For weight loss, does ‘slow and steady’ really win the day?

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Where weight loss is concerned, the maxim has traditionally be ‘slow and steady wins the day’. I’ve lost count of the number of times I’ve heard that rapid weight loss generally leads to rapid weight regain too. Like a lot of nutritional ‘truths’ though, a recent study suggest that this meme is wildly misleading. If anything, more rapid weight loss appears to lead to better results in the long term.

The study in question was published on-line last week in the International Journal of Behavioral Medicine [1]. In this study, middle-aged women (average age 59) reduced calories and upped their exercise levels to an extent calculated to bring about a weight loss of 0.45 kg (1 lb) a week over a 6-month period. The study participants then engaged in a year-long ‘maintenance’ programme.

The researchers undertook an analysis of the initial rate of weight loss and how they fared in the long term. The women were categorised according to the following criteria:

‘Fast’ losers: initial weight loss of 0.68 kg or more each week
‘Moderate’ losers: initial loss of between 0.23-0.67 kg per week
‘Slow’ lowers: initial loss of less than 0.23 kg per week

At 6 months, the weight loss results of these groups was:

‘Fast’ losers: 13.5 kg
‘Moderate’ losers: 8.9 kg
‘Slow’ lowers: 5.1 kg

At 18 months, the losses were:

‘Fast’ losers: 10.9 kg
‘Moderate’ losers: 7.1 kg
‘Slow’ lowers: 3.7 kg

All these results were statistically significant. In other words, more rapid weight loss initially was associated with better results in the medium and long term. The authors of this study concluded: “Collectively, findings indicate both short- and long-term advantages to fast initial weight loss. Fast weight losers obtained greater weight reduction and long-term maintenance, and were not more susceptible to weight regain than gradual weight losers.”

Now, there are several potential explanation for why more rapid losers did better in the long term. One is, they did more in terms of cutting calories/upping activity. Another is that they had greater propensity to lose weight, say for metabolic reasons (e.g. generally more rapid metabolic rates). It is possible, therefore, that more rapid weight loss does not cause better results (the two things might just be associated with each other).

However, what the results of this study do suggest, that more rapid weight loss is not a barrier to sustained weight loss. If anything, faster weight loss initially may augur well for those looking to the long term.

References:

1. Nackers LM, et al. The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race? International Journal of Behavioral Medicine 5 May 2010 [epub ahead of print]

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