While everyone knows that losing weight can be hard, it can sometimes be just as tricky to keep it off once you hit a healthy goal weight.
Past research shows that more than 50% of people who lose weight regain it within two years, and up to 80% regain it within five years.
Maintaining weight loss is currently a hot topic of discussion, thanks to the recent increase in glucagon-like peptide-1 (GLP-1) receptor agonists such as Wegovy and Zepbound. Recent studies show that some people who stop taking a GLP-1 regain as much as 60% of their lost weight within one year.
“A major part of people with obesity who initially lose weight tend to put some or all of it back on again,” Marwan El Ghoch, MD, associate professor of food science in the Department of Biomedical, Metabolic, and Neural Sciences at the University of Modena and Reggio Emilia in Italy, told Medical News Today.
“This usually happens three to five years after weight loss, regardless [of] the treatment they underwent. Therefore, I think that the most important and greatest challenge when treating obesity is preventing weight regain in the long term,” he said.
El Ghoch is the co-lead author of a new study published in the International Journal of Environmental Research and Public Health that found walking about 8,500 steps a day may help a person maintain their weight loss after dieting.
For this study, researchers analyzed data from 18 previously conducted trials involving participants who were overweight or obese and who were either dieting on their own or participating in a lifestyle modification program that included dietary recommendations and exercise advice, such as walking more and reaching a certain number of steps per day.
El Ghoch said he and his colleagues decided to examine a potential link between daily steps and their impact on maintaining weight loss to help test two hypotheses.
“Usually, after the weight loss phase, a phenomenon called metabolic adaptation, which is simply the body’s physiological response to weight loss where the metabolism slows down significantly, as the body perceives the calorie deficit and weight loss as a threat to survival and accordingly try to contrast this to prevent further weight loss.”
— Marwan El Ghoch, MD, co-lead author of the study
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“I thought that increasing physical activity in terms of daily steps can be of help in maintaining the weight loss during the later phase of the weight management programs,” he said.
“Moreover, many patients after [the] weight loss phase return to the previous unhealthy habits and behaviors that they used to have before such overeating and sedentarism,” El Ghoch continued.
At the study’s conclusion, scientists found that participants who followed a lifestyle modification program and increased their daily steps to about 8,454 by the end of the weight loss journey lost an average of 4.39% of their starting weight.
Those same participants, when continuing to get in about 8,241 steps a day, were able to keep off an average of 3.28% of the weight they had lost.
Researchers found that those dieting on their own didn’t increase their daily steps or lose any weight.
El Ghoch said that these findings imply that patients with obesity who are willing to start a lifestyle modification program for weight management, should always be encouraged to progressively increase their daily step from baseline through the weight loss phase — reaching around 8,500 steps/day — and maintain this level of steps during the weight maintenance phase, since this behavioral strategy is associated with maintaining significant weight loss in the long term and prevent weight regain.
“As [such], these programs should be always considered a valid option, especially as a first-line intervention, since they can lead to clinically meaningful weight loss (≈4–5%) and weight loss maintenance (≈3.5%). These findings need to be openly and clearly discussed with patients before starting any lifestyle modification program due to its important impact on the treatment outcome.”
— Marwan El Ghoch, MD, co-lead author of the study
MNT spoke with Swapnil Patel, MD, MHCM, FACP, vice chair of the Department of Medicine at Hackensack Meridian Jersey Shore University Medical Center, and assistant professor at the Hackensack Meridian School of Medicine in New Jersey, who commented that his initial reaction to this study’s findings is that this suggests a simple, actionable strategy for patients to maintain weight loss.
“The finding that approximately 8,500 steps per day is associated with preventing regaining weight is a target that I can share with my patients. This research reinforces the importance of a comprehensive lifestyle approach, combining both healthy diet and physical activity, for long-term success.”
— Swapnil Patel, MD, MHCM, FACP
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Patel said it’s important for researchers to continue to find new ways in which people can help keep weight off after dieting, especially in a world where many people are using GLP-1s to lose weight and may experience issues maintaining weight loss if they stop using the medication.
“While GLP-1s are effective for weight loss, many patients regain weight after stopping them,” he explained. “This study highlights a non-pharmacological approach, and a tenet of good health — physical activity, that is valuable for long-term weight management, either as a stand-alone strategy or in conjunction with weight loss medication.”
MNTalso spoke with Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, about this research, which he said shows the importance of regular exercise.
“It’s what we emphasize to our patients that can enhance and maintain weight loss, but we still emphasize that the majority of weight loss comes from the diet,” Ali explained.
“Being consistent with some sort of exercise not only can help maintain weight loss and enhance weight loss, but also helps to preserve muscle and reduce muscle loss. So that’s also important [for] any kind of weight loss journey is to minimize muscle loss. [W]e see it in our surgical patients as well, so anything that can help to minimize that and also enhance maintenance of weight loss is going to be helpful,” he said.
For readers who may worry about hitting an 8,500-step goal every day in a seated office environment, Ali advised breaking it up — walking before and after work.
“The main thing, if you can’t hit the 8,500, is just being consistent. Try to get a minimum of 30 minutes or more of exercise a day, and again, you can break it up into smaller portions.”
— Mir Ali, MD
“It’s tough to figure out a regimen for everybody because everybody’s schedule and their activity level and their health is different, so it’s just trying to find something that you can be consistent with, and walking is great exercise,” Ali added. “It’s just finding the time to do it adequately.”
