Most People Don't Lose Weight Long Term, Study Finds

Illustration for article titled Most People Don't Lose Weight Long Term, Study Finds
Photo: Patrick Sison (AP)

New research is the latest to suggest that sustained weight loss is extremely difficult for most people. The study tracked people in the general public for over a decade and found that those who were already overweight or obese tended to stay overweight or obese. People who remained obese also appeared to have a higher risk of heart problems and dying earlier than others at a lower body mass index, or BMI. The findings highlight the challenges of weight loss, which is often framed as something anyone can do with enough willpower.

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The study was conducted by researchers from the University of Nottingham in the UK. They looked at anonymized medical records from over 200,000 residents over the age of 18, using a nationally representative and government-created database of people who had visited a primary care doctor (the UK, unlike the U.S., has a completely nationalized health care system). They specifically focused on people over the age of 18 who were overweight or obese but free of known heart issues and who had their BMI checked several times during the study period (1999 to 2018).

These patients were separated into four groups: People who were overweight with a BMI between 25 to 30, and those with mild, moderate, or severe obesity, or a BMI 30 and over. They were tracked for a median length of about 11 years. During that time, the researchers found that people as a whole stayed in the same weight category they were in at the start of the study. Across all groups, the average person’s BMI rose by about one.

“The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term,” the researchers wrote in their paper, published Wednesday in BMC Public Health.

Other studies from other countries have found that people tend to not lose the weight they gain as they get older. Many have also found that sustained weight loss is difficult to achieve even for people who are trying to lose weight and succeed at it for a short while, outside of interventions like bariatric surgery.

The authors say theirs is the first and largest study of its kind to look at how BMI might change over time in the general population and how these trends could affect a person’s heart health and longevity. And on that last note, the findings weren’t encouraging either. Compared to overweight people, people who were severely obese (a BMI over 40) had a roughly threefold higher risk of heart failure as well as dying earlier from cardiovascular disease or all causes in general. This was the case after accounting for other risk factors they may have had at the start of the study.

The authors do note that BMI isn’t always a great measurement of a person’s current and future health. Different populations may carry the same risk for conditions like type 2 diabetes at a lower BMI than others, for instance. And on an individual level, a person in good health with lots of body muscle can still end up categorized as being overweight or obese.

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But coupled with other evidence, the authors say there’s a clear overall link between having obesity and being at higher risk for future health problems. And right now, our current approaches to helping people avoid or treat obesity simply aren’t working. “More effective policies and weight-management interventions at societal, cultural and health service levels are needed to address this increasing burden,” the study authors wrote.

Even now, TV shows like “The Biggest Loser” (resurrected last year) frame weight loss as a matter of willpower, often at the cost of the contestants’ own health. Scientists are currently researching new medical approaches to weight loss, including ongoing trials of a diabetes drug that seems to both reduce weight and improve other markers of health, like blood pressure.

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Science writer at Gizmodo and pug aficionado elsewhere

DISCUSSION

Genetics is difficult to beat, and while some of it is a matter of willpower, it’s a matter of how much willpower you can live with for the rest of your life.

I’ve been up and down my entire life, I was actually very skinny as a child, gained weight in middle school, and graduated high school at 255lbs.

My second year in college, I hit it hard. I worked out every day, I ran every night, I cut carbs completely and cooked every meal myself. I dropped an impressive (but looking back, relatively mild) 55lbs. I found that I can’t get much below 199, no matter what, that is my rock-bottom weight, and I was running 7 miles. I was killing myself, but I had the free time and energy to do it at 20 years old.

Over time, I slowly gained it back by simple carelessness. I actually eat very healthy, I stay active, I can still lift, I can still run, I can still swim over a mile nonstop. My family cooks a lot, I really only drink water, I hate fast food and soda. I do like big portions, though, and I’ve let my weight slowly slide. At 36, I got back up to 255lbs....by being relatively healthy.

Well, I’m on my way back down, again, I’ve tried a lot of diets, I’ve tried a lot of exercise, the main thing is I don’t want to deprive myself of the things I enjoy. I don’t want to feel guilty for having a donut once in a blue moon, or for wanting some rice or some bread.

It’s not about self-control and effort, it’s about absolute deprivation and guilt that makes weight loss so hard. I have more self-control than most, and I’m extremely well trained and active, but it’s a life-long battle fighting nature and guilt.

In the last 3 months, I’m down 20lbs, I’m now 235 and I have another 30-35lbs I wish to go...I’m having success. How am I doing it? I’m killing myself...quite literally. I’ve never been so unhealthy. I exercise very little, I’m slamming energy drinks, I’m eating nothing but meat and Adkins Bars/Shakes. I’m stacking artificial vitamins and OTC medications, like Aspirin. I’m wired during the day and I crash at night. I have to level off every few weeks to take the edge off.

How hard is it for some people to lose weight? It’s deadly.

My wife went the surgical option. I supported such a major endeavor because we did the research, we talked to doctors, and I completely understand her plight. As a woman, it’s even harder for her than it is for me. The only reason I didn’t do it is because I still want to be able to enjoy food, even if it’s only a few times a year. She gave up a long life of enjoying food, because there is no magical solution and no amount of willpower that can overcome some body types.

Now, don’t get me wrong. I’ve watched “My 600lb life,” there is something that can be said about willpower and making an effort when you don’t leave the house and you basically spend 50% of your conscious life consuming fast food and pasta. But if you think any of these people ever stood a chance getting and staying under 250lbs without medical intervention, you’re definitely mistaken.