor can he imagine eating any less (or changing much about his food choices)- but he wants to lose weight. Unfortunately, there is no magic trick I can pull out of my hat for him. Instead of following the same old dietetic approach of offering advice on eating more fibre, less dense foods, etc, I decided to listen to what he was really saying. Reflecting back to him this conundrum and pointing out the facts that he just mentioned (not possible to change exercise or eating),  I helped him come to the conclusion that maybe maintaining his weight right now is the best option. It is a good option because anything else may lead him to further frustration.
The other client was in a similar position except her family and work obligations meant she could not spend any more time exercising. She already was very conscious of what she ate and could not dream of eating less or being more careful.
Neither person was putting their lives in danger by maintaining their weight. In fact, by realistically maintaining rather than unrealistically losing weight and likely putting it back on, they are actually healthier.
Sometimes the role of a "Diet"itian is to give clients permission to maintain weight rather than take jabs at their weight like so many others do.