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Wed Dec 3, 2014, 02:30 AM

Good statistics on weight loss success seem hard to find.

The general impression I get (and the impression that most people seem to have) is that weight loss success is rare.

But what do we even mean by "success"?

"Success" at weight loss isn't easy to define. Here's one study:

http://ajcn.nutrition.org/content/82/1/222S.long

...that defines "success" as "losing at least 10% of initial body weight and maintaining the loss for at least 1 y(ear)". With that criteria, the study says roughly 20% of individuals succeed.

That to me seems like a fairly low bar for success, however, and even at that low bar only 1 out of 5 people (according to that one study) succeed.

According to this Wikipedia entry:

http://en.wikipedia.org/wiki/Management_of_obesity

..."Success rates of long-term weight loss maintenance with lifestyle changes are low ranging from 2 to 20%". I'm guessing that the 2% rate is for much tougher criteria regarding duration and amount of loss.

According to this 1999 NYT article:

http://www.nytimes.com/1999/05/25/health/95-regain-lost-weight-or-do-they.html

...a widely-repeated claim that "95 percent of people who lose weight regain it -- and sometimes more -- within a few months or years" isn't based on very good data or methodology. "'The true failure rate could be much better, or much worse', (Dr. Brownell) said. 'The fact is that we just don't know.'"

My admittedly cursory Googling hasn't turned up much that's been done between 1999 and now to greatly clarify the situation. There are plenty of separate studies on what supposedly works better than something else, on what doesn't work well at all, but all of that doesn't seem to coalesce into a Big Picture for weight loss success in general.

Here's a start on the kind of statistics I wish were easier to find:

http://weightology.net/weightologyweekly/?page_id=95

This gives success rates for different amounts of weight loss, but it's still only for one open-ended time range, "more than one year".

In my own life, over most of the 1990s, I previously had what would probably be categorized as "long term success" by keeping off around 65 lbs (I didn't start out with weighing myself right away, so I don't know exactly where I started, and hence don't know exactly how much I lost) for about nine years.

Long term though it may have been, it wasn't permanent. Some who are skeptical about weight loss might say, "See! It hardly ever works out!" based on that. Others would still count all of those lean and fit years as a win.

I took me over ten years to get back on the fitness wagon. I had reached a peak weight that was definitely higher than my previous peak weight, maybe as much as 20 lbs. higher. This is what some people might categorize as a weight loss failure ("See! He shouldn't have bothered trying to lose weight because he ended up putting on even more!", but it happened so very many years after my previous peak weight that I easily could have drifted up to that new peak, and even higher, if I hadn't had those lean years in between.

At this point I'm in very good physical condition again -- not just a lean, healthy weight, but good overall fitness, and actually better strength and endurance than I'd achieved before. Having abandoned the low fat diet that was all the rage when I first lost weight in the '90s, I've found a way of eating that's both healthier and less of a struggle to maintain. While I wouldn't say I enjoy all of the exercise I do now, I don't hate and dread it as much as I did before, and (this is new for me!) I even do actually enjoy some of it.

While I have an overall positive feeling about sticking to exercise and better eating this time around (I did already manage to suffer through less satisfying food and less enjoyable exercise for nine years, after all), I still worry a bit about "beating the odds". For one thing, I exercise so much now that I know it would be impractical for most people to manage what I do -- I typically burn over 1000 calories every day, six days per week. Can I really keep that up year after year? Having a very short commute and a gym at the office aren't necessarily things I can count on long term. If I lose those advantages I wonder what would give, where I'd compromise.

So far I've kept off 20% of my peak weight for over two years, and a little over 30% of my peak weight for about a year and a half. That counts as "success" by some standards, even perhaps "long term success"... but in my mind it won't feel like what I'd call long term success until I've stayed at or close to my current weight for five years or more.

I don't know whether to feel good that I'm "beating the odds" (which apparently I am, even as roughly defined as those odds are), or worried that the odds are against me.

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Response to Silent3 (Original post)

Wed Dec 3, 2014, 02:45 AM

1. One of the things in life where statistics are meaningless.

If you have the motivation, knowledge, and discipline, your chances of successful weight loss (and subsequent maintenance) are almost certain.

The same cannot be said about many other goals in life, which can be limited by genetic athletic ability, intelligence, earning power, or social status.

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Response to Silent3 (Original post)

Wed Dec 3, 2014, 04:12 AM

2. That's because weight loss is a huge industry with a lot of money changing hands

The few long term statistics out there are dismal ones, whether the ideal weight was achieved through slow starvation, drugs, or surgery. Fat people often don't lack will power, at all, they've lost the equivalent of their extra body weight many times over, often losing their full body weight more than once before they finally give up.

The morbidly obese are a slightly different story and while they don't end up particularly willowy, they often do manage to keep enough weight off after surgery or other drastic measures to keep enough of it off to increase their life expectancy.

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Response to Silent3 (Original post)

Wed Dec 3, 2014, 07:11 PM

3. The modern lifestyle, and our expectations about food.

Think of cave dwellers, always searching for food, and eating last scrap whenever they could. Always having to forage for roots and grubby edible insects, and chasing after prey.
Were they overweight? I doubt it.

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Response to Quantess (Reply #3)

Wed Dec 3, 2014, 08:12 PM

4. Then again, the average cave dweller life expectancy was in the 20s or less...

...so I'll take modern living, even if I had to eat at McDonalds's every day, over a cave man existence.

The real trick is to get the best of both worlds.

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Response to Silent3 (Reply #4)

Wed Dec 3, 2014, 08:32 PM

5. Absolutely, and we can, which is the best part.

Thanks for not freaking out over my previous post.
I hope you understand I meant that you can choose to reject the typical american diet that is so prevalent in our culture.

By that I mean, large portions, lots of fried stuff, etc.... Oh who am I kidding? I am talking NEARLY EVERYTHING in typical american diet is crap. Fattening, bad for you, and in too large portions. It is extremely difficult to overcome.

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Response to Quantess (Reply #5)

Thu Dec 4, 2014, 02:34 AM

7. Portions. Especially in restaurants.

 

That's a huge problem. I've reached a point in my life where my appetite is definitely smaller than it used to be, and I get very frustrated by how large restaurant portions can be. At least I qualify for a senior meal or discount, but the restaurants need to reduce portion sizes in the first place.

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Response to Silent3 (Reply #4)

Thu Dec 4, 2014, 02:32 AM

6. Do keep in mind that the life expectancy of a cave dweller

 

was so low simply because of a very high infant and child mortality. People in the past did not age any faster than we do now, although they certainly didn't have anything like the modern medical care we have today. Even something as simple as aspirin makes a difference. And just understanding the germ theory of disease helps. Heck, if any of us here were transported back into the past, we'd do rather well in maintaining health just because of knowing such things.

Back to the weight loss issue. It's my understanding that even if a person can't maintain an "ideal" weight all the time, the periods of lower weight are beneficial.

Another issue is that we all live a vastly more sedentary life than our ancestors did, and we have access to food in an amazing way. In this country, while people do go hungry, actual starvation is almost unheard of. Even though a lot still needs to be done, food banks and kitchens that feed the homeless (I volunteer at one) make a huge difference in this area.

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Response to SheilaT (Reply #6)

Thu Dec 4, 2014, 08:56 AM

8. I realize that high infant mortality played a part...

...in those shorter average lifespans, but even those who lived to adulthood still often died young by modern standards.

From https://www.sciencenews.org/article/living-longer-comes-easier:

Despite what the fashion magazines tell you, 40 isnít the new 30. Seventy is.

A new study finds that humans are living so much longer today compared with the rest of human history that the probability of dying at 72 is similar to the death odds our ancestors likely faced at 30.


A few people in our "all natural" past did indeed live into their sixties, seventies, occasionally beyond, but even from a standard of mortality as measured during adulthood (rather than from birth) this was a far more rare thing.

And yes, the better sanitation that comes along with understanding the germ theory of disease, and other medical advances, are a big part of where we get our current lifespans. Further, also as you mention, there's the modern availability of food that makes starvation and large calorie deficits (at least in wealthier countries) much less common.

Yet still, even given all of that, how large an advantage could an "all natural" diet be, and how truly terrible could today's processed food and preservatives and artificial flavors be, if such great increases in lifespan came along at the same time those things came along?

Is there solid evidence that we'd be living on average into our late nineties if we ate like a well-supplied non-starving cave man ate? Is there any evidence that if cavemen ate at McDonald's they'd have had average lifespans only in the teens instead of the twenties?

Don't get me wrong. I think there's a lot to be gained by being more careful about what we eat, not just in longevity but in quality of life. All I object to is taking far too seriously grand oversimplifications like "Natural GOOD! Artificial BAD!". A long, healthy life as a commonplace phenomenin is itself one of the most unnatural things there can be, and I'm all for it.

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Response to Silent3 (Reply #8)

Thu Dec 4, 2014, 11:42 AM

9. People died earlier from all sorts of things that simply aren't fatal today,

 

as you point out. There's often a misconception that because people in the past died younger on average, they therefore aged more rapidly, and that's not true.

I once read that someone had looked carefully at the human body and how it typically ages, and came to the conclusion that age 82 is the approximate average life span absent earlier death from injury or disease. Have no idea how true that number is, but my own casual observation of people over the years makes that number look about right. Sometimes I'm quite startled by how much older some people are at a given age than others.

Eating like a caveman is one of those current fad diets, but as something else I recently read pointed out, you have to ask yourself,which caveman? What part of the world?

I doubt transporting a McDonald's back to paleolithic times would noticeably shorten the life of the people back then, simply because the every day dangers in their lives were already so great. A broken bone could be fatal.

I am absolutely with you on the grand oversimplifications, especially about food. I'm made crazy by the demonization of certain foods, and the glorification of others. Or sweeping statements about things like how terrible wheat is for everyone. Or how no one should eat meat.

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