Often lost amid the reports about the obesity epidemic are studies showing that 20 percent of overweight people not only manage to lose pounds but maintain a healthier weight long-term.
These so-called "successful losers" intrigue scientists, who see promise in their experience and lessons for others. In a new update from the National Weight Control Registry -- a database of 4,000 people who have shed an average of 73 pounds and kept it off for more than five years -- scientists reveal some of the habits that foster long-term success.
The biggest surprise from the study is that weight maintenance gets easier with time.
"It's a very positive message," said Suzanne Phelan, assistant professor of psychiatry and human behavior at Brown University's Weight Control and Diabetes Research Center in Providence, R.I., and a co-author of the study. People who maintain their new weight for two years "have a greater likelihood of keeping it off for two more years. Those who maintain it for five years have even greater odds of maintaining their weight loss. With time, the odds of regaining weight go down and down and down," she said.
Not that maintaining weight loss is easy. As many of the Lean Plate Club's successful losers note below, achieving a healthier weight takes focus and commitment. The registry members report that, too.
"We know that they are working very hard to keep off the weight," Phelan said. "They're exercising very hard. They eat fewer calories. They're monitoring their weight. I think it may be kind of akin to brushing your teeth. Once you have the habit, you wouldn't think of not doing it." Successful losers, she said, "just do these things and have adopted them as part of their lifestyle. Maybe it doesn't take as much conscious effort over time."
We've asked some of the Lean Plate Club's successful losers to share their stories and compared them with the registry's findings.
No Quick Fixes. Nutrition fads come and go. Successful losers report reaching a healthier weight the old-fashioned way: They count calories, reduce calorie-dense food and move a lot more.
Nearly half of those in the national registry reported losing weight entirely on their own. The rest got assistance from commercial weight-loss programs, a physician or a nutritionist. "Over the years, I tried a lot of different things -- Jenny Craig, Weight Watchers a couple of times, different combinations of diets in magazines," said Melissa Glasssman, a lawyer who practices in Tysons Corner. "I could always lose 10 to 20 pounds, but would always gain back more than that."
It was only by changing her habits that Glassman shed 125 pounds -- half her body weight -- in the past couple of years. "It's the little things that you incorporate into your daily life that help keep you on track," she said. "It doesn't have to be entirely about deprivation or exercising two hours a day."
Be Active. While it's possible to lose weight by cutting back on calories alone, only 10 percent of registry participants used that approach. Most -- 87 percent -- ate fewer calories and boosted their physical activity.
Successful losers also remained active even after losing weight. They spent an average of at least an hour a day engaged in moderate physical activity -- equal to walking 3 to 4 miles per hour.
How successful losers stay active varies. The study found that about 20 percent of registry participants lift weights or ride a bike. Aerobic exercise, such as step aerobics classes or exercise tapes, is the choice of 18 percent of those in the registry. But brisk walking is the way that most stay active.
Walking helped Tarasia Remhof, 45, lose 156 pounds since 2001. "The only thing I do [for physical activity] is walk," said Remhof, a Coast Guard officer based in the District. "I adopted a 50-pound mutt from the shelter that is very active and high-energy. If we don't go for two walks a day, she's not destructive, but annoying. So we go for about two miles in the morning and about a mile at night."
Regular constitutionals have also helped Richard Morris, 45, of Woodbridge, lose more than 100 pounds during the past two years. Each morning, Morris and his wife leave their home by 4:30 a.m. and spend the next two hours walking before getting their children off to school.
"I realized that exercise had to be a huge part of this equation," said the 6-foot-tall Morris, who once weighed 400 pounds and now hovers at a far healthier 260 to 265. "I have to make a serious commitment to exercise," said Morris. "I have the same 24 hours in the day as everyone else. This is not a matter of time, but of priorities."
Track Your Weight. Nearly half of successful losers weigh themselves daily, according to the study, which appears in the July issue of the American Journal of Clinical Nutrition. Thirty percent report climbing on the scale once a week.
"The scale is just a number to me now," said Arlene Rimer, 53, a Toronto lawyer and filmmaker who, since 2002, has lost 140 pounds from her peak weight of 315 pounds. Regular weigh-ins have taught Rimer that her weight naturally fluctuates by a couple of pounds either way. Getting on the scale "doesn't make or break my day," she said.
Enlist Support. Tarasia Remhof teamed with her twin sister who lives in Texas to lose weight. Both joined Weight Watchers groups, then used phone calls and e-mails to encourage each other's efforts. Deborah Kosnett of Gaithersburg found support from her husband, who bought her a "comfort" bike with a wider seat and extra shock absorption. Both Rimer and Morris lost weight with their spouses.
Glassman, who like many people spends most of her workday sitting, spent a year with an exercise group that focused on strengthening core muscles, weight training and provided plenty of support. "Part of my success is that I built a lot more muscle mass than I had before, and that made a big difference" in burning calories, she said.
Start Your Day With Breakfast. Almost 80 percent of diet registry participants ate breakfast every day. The typical breakfast was cereal with skim milk and fruit. Make it whole-grain, unsweetened cereal. That combination is more likely to provide staying power until lunch.
Set Small Goals. Most people "want to lose 30 percent of their body weight," said Phelan, who co-authored the study with Rena Wing, director of Brown University's Weight Control and Diabetes Research Center. Yet from a medical standpoint, losing just 10 percent of body weight -- 20 pounds for someone who weighs 200 pounds -- "is very beneficial," Phelan said. Rather than setting yourself up for failure, establish a more reasonable goal. Achieve that, then try for more.
Find Motivation to Get Started. Reaching their all-time highest weight prompted 21 percent of registry participants to become successful losers. But the most common trigger was a medical event -- for example, a doctor's advice to lose weight, diagnosis of a condition such as high blood pressure or a family member's heart attack.
"My health was going bad," noted Kosnett, 52, a certified public accountant who has lost 80 pounds since 2002. "I had pre-diabetes. My total blood cholesterol was not so great. It went as high as 260. My HDL (the 'good' cholesterol) was really lousy. But the straw that broke the camel's back was when I went out to sweep my front porch and I started panting. I thought, 'This is really stupid.' "
Set a Limit for Regaining Pounds. If you reach it, switch from weight maintenance back to weight loss. Successful losers still experience slips but appear to be better than others at identifying them and making quick course corrections. "We found that once you start to regain weight, if you put on more than 10 pounds, then your chances of recovery are slim," Phelan said. "Every day, I have to stay on top of this," said Glassman.
Plan Ahead. Glassman eats only at restaurants where she knows the menu and can find something healthy to order. Each Monday, Remhof stocks a week's worth of food in a freezer at her office to microwave for lunch each day.
When Kosnett needed back surgery last year, she took precautions to maintain her weight. Knowing that she wouldn't be able to work out and would require prednisone, a powerful steroid that often adds weight, Kosnett reduced her intake to 1,900 calories a day and carefully recorded what she ate. She also added more high-volume food -- especially fruit -- to combat hunger. Bottom line: She lost five pounds during her convalescence and achieved her Weight Watchers' goal weight.
Figure on Plateaus. Even when you do all the right things, it's not unusual for weight loss to stabilize for a while. Kosnett experienced a plateau that lasted a year and a half. Rimer had already lost 70 pounds when she hit her first plateau, which lasted four months. Although initially discouraged, Rimer said she felt better when she realized that "it was awesome to maintain this huge weight loss." Her second plateau occurred after she had lost 100 pounds. "I couldn't get upset by it," she said. "My body had to get used to . . . the new way of eating, the intensifying activity. . . . We are not robots."
Reward Yourself. Behavioral research shows that this is key for long-term success. Glassman gave herself plenty of rewards unrelated to food for sticking with her healthy habits. "I got a pedicure or a manicure," she said. She also treated herself to new clothes at a discount store while she transformed her body so that she didn't wind up with an expensive wardrobe that was unusable. "I didn't want to spend a lot of money, because I was still in the process of losing weight," Glassman said.
Stick With It for the Long Haul. The study found that successful losers continue their efforts for many years after they have trimmed their waistlines. That finding resonates with Glassman. "I know if I use the habits and the information that I've learned . . . it will be okay," she said. "I truly feel for the first time that my weight is under control."
For more on what Lean Plate Club successful losers do to achieve a healthier weight, log on to www.leanplateclub.com, where you can listen to audio clips from some of the members featured in this column.
Share your tips or ask questions about nutrition and activity when Sally Squires hosts the Lean Plate Club online chat, from 1 p.m. to 2 p.m. today, on www.washingtonpost.com. Can't join live? E-mail firstname.lastname@example.org anytime. To learn more, and subscribe to our free e-newsletter, visit www.leanplateclub.com.