What the National Weight Control Registry Tells Us About Weight Loss

We’ve been discussing the various "weighs" Americans go about weight loss, such as intermittent fasting and regular exercise. The next phase is exploring the data. If you’ve never heard of the National Weight Control Registry, then you’re missing out on some key research.What is the National Weight Control Registry?The National Weight Control Registry is a large, volunteer database of individuals who have lost at least 30 pounds (13.6 kg) and maintained that loss for over a year. This observational study originated in 1994 and is ongoing.The registry began as a collaboration between two researchers: Rena Wing, PhD, of Brown Medical School and James Hill of the University of Colorado. Both wanted to answer these questions:

1. Are there individuals who are successfully maintaining a substantial weight loss?
2. What are the characteristics and strategies that have helped these individuals experience success?

Measurements included weight, eating behavior, exercise habits, and other health-related and/or psychosocial factors. Participants have been observed over the past 28 years. To participate in the study, volunteers must be 18 years old or older and they must have lost a minimum of 30 pounds and kept it off for at least one year. Over 10,000 people have enrolled in the study thus far.Who Participates in This Study?Right now 80% of the study subjects are women and 20% are men. The average female age is 45 with a weight of 145 pounds, while the average age in men is 49, with a weight of 190 pounds. Most members have lost an average of 66 pounds and have maintained the loss for 5 ½ years.There’s quite a bit of variation within the group. The lowest weight loss is 30 pounds while the highest is up to 300 pounds. Weight loss maintenance has ranged from 1 year to 66 years. Some participants lost the weight quickly, while others have taken several years to lose weight.About 45% of the volunteers lost weight on their own, while the other 55% used some type of program -- think nutrition counseling, trying a fad diet, improving exercise habits, or beginning weight loss medication. Nearly all participants (98%) altered their eating habits in some way. In addition, 94% of participants report doing some form of regular exercise, the most common of which is walking.What Works Best for the Participants?According to the registry, the following habits have been observed to return the best results:

• 78% eat breakfast daily
• 75% weigh themselves at least once per week
• 62% watch under 10 hours of TV per week
• 90% do some form of exercise for an hour each day.

The researchers note that manipulations in carbs, fat, calories, and timing of meals have all resulted in successful weight loss. What’s key to remember is that what works for one person may not work for someone else. Sustainable habits make the biggest difference in success.A Note from Lisa:While the National Weight Control Registry boasts some impressive numbers when it comes to weight loss, research tells us that people don’t need to lose that much weight to improve their health. For example, a weight loss of 5-7% (10 to 14 pounds in a 200-pound person) can lower blood sugar, blood cholesterol, and insulin levels. This small weight loss may seem more attainable to most than some of the dramatic shifts in the registry.Weight Control Tips for Your Clients:

1. Eat breakfast. While intermittent fasting suggests skipping breakfast, eating breakfast has been found to be effective in weight loss maintainers. Include savory, high-protein items like eggs, cottage cheese, or beans to curb appetite.
2. Include fiber. Whole grains, fruits, vegetables, beans, legumes, nuts, and seeds provide fiber, which digests slowly and aids in satiety. Fiber also alters the gut microbiome, which may affect how food is metabolized and used.
3. Chew your food! A recent study indicated that chewing for longer periods of time aids in weight loss. (Chewing burns calories through the thermic effect of food).
4. Keep moving. It’s not enough to take one kickboxing class per week. Consistent exercise moves the needle when it comes to weight loss. Try small bouts of exercise throughout the day if you’re unable to commit to an hour at a time. Walk the steps at work, park farther away from your destination, every little bit helps!
5. Use food records. Clients don’t need to be beholden to online apps, but tracking food intake has been shown to aid weight loss. Have them use a small notebook or journal, online app, or keep a record on a computer.

By Lisa Andrews, MEd, RD, LDPDF Handout for your Clients: 5 Simple Strategies for Weight ControlReferences: 

1. http://www.nwcr.ws/Research/default.htm
2. Benefits of moderate weight loss in people with obesity | National Institutes of Health (NIH)
3. Kim JY. Optimal Diet Strategies for Weight Loss and Weight Loss Maintenance. J Obes Metab Syndr. 2021 Mar 30;30(1):20-31.
4. Yuka Hamada, Naoyuki Hayashi. Chewing increases postprandial diet-induced thermogenesis. Scientific Reports, 2021; 11 (1) DOI: 10.1038/s41598-021-03109-x
5. Paixão C, Dias CM, Jorge R, Carraça EV, Yannakoulia M, de Zwaan M, Soini S, Hill JO, Teixeira PJ, Santos I. Successful weight loss maintenance: A systematic review of weight control registries. Obes Rev. 2020 May;21(5):e13003.