I’ve written before that quitting smoking is the hardest thing I ask my patients to do.  Losing weight is the second hardest.  Many patients struggle for years with their weight, and frequently after successfully losing weight, slowly regain it.

Last week’s New England Journal of Medicine had an important article about keeping weight off:  A Self-Regulation Program for Maintenance of Weight Loss.  The study enrolled people who had already lost at least 10% of their body weight in the last 2 years.  On average, they had lost 42.5 lbs.  They were randomized to three groups.  The control group received only quarterly newsletters.  The two intervention groups were counseled to weigh themselves daily and to self-regulate their diet and exercise in order to return their weight to normal if it increased.  The intervention groups met weekly.  One group met face-to-face, and the other met over the internet.

The sobering results are that, while the intervention group did much better, all three groups gained weight.  The face-to-face group gained an average of 5.5 lbs, the internet group an average of 10.4 lbs, and the control group an average of 10.8 lbs.  So daily self-weighing, self-regulation of diet and exercise in response to weight changes, and weekly face-to-face meetings to reinforce and support the self-regulation training seems to have done best.

I’ve always asked patients to weigh themselves weekly, thinking that daily weighing would increase anxiety without adding useful information.  This is clearly not the case.  A daily habit is probably much easier to maintain than a weekly one.  The authors note in their conclusion

Although concern has been expressed about possible adverse effects of regular self-weighing, there is little evidence to support this concern and no evidence of adverse consequences of the interventions in our trial.

This is a good reminder that regardless of how people lose weight, ongoing intervention is required to prevent regaining the weight.  Daily self-weighing and weekly face-to-face meetings worked best, which is similar to the strategy used by Weight Watchers, a weight loss and weight maintenance program I’ve recommended to many patients.

So if you’re trying to lose weight or you’ve lost weight and don’t want to gain it back, dust off your scale, get into a regular exercise program, and think about joining a weight loss program.  If you’d like a weight loss coach who can meet with you personally, or a personal trainer to help you exercise, let me know.