Practices Associated with Weight Loss Versus
Weight-Loss Maintenance
Results of a National Survey
Christopher N. Sciamanna, MD, MPH, Michaela Kiernan, PhD, Barbara J. Rolls, PhD,
Jarol Boan, MD, Heather Stuckey, DEd, Donna Kephart, PhD, Carla K. Miller, PhD,
Gordon Jensen, MD, PhD, Terry J. Hartmann, PhD, Eric Loken, PhD,
Kevin O. Hwang, MD, MPH, Ronald J. Williams, MD, Melissa A. Clark, PhD,
Jane R. Schubart, PhD, Arthur M. Nezu, PhD, Erik Lehman, MS, Cheryl Dellasega, PhD
Background: Few studies have examined the weight-control practices that promote weight loss and
weight-loss maintenance in the same sample.
Purpose: To examine whether the weight control practices associated with weight loss differ from
those associated with weight-loss maintenance.
Methods: Cross-sectional survey of a random sample of 1165 U.S. adults. The adjusted associations
of the use of 36 weight-control practices in the past week with success in weight loss (10% lost in the
past year) and success in weight-loss maintenance (10% lost and maintained for 1 year) were
examined.
Results: Of the 36 practices, only 8 (22%) were associated with both weight loss and weight-loss
maintenance. Overall, there was poor agreement (kappa=0.22) between the practices associated with
weight loss and/or weight-loss maintenance. For example, those who reported more often following
a consistent exercise routine or eating plenty of low-fat sources of protein were 1.97 (95% CI=1.33,
2.94) and 1.76 (95% CI=1.25, 2.50) times more likely, respectively, to report weight-loss mainte-
nance but not weight loss. Alternatively, those who reported more often doing different kinds of
exercises or planning meals ahead of time were 2.56 (95% CI=1.44, 4.55) and 1.68 (95% CI=1.03,
2.74) times more likely, respectively, to report weight loss but not weight-loss maintenance.
Conclusions: Successful weight loss and weight-loss maintenance may require two different sets of
practices. Designing interventions with this premise may inform the design of more effective
weight-loss maintenance interventions.
(Am J Prev Med 2011;41(2):159 –166) © 2011 American Journal of Preventive Medicine
Introduction
O
ver the past 20 years, the percentage of over-
weight and obese Americans, as well as the prev-
alence of weight-related comorbidities, has
grown tremendously.
1
Approximately 20% of U.S. adults
are able to lose and maintain at least 10% of their body
weight for at least 1 year, but each weight-loss attempt is
relatively unsuccessful.
2,3
Approximately one third of
weight lost is regained within 1 year, and the remainder is
typically regained within 3 to 5 years.
4
Although the ele-
ments of formal weight-loss programs (e.g., self-monitoring,
stimulus control), which consistently lead to average
weight losses of approximately 10% of body weight at
From the Department of Medicine (Sciamanna, Boan, Stuckey, Williams),
Department of Pediatrics (Williams), and Department of Surgery (Schu-
bart), Penn State Hershey Medical Center; the Department of Nutrition
Sciences (Rolls, Jensen, Hartmann), Department of Human Development
and Family Studies (Loken), Department of Public Health Sciences
(Kephart, Lehman), and Department of Humanities (Dellasega), Penn
State University, Hershey; the Department of Psychology, Drexel Univer-
sity (Nezu), Philadelphia, Pennsylvania; Stanford Center for Research in
Disease Prevention, Stanford University (Kiernan), Stanford, California;
Department of Human Nutrition, Ohio State University (Miller), Colum-
bus, Ohio; Department of Medicine, University of Texas Medical School at
Houston (Hwang), Houston, Texas; and Department of Community
Health, Brown University (Clark), Providence, Rhode Island
Address correspondence to: Christopher N. Sciamanna, MD, MPH,
Penn State Hershey Medical Center, Department of Medicine, Division of
General Internal Medicine Mail Code H034, 500 University Drive, Hershey
PA 17033. E-mail: cs19081@gmail.com.
0749-3797/$17.00
doi: 10.1016/j.amepre.2011.04.009
© 2011 American Journal of Preventive Medicine • Published by Elsevier Inc. Am J Prev Med 2011;41(2):159 –166 159