Indeed, previous failed attempts at achieving durable weight loss may have contributed to the recent decrease in the percentage of people with obesity who are trying to lose weight 5 and many now believe that weight loss is a futile endeavor 6. In a meta-analysis of 29 long-term weight loss studies, more than half of the lost weight was regained within two years, and by five years more than 80% of lost weight was regained ( Figure 1) 4. Substantial weight loss is possible across a range of treatment modalities, but long-term sustenance of lost weight is much more challenging, and weight regain is typical 1– 3. Hoping to motivate him, you remind him how bad he will feel if he regains more weight, and you tell him to make a follow-up appointment for six months and warn him that if he doesn’t turn things around quickly he will have to restart his blood pressure medications. You just need to work harder and take control of this again.” You feel for him, but you know that you need to be stern to get him past this backsliding. “I know it’s not easy, but I can’t help you unless you’re willing to help yourself. And no matter how hard I try to stop eating after one serving, I just can’t seem to do it anymore.” Feeling defeated, he says “I don’t even know what’s the point of doing this anymore!”įrustrated, you remind him that he was able to do it just fine when he was losing weight initially, and he just needs to keep working hard at it.
It feels like every moment of the day I can’t help but think about food – it was never like this before I lost the weight. I keep trying, but there must be something wrong. “I don’t know what to do…the weight keeps coming back on. You were excited to hear about his continued progress and see how much more he’s lost, but you felt immediately dejected to see that he had regained almost 60 pounds. Today he comes in for his annual physical examination. He lost 85 pounds three years ago by carefully following your guidance to decrease his caloric intake to 1500 calories per day and exercise six days weekly. Robert is a 47 year old patient who initially weighed 270 pounds.
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