Who loses weight and keeps it off? A representative population survey of 2000 overweight/obese adults

Abstract

Background: Most weight loss (WL) attempts take place in the ‘real world’, outside of controlled clinical or research contexts. Consequently, little is known about factors influencing the success of these efforts. We undertook the largest European survey to date of WL, WL maintenance and their correlates in overweight and obese adults. Methods: Nationally-representative population samples from the UK, Portugal and Denmark (N=2000; 1021 men) completed an online survey. Inclusion criteria were BMI ≥25kg/m2 and ≥1 completed WL attempt. Respondents reported details of their most recent completed WL attempt, any subsequent regain, WL strategies used, psychological and demographic data. Using regression analyses, correlates of WL and maintenance were identified. Findings: Mean reported WL was 9%. 1310 respondents (67%) achieved clinically significant WL (≥5%). Respondents with greater WL used professional support and employed more numerous self-regulatory WL strategies. Most respondents explicitly discontinued weight management strategies once active WL ended. Overall, respondents regained weight to 2% below start weight. However, 516 (26%) respondents maintained ≥5% WL. These respondents were older, with a higher initial BMI, greater and faster WL than the remainder of the sample. They reported less loss of control over eating, and lower frustration and greater motivation to re-initiate WL in response to minor regains. Discussion: These findings highlight novel, ecologically-valid correlates of 'real world' WL and WL maintenance success in large, nationally-representative samples. They potentially inform the development of generalisable guidance to support WL maintenance in the overweight/obese European general population, e.g. by encouraging WL re-initiation following even minor regains.