There are various ways you can approach it, but no matter which overall dietary strategy you choose to employ, sustaining fat loss is difficult. Most chronic dieters will attest to the fact that they don’t necessarily have a problem losing fat, it’s sustaining the fat loss that seems near impossible. Studies have confirmed this, repeatedly demonstrating that the vast majority of dieters will lose fat initially, but the problem is that nearly all dieters will re-gain fat, and will often go on to exceed their initial weight. In a meta-analysis of 29 long-term weight loss studies, more than half of subjects lost weight was regained within two years, and by five years more than 80% of lost weight was regained (1).
While many people find it hard to believe, especially those who feel like they’ve been trying to lose fat for some time, humans can lose fat and not regain it. Successfully maintaining fat loss takes consistency, a well-planned sustainable diet, exercise, support and last but not least, patience. Additionally, it helps to understand what you are up against, as unfortunately, physiological adaptations to weight loss favour weight regain. By trying to maintain weight loss, you are to some extent fighting our physiology.
The maintenance of body weight is tightly regulated by the interaction of various processes, including homeostatic, environmental and behavioural factors. By means of survival, we have evolved sophisticated homeostatic processes to protect fat stores once we have them. When fat is lost, compensatory changes in biological pathways occur that influence the neuroendocrine system and consequently affect energy homeostasis, appetite hormones such as ghrelin and leptin and affect nutrient metabolism (2). Additionally, genetic, behavioural and environmental factors can influence homeostatic processes, which further influence an individuals ability to lose fat.
Despite physiology naturally working against us, there are ways in which you can work with the body and achieve sustainable fat loss. To achieve fat loss and maintain a healthy weight, obesity reducing behaviours that counteract physiological and adaptations and other factors associated with weight regain must be adopted. While there is no ‘one size fits all’ when it comes to sustainable fat loss, there are multiple factors that appear to be universally agreed upon for a higher chance of success. These include a sensible calorie deficit, predominantly healthy food choices, regular exercise, adequate protein intake and behavioural support.
Setting an individual a sensible calorie deficit based on their gender, life stage and activity level is the first step towards sustained fat loss. For fat loss to occur an individual must be in a calorie deficit, ensuring that the body is utilising more energy than it expends (3).
However, while a calorie deficit is first and foremost when it comes to fat loss, it is important to also consider the nutritional value in the food consumed. Opting for high energy, low fibre and heavily processed foods, even if low in calories, may still negatively influence weight loss. A 2019 study investing the effects of processed foods vs non-processed foods on overall energy intake in ward patients demonstrated that weight changes were strongly correlated with energy intake, with subjects on the processed diet choosing to consume greater amounts of foods than those on the non-processed diet, despite the meals being matched for calories, energy density and macronutrients. Subjects on the ultra-processed diet gained weight, whereas those on the non-processed diet lost weight (4). This emphasises the importance of a healthy, well-balanced diet for sustainable fat loss, and of course overall health.
In terms of nutrient breakdowns for fat loss, protein is arguably the most important macronutrient to get right. Dietary protein is beneficial for the management of body weight and fat mass, as it promotes satiety, energy expenditure and alterations to body composition in favour of fat-free mass. During energy restriction or a calorie deficit, maintaining an optimal protein intake has been shown to sufficiently support fat loss, whilst maintaining muscle mass (5).
Understandably, those wanting to lose fat want it to happen sooner rather than later. However, it is important to understand that extreme, fast fat loss is more often than not, a recipe for short-lived success. While there is no denying that highly restrictive low-calorie diets achieve fast weight loss initially, it is important to consider what the ‘weight lost’ is actually composed of. During energy restriction, the body starts tapping into its glycogen stores. As glycogen is bound to water, when glycogen is utilised for fuel, the bound water is also released. This is why many dieters experience an initial drop in weight during their first week on a new diet. Once the body has utilised all of the glycogen stores, weight loss will begin to stabilise (6). However, if a calorie deficit is set too low and protein requirements are not met, the body will next begin to break down muscle mass, which will result in a loss of overall weight, but not fat. This is problematic as lean body mass is valuable for supporting fat loss and a loss in lean body mass has multiple negative health implications (7). This once more reiterates the importance of a sensible calorie deficit and sufficient dietary protein.
In a time when immediate gratification and results are expected, employing a moderate approach can seem ineffective and painstaking at first. But with the right nutritional and behavioural support, patience and consistency, incremental behaviour changes can result in sustained fat loss. When it comes to fat loss, slow and steady wins the race.
This article was written by Holly for The H and P Collective.
(1) James W Anderson, Elizabeth C Konz, Robert C Frederich, Constance L Wood, Long-term weight-loss maintenance: a meta-analysis of US studies, The American Journal of Clinical Nutrition, Volume 74, Issue 5, November 2001, Pages 579–584, https://doi.org/10.1093/ajcn/74.5.579
(2) Greenway F. L. (2015). Physiological adaptations to weight loss and factors favouring weight regain. International journal of obesity (2005), 39(8), 1188–1196. https://doi.org/10.1038/ijo.2015.59
(3) Blomain, E. S., Dirhan, D. A., Valentino, M. A., Kim, G. W., & Waldman, S. A. (2013). Mechanisms of Weight Regain following Weight Loss. ISRN obesity, 2013, 210524. https://doi.org/10.1155/2013/210524
(4) Hall, K., Ayuketah, A., Brychta, R., Cai, H., Cassimatis, T., & Chen, K. et al. (2019). Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metabolism, 30(1), 67-77.e3. doi: 10.1016/j.cmet.2019.05.008
(5) Drummen, M., Tischmann, L., Gatta-Cherifi, B., Adam, T., & Westerterp-Plantenga, M. (2018). Dietary Protein and Energy Balance in Relation to Obesity and Co-morbidities. Frontiers in endocrinology, 9, 443. https://doi.org/10.3389/fendo.2018.00443
(6) Kreitzman, S., Coxon, A., & Szaz, K. (1992). Glycogen storage: illusions of easy weight loss, excessive weight regain, and distortions in estimates of body composition. The American Journal Of Clinical Nutrition, 56(1), 292S-293S. doi: 10.1093/ajcn/56.1.292s
(7) Willoughby, D., Hewlings, S., & Kalman, D. (2018). Body Composition Changes in Weight Loss: Strategies and Supplementation for Maintaining Lean Body Mass, a Brief Review. Nutrients, 10(12), 1876. https://doi.org/10.3390/nu10121876