Many people are trying to lose weight, and they usually end up with the conclusion that “diets suck”. Even in the cases that they manage to achieve a satisfying result, after some months of not dieting they experience, very often, a weight regain. This weight regain in many cases is more than the weight they initially lost, and they end up with more weight and even worse associated health problems than before including diabetes, high cholesterol or triglyceride levels, metabolic syndrome and hormonal abnormalities. Every such cycle of weight loss followed by weight regain is linked to a net increase in weight gain and body fat because when we lose weight we lose both fat and some muscle mass, but when we regain the weight we regain only fat (1).
The studies show that 80% of people who lose more than 10% of their body weight on a diet will have put that weight back on within a year, and one third to one half will have put more back on than they originally lost (2). What is more shocking is that each subsequent time a person goes through the cycle of weight loss than regain, often called ‘yo-yo dieting’, the amount of weight regain grows, and the associated health problems such as high blood pressure, high cholesterol and high blood sugar also get more serious (3,4).
What are the reasons for failing to lose weight and keep it long term?
In many cases the causal reason for obesity is psychological. Thus, even when you manage to have some weight loss through diet, if you didn’t fix the psychological issues it is possible that this will lead soon to weight regain. Another group of people manages to lose weight if they have someone checking and controlling their diets and when there is no doctor or dietitian supervising and advising them, they lose control and start again the unhealthy eating habits. On the other hand, there are people who don’t try enough to learn how to eat healthily and search for a magic pill or magic diet and when these methods fail they get disappointed and stop any further attempt to improve their weight. On top of these, the lack of physical activity, the lack of time to prepare healthy meals and impatience to get quick results lead to a failure in achieving or maintaining a successful weight loss.
A promising progress
According to a recently published paper(2019) the definition for the person who has a successful weight loss is:” A successful weight loss maintainer is defined as an individual who voluntarily decreases ≥10% of the initial body weight and keeps the lost weight for ≥1 year”(5).
Managing to limit and avoid weight cycling in the first year after weight loss is crucial for sustainable long-term weight maintenance and literature shows that there is a 50% decrease in the risk for weight regain in individuals who managed to maintain their successful weight loss for 2 years. The pillar of the strategies to achieve the above-mentioned result is the nutritional intervention usually including calorie and/or fat restriction, ketogenic diets, intermittent fasting or combinations of the above(5).
There is a recently published study (2019) reporting that hypercaloric diets are closely related to the obesity etiology and also cause alterations in gut microbiota functionality (6).
This study was performed in rats to evaluate the effect of a hypercaloric diet on the gut bacteria and it involved the antibiotic treatment to deplete the microbiota before fecal microbiota transplantation to verify its effects on gut microbiota-host homeostasis. . The researchers concluded that the gut microbiota is very important for maintaining health, playing a role in both the metabolism and body homeostasis. Additionally, they mentioned that any microbiota alteration during high fat diet-induced obesity is a problem that needs to be addressed. Moreover, the diet has proved to affect the composition of the gut microbiota, while antibiotics showed that they affect negatively the microbiota biodiversity. The fecal microbiota transplantation is effective in recolonizing the gut microbiota and in restoring some metabolic functions showing that it can be considered as a new tool to complement the conventional treatments for obesity based on healthy dietary and behavioral factors (6).
The Secret to Maintaining a Healthy Weight Long Term
Although Fecal transplantation is very promising there is still much research to be done to prove its efficacy and role against obesity Moreover, the frequent use of antibiotics can also cause problems by killing beneficial bacteria as well as bad bacteria.At the moment there is no magic pill or magic diet that will result in weight loss with zero effort. At the only reliable way to lose weight long term, and keep it off is to eat healthily without starving yourself. Of course, some kind of diets like ketogenic could be followed initially to help you make a good start, but if you want a long term result you should later adopt a more realistic and balanced diet. That means eating a variety of foods, cutting out processed foods, refined carbohydrates and sugar. Adding quality foods like salads, fruits and nuts in your meals will help you get the necessary fibers and feel the sense of satiety which is necessary to avoid starving.
You don’t have to reduce your calories in an extreme level, because you need energy for your daily activities and you need to get the necessary micro and macro nutrients. When starting dieting allow yourself some period of days to adapt to the new status and the need for sweet and junk foods, but these pass with time, and they are much more bearable when calories are not extremely restricted. The longer we spend without processed food the more our hormones are balanced, and the fewer cravings we get.
In addition, we need to feed our guts. That means adding fermented foods and drinks to our diets (choose ones you like!) such as sauerkraut, Kefir or Kombucha (Kombucha is my personal favourite), as well as adding a good probiotic daily, and ensure you get plenty of fiber in your diet, which acts as food for you gut bacteria (known as prebiotics).
The next thing is to make sure that you have frequent sessions of physical activity during the week, but choosing the ones that you enjoy, that you will keep doing long term. If you don’t enjoy it, it’s almost sure that you will soon give it up which will not help you to achieve your goal. Physical activity is important and you need to make a combination of aerobic exercise and weight training managing to increase your muscle mass and your metabolism. If your time is limited you can try to spend about 20 minutes doing a high-intensity interval training and take advantage of this duration for the maximum possible results.
Patience is the key not only to achieve the desired weight but also to maintain it. It is easier to lose weight than maintaining it, so our effort should not stop as soon as we achieve our target weight. We should adopt a lifestyle that combines healthy eating, exercise, enough sleeping time to balance our hormones and pleasant hobbies that will offer to us the necessary mental stability and relaxation(7).
(1) Di Germanio, C., Di Francesco, A., Bernier, M. and de Cabo, R., 2018. Yo‐Yo Dieting is Better than None. Obesity, 26(11), pp.1673-1673.
(2) Dulloo, A. and Montani, J., 2015. Pathways from dieting to weight regain, to obesity and to the metabolic syndrome: an overview. Obesity Reviews, 16, pp.1-6.
(3) Pietiläinen, K., Saarni, S., Kaprio, J. and Rissanen, A., 2011. Does dieting make you fat? A twin study. International Journal of Obesity, 36(3), pp.456-464.
(4) Montani, J., Schutz, Y. and Dulloo, A., 2015. Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk?. Obesity Reviews, 16, pp.7-18.
(5) Contreras, R., Schriever, S. and Pfluger, P., 2019. Physiological and Epigenetic Features of Yoyo Dieting and Weight Control. Frontiers in Genetics, 10.
(6) Guirro, M., Costa, A., Gual-Grau, A., Herrero, P., Torrell, H., Canela, N. and Arola, L., 2019. Effects from diet-induced gut microbiota dysbiosis and obesity can be ameliorated by fecal microbiota transplantation: A multiomics approach. PLOS ONE, 14(9), p.e0218143.
(7) Hall, K. and Kahan, S., 2018. Maintenance of Lost Weight and Long-Term Management of Obesity. Medical Clinics of North America, 102(1), pp.183-197.