Determinants of weight loss maintenance: a systematic literature review

Abstract

Background: Weight loss attempts often result in regain and weight loss maintenance remains to be a challenge. To be able to effectively promote weight loss maintenance in overweight/ obese adults who recently lost weight, knowledge on underlying determinants is needed. We aimed to systematically synthesize the literature on determinants predictive of weight loss maintenance in overweight and obese individuals. Methods: Using the PRISMA statement, prospective studies were identified from searches in Pubmed and PsycINFO from 2006. Included articles were scored on their methodological quality and a best-evidence synthesis was applied to summarize the results. Findings: 8.222 articles were found and 50 articles were selected. Fat intake reduction, increase in fruit and vegetable consumption, improving portion control, decreasing energy density, using caloric restriction, increasing physical activity, increasing intrinsic motivation for exercise, improving physical self-worth, and improving self-efficacy for barriers to exercise, and self-weighing or monitoring body weight were found to be positively predictive of weight loss maintenance. Increase in the consumption of sugar-sweetened beverages, emotional eating, and a high score in perceived barriers to exercise negatively predicted weight loss maintenance. Discussion: Behavioral and cognitive determinants that promote a reduction in energy intake, an increase in energy expenditure, and monitoring of this balance are predictive of weight loss maintenance. Our results supported existing literature, but also found conflicts. More high quality studies investigating- especially cognitive and social (environmental)- determinants of weight loss maintenance are needed to improve are knowledge on relevant determinants of weight loss maintenance.