[cm2012]

PSA: Every legitimate long term study of major non surgical weight loss shows that it doesn't happen for the vast, vast majority of people. It's basically freakish when succesful in the long term.

1) ["In controlled settings, participants who remain in weight loss programs usually lose approximately 10% of their weight. However, one third to two thirds of the weight is regained within 1 year, and almost all is regained within 5 years. "](http://www.ncbi.nlm.nih.gov/pubmed/1580453)

2) Giant meta study of long term weight loss: ["Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3% of initial body weight."](http://ajcn.nutrition.org/content/74/5/579.full)

3) Less Scientific: [Weight Watcher's Failure - "about two out of a thousand Weight Watchers participants who reached goal weight stayed there for more than five years."](https://fatfu.wordpress.com/2008/01/24/weight-watchers/)

4) [The reason why it's impossible seems to be that although calories in < calories out works, the body of a fat person makes it extremely difficult psychologically to eat less.](http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-...) This is borne out by the above data.

5) [The only thing that does seem to work in the long term is gastric surgery.](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421028/)

Moreover, you won't find any reputable study on the web where the average person lost 10%+ of their body weight and kept it off for five years. Not even one.

[vonmoltke]

> 2) Giant meta study of long term weight loss: ["Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3% of initial body weight."](http://ajcn.nutrition.org/content/74/5/579.full)

I think you misread the results of that study. It's countering your point, and demonstrating that the structure and initial success of the diet affects the long-term success of the weight loss.

[cm2012]

The average weight loss was still averaging 3% - basically nothing for an obese person.

[steven777400]

Respecting both your disclaimer on #3 and the older date on the article, it's amazingly depressing to realize that probably most participants in a program DON'T reach their goal weight. This is saying that even of only the relative few who do reach their goal, still, the vast vast majority will not be able to maintain it.

Personal experience, I worked hard to lose about 40 pounds and keeping it off is an interminable nightmare. First, people said "oh, when you lose the weight you'll feel better and other people will treat you better..." and so on... Well I lost the weight and I don't feel any different and people don't treat me different (except for all the awkward "wow you look so different" type questions).

It feels like it's not worth it. Plus the fact that every day, day in and day out I have to struggle with limiting my calories and monitoring my weight. It just takes all the joy out of life. (Of course this is personality dependent! For me, stuffing myself with sweet, rich food until I felt like I would burst is just one of the best most satisfying feelings ever... if I could just somehow reprogram the mental pathways there......)

[Nadya]

>Of course this is personality dependent! For me, stuffing myself with sweet, rich food until I felt like I would burst is just one of the best most satisfying feelings ever... if I could just somehow reprogram the mental pathways there......

What worked for me:

Find a flavor you absolutely hate. Be it some hot sauce or mustard or whatever. Top whatever sweet, rich food you enjoy with that topping any time you wish to enjoy said sweet, rich food. This corrupted my memories of "this food was sweet and rich" with "Oh god, last time I did that it was terrible I nearly threw up".

I don't drink alcohol, so I put some rum in my Dr. Pepper. Now I don't drink soda anymore. Ever tried chocolate icecream with mustard? The memory will have you avoiding chocolate icecream like your life depends on it.

It took a bit of self control (actually taking a bite of mustard covered chocolate icecream was tough) but I have such bad memories of the things I used to crave that I no longer crave them. I know they're amazing by themselves but I can't bring myself to partake in them anymore.

[bmh_ca]

> 5) [The only thing that does seem to work in the long term is gastric surgery.

Arguably not "average" people, but there is a club of "extreme calorie counters" who have maintained substantial weight loss over many years.

I wish I could find the link to the documentary, but the search signal-to-noise ratio is problematic. It feels like something I saw on an investigative journalism program e.g. The Fifth Estate. In any case from recollection, this is what I recall:

- There were something like 30,000 members worldwide - Membership required maintained weight loss - They generally counted and journaled every calorie, with remarkable rigour

This appears to be the one alternative to gastric bypass that has repeatable success. It's just not achievable by most.

Incidentally, only Roux-en-Y laparoscopic gastric bypass has been associated with long term successful weight loss; the "tube" mini-gastric bypass has not; I'm not sure about others, as some experimental alternatives are cropping up.

[kitrose]

Oh boy, this is a classic example of "science" hiding behind obvious facts:

I spent 18 mos. leading a section of a major study within the armed forces testing physical transformations, mainly focused on gender differences but the point still stands. At this point I have seen hundreds of first-hand examples (if not a thousand plus).

Step 1: Be any profile of relative fitness from normal to your average to slightly overweight 18-20 year old American male/female.

Step 2: Be inducted to the Marines or similar armed forces where you are required for 5 years to wake up and conduct a high level of physical exercise as a mater of daily life.

Result: You've lost 10%+ off your body weight and kept it off for the duration.

It's just so exceedingly simple. Set conditions for a lifestyle where you are burning more calories than consumed and weight loss will continue. It's not some crazy secret. Everything else is crap.

[throwanem]

> Be inducted to the Marines

> It's just so exceedingly simple.

[mahyarm]

I lost a bunch of weight with calorie counting and then gained it back after 2 years. But I'm fine with that. I started losing it again recently and I've already lost about 8lbs. After you do it a few times it gets easier as your skill in it gets better and your body & mind become more resilient to being in weight loss mode.

The way I'm doing it now is so easy (subway, chipotle, trader joes & calorie counting) that I feel fine in being in a yo-yo of a slow gain of 10lbs over a year and then losing 10lbs over a month or two.

It's not a useful attitude to be fatalistic about weight loss.

I track my weight regularly to make sure weight gain doesn't creep up on me.

[bmh_ca]

> It's not a useful attitude to be fatalistic about weight loss.

Nor is it useful to promise people trips to the top of Everest on a hand glider, but that's empirically what most weight loss advice entails.

[mahyarm]

Thats a fatalistic attitude to weight loss advice too. Weight loss advice can be complicated, but calorie counting and eating at subway everyday really does work.

[falcolas]

Counting calories is hard.

https://youtu.be/HGunZpKLb5o

TL;DW: Calculating the actual energy in a day's worth of well labeled foods resulted in a 500 calorie overage.

This doesn't even account for how your body absorbs calories different from every other body, and probably even differently every day.

[mahyarm]

Being perfectionistic about calorie counting is not necessary. It still works. The approximate measure is quite enough. And if you don't have the time to do it, just eating from chains that already do it for you works quite well.

[bmh_ca]

> calorie counting and eating at subway everyday really does work

Is there any evidence of that?

[mahyarm]

Myself and many others? I've been doing it for the past few weeks and I lost a bunch of pounds. A few weeks before that I was eating at chipotle everyday and was getting similar results.

Try not to lose weight eating only 1600 calories a day. It's pretty difficult to do unless your 90lbs and 5 feet tall!

Subway, chipotle and other chains provide calorie counts for their food. Don't add calorie-full condiments to your subway sandwiches (mustard, not mayo) and stay within that limit +/- 100 or 200 calories.

[bmh_ca]

Thank you for taking the time to post the basis of your belief.

The problem with your argument is twofold. First it's anecdotal, not a statistically significant sample with a control group. Second, it's temporally insignificant, therefore does not account for those periods of most significance - years 5+.

I hope you personally do well over the next few years but, based on observations conforming to principles we understand to constitute reliable evidence, such would be an exceedingly rare exception.

[cm2012]

Bariatric surgery is the best answer for most lifelong obese people.

[appleiigs]

Or maybe they should move to a weight-maintenance program after the weight-loss program?

Why is surgery your conclusion when it's not surprising that people revert to their old weight after reverting to their old diets.

I read the abstracts and the studies only have weight-loss programs. Even the weight watchers article (which by the way is not a study) says: "Lifetime Members are only "the most successful” Weight Watchers members who achieve their “goal weight” (usually a BMI of 25) and maintain it for 6 weeks."

[JustinAngel]

> "At this point I should say that I’m not a healthcare professional and I’m not recommending my dietary changes to anyone. I was in intense emotional pain every single day and made the decision to capitalise on it."

[mmozuras]

Lost 26kg (25% of my weight) in 2013. Doing great so far. Stepping on the scales every day makes sure that weight gain doesn't creep up on me.

[sauronlord]

That's great news for people like me, thin people and the OP. I lost 65 pounds in 10 months. (220 to 155) and kept it off for 7 years.

Once again, it means less competition for resources as the population mass gets bloated.

[pizza]

I wonder what the research into environmental contribution says? Like, how people change weight in different social situations.

[maxerickson]

I wonder how many people lose significant amounts of weight without entering a program.

[toomanybeersies]

That's an interesting note to make. One could imagine that those who enter Weight Watchers are those that lack the fortitude to lose weight on their own, and that signing up to Weight Watchers isn't going to change their psyche in that regard.

[richardboegli]

That is REALLY interesting! I'm going to spend some time reading into this!

[vivekseth]

In these studies what kind of exercise did the participants do?