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The psychology behind maintaining weight loss

January 02, 2020 | UCI Health
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Nearly 40% of Americans are obese and the costs in terms of disease, psychological health and medical spending are staggering. Although fewer Californians — about 25%, according to the U.S. Centers for Disease Control & Prevention — are considered obese, statewide costs are still huge.

It’s no wonder that dieting continues to be big business. Everywhere you turn someone’s advertising a diet: high-fat, low-carb ketogenic diet; paleo “caveman diet”; plain low-carb or low-fat diets, or vegan, flexitarian or Mediterranean regimens.

The options and the hype seem endless. And people do lose weight on many of these diets.

Keeping the weight off

Maintaining the weight loss is the challenge. Studies suggest that most dieters end up gaining back the lost pounds within three to five years, according to Katie Rankell, a registered dietitian and program director of the UCI Health Weight Management Program.

Why is that? There’s a psychological component to weight loss that is responsible, and it is powerful, says Rankell.

“Most people start their weight-loss journey feeling like losing the weight is going to be the hardest part. When they lose weight, they feel successful. But eventually they go right back to their old habits.”

When that happens, Rankell says, “You gain weight.”

Behavioral, lifestyle changes needed

The key to maintaining weight loss is making a range of behavioral and lifestyle changes to counteract deeply ingrained, lifelong habits, Rankell says. And that isn’t easy.

“Weight is hugely psychological,” she says. “If it was just a hunger thing, we’d eat when we are hungry and stop when we’re full.

“I think it takes even more practice to maintain weight loss, because you have to maintain a healthy lifestyle.”

Set yourself up for success

Eating habits responsible for putting on weight must be replaced with healthier meals, which requires new ways of shopping and cooking.

Here are some adaptations Rankell recommends for successful dieters once they’re back in the post-diet, real world:

  • Plan your meals: Decide in advance what you’re going to cook, then shop for and limit yourself to those choices.
  • Keep healthy snacks available: Stocking your work space with apples, nuts or other good snacks will empower you to bypass the pastries set out at a conference table or treats shared in the breakroom.
  • Get good sleep, manage stress: Mild yoga, meditation or calming apps can help you get needed sleep and reduce stress in order to focus on healthy choices and avoid the weight gains associated with too little sleep and too much stress.
  • Avoid psychological eating: Instead of treating or comforting yourself with food, choose non-food-related rewards such as listening to music, reading a book, taking a trip or buying a new outfit.
  • Divert negative self-talk: Instead of blasting yourself with criticism or discouragement (“I’ve blown it, I’ll never keep the weight off”), look for tools to help you redirect your thoughts and stay positive.
  • Exercise: Get moving. In the UCI Health Weight Management Program, 90% of people who’ve maintained their weight loss for five years exercise an hour each day.
  • Be accountable: Weigh yourself daily, keep an exercise log and write down what you are eating. Pick a number on the scale and agree that if you hit it, it’s time to get support and return to what you were eating when you lost the weight.

A lifestyle commitment

Long-term weight control often requires more than sticking to a set number of calories and an exercise regimen.

“You need a structure in place to maintain the weight loss,” says Rankell. That’s why graduates of the weight management program continue to attend weekly sessions.

“Our graduates have been in our long-term program an average of seven years. They acknowledge that weight is their struggle and feel it’s worth it to come in once a week to keep the weight off.”

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