Recidivism among dieters has prompted major revisions in treatment methodology as researchers discover the significant contributions of genetics, psychology, and environmental factors to eating behavior. More than 85% of Americans have dieted during their lifetimes, yet the majority of diets offer little flexibility to accommodate the biopsychosocial components of the dieter’s life. Weight regain is virtually inevitable under these circumstances as self-regulation and emotional management deteriorate. No longer can the traditional focus of nutrition from the calories in versus calories out approach; exercise; and cognitive behavioral therapy (CBT) be considered the gold standard intervention trifecta. Studies report a 98% relapse (weight regain) rate following weight loss. Approximately 50% is gained back after three years and the rest gained back after five years. While discouraging, we can learn a lot from the two percent who are successful maintainers. What do they do? How do they think? Where do they differ in regards to behavior? Research accessing the lived experiences of successful and unsuccessful maintainers offer rich details that those of us who are actively engaged in the weight loss process and preparing to embark into maintenance can begin applying.
1. Be constantly vigilant: The dedication you implement during weight loss must continue during maintenance. The effort you put toward your health cannot stop once you have reached your goal weight. Ask what you are doing now that you are willing to continue with when you achieve your goal. Defensive pessimism, a concept described in the weight loss literature, explains the adoption of an approach with a foothold in reality. Successful maintainers anticipate threats that may occur, know that there will be times they struggle, and plan ahead accordingly. Any goal that is met with commitment is one we will work toward with a “no matter what” attitude. Relying on motivation for goal achievement will lead to disappointment—we will often “not feel like it” or “not want to” do something, but those who keep on keeping on understand the fleeting nature of feelings. With practice, they can more easily move past them and onto how happy and encouraged they will feel if they follow through with what they know is in their best interest. Self-determination theory classifies these types of goals as intrinsic. Weaved into the fabric of our lives, intrinsic goals parallel our core values.
2. Develop a support system: Not only is support the number one factor contributing to well-being and resilience, it is a primary element in maintaining commitment to weight maintenance related behaviors. While research shows that responsibilities in other contexts, such as familial, relationship, career, etc. can create tension that can lead to goal-compromising behaviors, having a support network minimizes the negative effects of goal threats.
3. Challenge your ingrained beliefs and behaviors: Most individuals who have been on and off of diets for most of their lives acknowledge the entrenched beliefs and meanings around food often created in childhood. Food as comfort, food as love, and food as a stress reliever are three of the most commonly held attachments to food. Many of us grew up hearing “clean your plate” or “you can have dessert when you finish your dinner.” Throwing away food was unacceptable. On the other hand, many are brought up in households of abundance. Food was always available and access unconnected to hunger. In essence, it was used as a pacifier when negative emotion was experienced (i.e. getting a cookie from during a time of upset). Successful maintainers become conscious of their motivations to eat and begin rewriting their narratives about food and the relationship they want to have with it.
4. Self-monitor: The National Weight Control Registry is a wealth of information from over 10,000 individuals who have lost and maintained their weight for significant periods of time. Self-monitoring is one behavior you will hear them mention repeatedly as critical to their weight maintenance success. Practical aspects of monitoring include consistent weight tracking, monitoring of portions, engaging in regular exercise, and setting boundaries around eating practices. Emotional monitoring to avoid engaging in stress eating or eating for reasons unrelated to hunger include practicing awareness and management of stress, choosing more effective methods of dealing with negative
emotion, but also being flexible and compassionate with one’s self when setbacks occur.
5. Adopt a growth mindset: Carol Dweck, a researcher from Stanford University, has studied the difference between a growth versus a fixed mindset and its impact on goal achievement. Individuals who take steps toward their goals with a growth mindset focus on discovery and exploration and believe that through learning they can develop skills and enhanced knowledge and proficiencies. It encourages persistence and expectations of failure for the purpose of greater success. We learned to walk by falling! A fixed mindset, on the other hand, encourages one to give up easily and reduces the likelihood that grit will be extended toward mastering something new. The concept of neuroplasticity and the manner in which we can be active participants through adulthood in changing our brains should provide ample evidence and motivation to continue learning! The growth mindset spurs individuals to be on the lookout for opportunities, and expansion of one’s biases and normal ways of behaving increases gray matter in the areas that matter most too. Your prefrontal cortex will thank you! Finally, successful maintainers adopt a non-perfectionistic approach. While they may not like failure, they embrace it and give themselves permission to experience it; they allow versus avoid painful emotions and disappointment, thus positioning themselves toward greater pleasure; and they are grateful for their successes.
6. Be structurally flexible: Successful maintainers understand how rigid food rules and depriving themselves of their favorite foods creates more cravings, more urges, and the propensity to binge. They realize that they can’t eat whatever, whenever, but they plan for indulgences in moderation. Structured flexibility gives them a sense of control without the belief that willpower will carry them through the tougher situations. They learn to ask questions of their cravings and check in with themselves to understand what might be driving their urge to eat. They practice recognition of black and white/all or nothing thinking as well as distorted thinking that propels them toward mindless or emotional eating. For example, the use of “I choose not to” versus “I can’t eat that” feels empowering and more intrinsically motivating. Being structured but flexible means having high expectations in combination with the understanding that uncertainty is inevitable and will require reflexivity and responsiveness rather than impulsivity.
7. Develop a toolbox of strategies: Different contexts demand different strategies. What is effective in one situation may not be appropriate for another. But successful maintainers know that they have the choice to change their environments or change the way in which they respond to them. In some contexts, an “if__________, then____________” approach can work well. This is called an implementation intention. For example, “If Don asks me if I want some dessert, then I will say ‘no thank you’ and excuse myself.” In other contexts a more flexible, responsive approach is needed. This could mean drinking more water when a cravings is felt; pausing to really assess physiological hunger; repeating a motivational, empowering mantra; asking a question to increase awareness; and/or slowing down during a meal to fully experience satisfaction and reduce overeating. In essence, successful maintainers create rituals—new patterns of behavior that help to create lasting, meaningful change.
8. Master mindfulness: Successful maintainers describe how they’ve acquired a new sense of themselves—about their bodies, about their minds, and about their lives and what is important to them. As they have practiced opening up to new experiences, objectively assessing their circumstances, and observing their behavior less judgmentally, they see their lives through new lenses. They practice being present, more compassionate, paying attention, deepening their awareness, avoiding avoidance, and intentionality. Through such practices, a successful maintainer can recognize that different identities sit down to eat sometimes – identities based on prior learning, on comparisons of self to others, and ideas about what others believe.
Don’t miss out on the discussion! Tell us about your emotional triggers and the biggest difficulties you’ve had as you move toward your goal of weight loss OR if you’re working on keeping it off! What bogs you down and gets in your way?