Lessons from Successful Losers

Kara Gallagher, PhD, FACSM
First published at www.MohrResults.com, August 2007

With the constant bombardment of statistics related to obesity and physical inactivity, it can become difficult to believe that weight loss is achievable.

  • 40% of the U.S. population participates in no leisure time physical activity.
  • 66% of the U.S. population is overweight.
  • 32% of the population is obese, etc.

However, when it comes to weight loss, not all of the news is bad. There ARE individuals who have been able to lose weight and keep it off; and not just a couple of pounds either. These people have achieved significant weight loss and maintained it for years. And while many of Americans and perhaps some of your clients continue to struggle with managing body weight, there are significant lessons we can learn from these successful "losers".

In 1994, Dr. Rena Wing and Dr. James Hill, two leading obesity researchers, established the National Weight Control Registry (NWCR). The purpose of the NWCR is to identify and study characteristics of individuals who have been successful at long term maintenance. To be eligible for the registry, an individual must have lost at least 30 pounds and maintained that weight loss for at least one year. However, the "average" weight loss is closer to 60 pounds, maintained for at least 5 years. Understanding what these close to 2,700 individuals do on a regular basis, may provide insights into behaviors that can help your clients successfully maintain and/or lose body weight. Here's what we have learned so far about weight loss from the NWCR "losers."

  1. Being an Overweight Child Predisposes You to Becoming an Overweight Adult. Nearly two-thirds of individuals in the NWCR were overweight as a child, and 60% report a family history of obesity. Furthermore, a recent study published in the British Medical Journal (2006) revealed that children do not necessarily 'outgrow' baby fat either. The study revealed that children who were overweight at age 11, were still overweight at age 16. This trend highlights the need for personal fitness professionals to consider training younger, overweight children and teens; this outreach will not only grow your personal training business but will improve the health of the nation as well.

  2. The Underlying Reason for Weight Change May Impact How Much You Lose. A long-term struggle with weight management does not have to mean a lifetime struggle with body weight. It does however, highlight the importance of recent history and the difficulty with getting started. Remember Newton's first law of motion? An object at rest stays at rest and an object in motion stays in motion, unless a force acts upon it. This law suggests that change is possible, with an appropriate and large enough force (motivation). The motivation to change can be anything from a simple class reunion or swimsuit season to a major health scare. Individuals in the NWCR were asked if there were specific reasons or "triggers" underlying their reasons for weight loss. These reasons were classified into medical reasons, such as "my doctor told me to lose weight," non-medical reasons such as "was approaching 40th birthday" or no reasons behind losing weight. Individuals who reported losing weight for medically related reasons had the greatest initial weight loss and they also gained less weight back over a 2 year period compared to those who lost weight for non-medical reasons or who had no underlying reason for weight loss. Question your clients on reasons for wanting to lose weight, and when possible recognize the opportunity to capture these more forceful "triggers" to help clients change.

  3. How Much You Eat Matters. In general, participants in the NWCR eat a low calorie, reduced fat diet consisting of approximately 1400 calories per day with 30% of the calories in the form of dietary fat. What should this tell you? That fast fixes won't work. They won't work because they do not allow clients to develop strategies that can be maintained for the rest of a person's life. In order for a person to successfully maintain a caloric intake of 1400 on average for a period of five years, he or she will need to find specific strategies that fit his/her lifestyle. Thus, extremely restrictive diets like "low-carbohydrate" or "cabbage soup or grapefruit diets" do not work long-term because they simply offer too little options for most people.

  4. The Types of Food You Eat and When You Eat is also Important. What are some key strategies for maintaining a relatively low caloric intake? Weighing and measuring foods, portion control, and eating breakfast. We have heard before that breakfast is the most important meal of the day; it fuels your body for the daily requirements that lie ahead, it also has been shown to better maintain insulin levels and control appetite. Instead of struggling with massive hunger swings throughout the day that leave you hungrier than a restless bear following hibernation, that bowl of oatmeal or vegetable egg white omelet in the AM allows you to make Mahatma Gandhi appear agitated!

    Individuals in the NWCR are minimalists in many ways -- minimal calories and minimal variety. Participants in the registry consume significantly less variety within all food groups, except fruit and combination foods, than recent weight losers following 6 months of weight loss treatment. This data suggests that to stick with weight loss, reduce eating options. If oatmeal in the morning works for you, consider trying every variety of oatmeal but reduce the total number of breakfast options you allow yourself such as eggs, pancakes, French toast, bagels, etc. However, bring on the fresh fruit to increase the available nutrients!

  5. Burning Calories is Critical. This statement is nothing new to personal fitness professionals. We know it. We believe it and in fact, believe it to our core. Exercise matters. Thankfully, scientific data supports this belief as well. Exercise helps with weight loss, and it becomes critically linked to being able to maintain significant weight losses long-term. Why? Exercise allows people to increase the number of calories they can consume so as the weight whittles away, they do not have to whittle away every piece of food as well. It also increases lean muscle mass, improves body composition and the overall appearance of the body, strengthens the heart and lungs, reduces the risk of disease, and oh yeah, makes you feel good. When researchers examined the physical activity habits of the NWCR participants they found that most were doing a significant amount of physical activity per week. On average this group of successful losers expends close to 3000 kilocalories, or the equivalent of walking 30 miles per week in exercise. In addition, the number one activity of choice for these "losers" is walking. If you want to encourage clients to make changes in exercise habits that will ultimately lead to success, suggest greater amounts of aerobic activity. Yes, weight training is important, beneficial, and highly encouraged, but the aerobic component appears to be most important when attempting to lose fat. The bottom line: Whatever exercise your clients are willing to do, that increases energy expenditure and that will fit their lifestyles for the long-term, is really the most important. Talk to your clients. Encourage them. Provide them with strategies for success.

What Doesn't Work?
When researchers examined the data to determine who was likely to gain weight, they found that eating more calories, increasing fat intake (or reducing carbohydrates), and reducing exercise were all linked with regained weight. I know, not rocket science, but it is not as apparent to clients who continually struggle with their weight. Therefore, we should be clear with clients on which behaviors lead to continued weight loss and weight loss maintenance and which may lead to the slippery slope to weight regain. Also, keep in mind that a one-size fits all approach isn't necessarily best. Data analysis from the NWCR is based on what worked for this group of individuals, half of whom lost weight without any formal weight loss assistance. Therefore, use these strategies while keeping your own success stories in mind. After all, don't your clients who are interested in weight loss really desire to become a "successful losers"?