Is Gradual Weight Loss Better Than Rapid Weight Loss For Long-Term Weight Control?

Slow and steady weight loss does not reduce the amount of or rate of weight regain compared with losing weight quickly, according to new research published Oct. 15 in The Lancet Diabetes and Endocrinology.

Led by principal investigator Joseph Proietto, MBBS, PhD, Sir Edward Dunlop Professor of Medicine at the University of Melbourne and Head of the Weight Control Clinic at Austin Health in Australia, the study sought to determine whether losing weight at a slow initial rate resulted in greater long-term reduction of weight and less weight regain than losing weight at a much faster initial rate.

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The study randomly assigned 200 obese adults (BMI 30–45kg/m2) to either a 12-week rapid weight loss program on a very-low-calorie diet (450–800 kcal/day) or a 36-week gradual weight-loss program that reduced participants’ energy intake by approximately 500 kcal-day in line with current dietary weight loss guidelines. Participants who lost more than 12.5 percent of their bodyweight were then placed on a weight maintenance diet for three years.

Results showed that participants who lost weight faster were more likely to achieve target weight loss as 81 percent of participants in the rapid weight loss group lost ≥12.5 percent of their bodyweight vs. 50 percent in the gradual weight-loss group. Further, the initial rate of weight loss did not affect the amount or rate of weight regain in these patients who entered the subsequent weight maintenance period, as similar amounts of weight were regained after three years by participants who had lost weight on either diet program. In addition, weight regain was around 71 percent in both groups after three years.

The authors note that their findings “are not consistent with present dietary guidelines which recommend gradual over rapid weight loss, based on the belief that rapid weight loss is more quickly regained.” They add that possible reasons for their findings include the notion that losing weight quickly may be a motivating factor for participants to continue their diet and thus achieve better results, and limited carbohydrate intake of very low-calorie diets might promote greater satiety, and less food intake by inducing ketosis.

Ultimately, as Corby Martin, PhD, Pennington Biomedical Research Center, Baton Rouge, points out in a related editorial comment, the study “indicates that for weight loss, a slow and steady approach does not win the race, and the myth that rapid weight loss is associated with rapid weight regain is no more true than Aesop’s fable. Clinicians should bear in mind that different weight loss approaches might be suitable for different patients in the management of clinical obesity, and that efforts to curb the speed of initial weight loss might hinder their ultimate weight loss success.”

Keywords: Carbohydrates, Caloric Restriction, Body Mass Index, Weight Reduction Programs, Weight Loss, Nutrition Policy, Ketosis, Energy Intake, Obesity, Diet

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