The maintenance of weight loss after behavioral treatment. A review.
Keeping weight off is about continued skill use and self-monitoring, not the size of the initial loss.
01Research in Context
What this study did
The authors pulled every study they could find on keeping weight off after behavioral treatment. They looked for clues about who stays slim and who gains it back. The review did not test a new diet; it asked, "What predicts long-term success?"
What they found
People who keep the weight off do three things. They stick to the skills they learned, keep watching the scale, and use personal coping tricks. The amount lost at first mattered less than these upkeep habits.
How this fits with other research
Wilder et al. (2023) make the same point for work settings. They say you must track response rate, not just a yes-no checklist, to see if staff keep using a procedure. Both papers warn that "percentage correct" hides drift over time.
Matthews et al. (1987) looked at metabolic rate and weight. They found biology matters, but the 1990 review shows behavior matters more for staying slim. The views pair, not clash: metabolism sets the speed limit; daily habits steer the car.
Santi (1978) built a better ruler for kids’ weight change. The 1990 paper adds the rule: teach the child to use that ruler himself. Measurement plus self-monitoring equals lasting change.
Why it matters
Stop celebrating the week the client hits goal weight. Shift praise to the next six months of logged meals, weekly weigh-ins, and planned coping. Build these three habits into discharge plans and booster sessions. If the scale creeps up, revisit the skills, not the entire diet.
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02At a glance
03Original abstract
This article reviews the recent empirical literature on the behavioral treatment of obesity in an attempt to delineate those variables that are most closely related to the posttreatment maintenance of weight loss. Such variables were found to fall into three general categories: adherence to treatment and use of behavioral skills, posttreatment vigilance regarding both weight fluctuation and the skills learned in therapy, and intraindividual physical and emotional factors. An attempt is made to develop a rational understanding of these findings, which appear to be consistent with Kanfer's self-regulation model of self-control. Implications for treatment and future research are discussed.
Behavior modification, 1990 · doi:10.1177/01454455900142001