Background: Current perception is that participants of a structured weight-loss program regain all of their weight loss within 5 years.

Objective: The objective was to examine the long-term weight-loss maintenance of individuals completing a structured weight-loss program.

Design: Studies were required to (1) have been conducted in the United States, (2) have included participants in a structured weight-loss program, (3) have provided follow-up data with variance estimates for ≥2 y. Primary outcome variables were weight-loss maintenance in kilograms, weight-loss maintenance as a percentage of initial weight loss, and weight loss as a percentage of initial body weight (reduced weight).

Results: 29 studies met the inclusion criteria. Successful very-low-energy diets (VLEDs) were associated with substantially greater weight-loss maintenance than were successful hypoenergetic balanced diets (HBDs) at all years of follow-up.

The percentage of individuals at 4–5 y of follow-up for VLEDs and HBDs were 55.4% and 79.7%, respectively. The results for VLEDs and HBDs, respectively, were as follows: weight-loss maintenance, 7.1 kg (95% CI: 6.1, 8.1 kg) and 2.0 (1.5, 2.5) kg; percentage weight-loss maintenance, 29% (25%, 33%) and 17% (13%, 22%); and reduced weight, 6.6% (5.7%, 7.5%) and 2.1% (1.6%, 2.7%).

Weight-loss maintenance did not differ statistically-significantly between women and men. 6 studies reported that groups who exercised more had statistically-significantly greater weight-loss maintenance than did those who exercised less.

Conclusions: 5 years after completing structured weight-loss programs, the average individual maintained a weight loss of >3 kg and a reduced weight of >3% of initial body weight. After VLEDs or weight loss of ≥20 kg, individuals maintained statistically-significantly more weight loss than after HBDs or weight losses of <10 kg.

[Keywords: weight maintenance, weight loss, meta-analysis, very-low-energy diet, hypoenergetic balanced diet]

…In conclusion, this meta-analysis of 29 reports of long-term weight-loss maintenance indicated that weight-loss maintenance 4–5 y after a structured weight-loss program averages 3.0 kg or 23% of initial weight loss, representing a sustained reduction in body weight of 3.2%. Individuals who participated in a VLED program or lost ≥20 kg had a weight-loss maintenance at 4–5 y of 7 kg or 29% of initial weight loss, representing a sustained reduction in body weight of 6.6%. Although success in weight-loss maintenance has improved over the past decade, much more research is required to enable most individuals to sustain the lifestyle changes in physical activity and food choices necessary for successful weight maintenance.

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