Weight cycling is so common among people who lose weight that it’s an epidemic. For those of us who’ve gone through it, each time it takes a huge personal toll. Despite this public and personal health tragedy, we talk about weight cycling as if it’s a natural and inevitable part of trying to lose weight. We even gave it a nickname – yo-yo dieting.
In fact, some people are convinced that we can’t lose weight and keep it off. They draw on their own weight cycling experiences. They misinterpret conclusions from large population studies to claim that you can’t permanently lose weight because diets don’t work. They also draw the premature and overreaching conclusion from body weight homeostasis or “set-point” studies that you’re destined to regain any weight you lose.
Convinced of the futility of weight loss, some give up. It’s understandable that you might think it’s impossible to lose weight and keep it off, especially if you’ve weight cycled yourself.
But they are wrong. Successful weight loss sustainers have been studied extensively in large registries for many years around the world. The National Weight Control Registry in the U.S. has followed over 10,000 sustainers who maintained an average of over 60 lbs. of weight loss for over 6 years. Studies from these registries have identified dozens of differences between sustainers and weight cyclers.
Decades of sustainer research tell us that you can lose weight and keep it off
“Okay, so it’s biologically possible to lose weight and keep it off. But it’s nearly impossible in an obesogenic world.” Every day, articles are written about why we can’t lose weight because society doesn’t provide what we need. Yes, it may feel like the odds are stacked against us, but that doesn’t mean it’s not possible. Sustainers in the registries do it in the real world. We’re going to bust all these myths.
This article is loaded with great news that will erase all your doubts. After reading it, you’re going to feel a tremendous burden lifted. And you’ll be in the right frame of mind to achieve sustained weight loss. You’ll stop wasting time wondering if it’s possible and instead be excited about making it happen.
Does Society Enable Weight Loss?
Clearly, our society has an obesogenic framework in place that promotes weight gain. But are all the pieces necessary for weight loss in place? Does the world in which we attempt to lose weight actually support it? Or is there something missing from our society’s “weight loss framework” that keeps us from achieving sustained weight loss?
The image above is a simplified problem-solving flowchart of all the societal conditions needed for an individual to lose weight. Let’s test how our society performs.
Awareness of Obesity? Check!
Most of us know obesity isn’t good for our health and that it hurts other aspects of our lives. Health care, media, and the marketing engine of the weight loss industry have made awareness a non-issue. Given the size of the weight cycling epidemic, most of us trying to lose weight have also experienced weight regain first hand. In fact, you might say we’re overly fixated on our weight.
Motivation, Willingness, and Effort? Check!
Most of us are motivated to lose weight. At any given time about 50% of overweight and obese adults are trying to lose weight. If you count people who tried in the past, most overweight and obese adults have attempted to lose weight at least once. Calling the obese and overweight lazy is a ridiculous contention, and counterproductive at best. I don't see an obesity epidemic among people who don't care. I see a weight cycling epidemic among people trying to improve their lives.
Solid Diet and Exercise Science? Check!
Sure, ongoing research on diet and exercise contribute important and useful findings regularly. But enough science has been produced that there is consensus about what is healthy. At this point there is a diet with every macronutrient permutation – low carb, high protein, low fat. Likewise, there is a spectrum of workouts with every combination of cardio, strength, flexibility, duration, and intensity. All new diets and exercise programs are derivatives of existing ones.
Sufficient and Accessible Resources? Check!
Many healthy diets and exercise routines result in weight loss. And the market for weight loss products and services is enormous at about $68 billion in 2017 and expected to continue to grow. Think weight loss professionals, programs, books, foods, gyms, videos, apps, etc. There is no lack of information, products, or services – free or paid. Anyone with the Internet has access to the answer “how to lose weight”.
It’s important to note that socioeconomics plays a huge role in the obesity epidemic. Weight loss for those in lower income levels is an extraordinary challenge that defies easy answers. For people in this situation, a lack of resources plays a huge role in their weight. At this time, I’m focusing on people who have the minimal resources needed to attempt weight loss. If we don’t have a solution for those with just the modest means necessary, we stand little chance of success to help those without.
Success Models Exist? Check!
There is extensive documentation and science about sustainers easily accessible on the Internet. Just search for “sustained weight loss” in your favorite search engine or at pubmed.gov.
Let’s Bust All the Myths and Stop Wasting Time
We dissected society’s “weight loss framework” to dispel the numerous myths that deficits in our society keep us from losing weight and keeping it off. Finger pointing articles appear regularly in the media, and they only serve to distract us.
So Do We Have What We Need?
The answer is a resounding YES. There is no question that a “weight loss framework” exists in our society. We live in an obesogenic environment, but society enables sustained weight loss as well.
This has huge implications for us as individuals and a society dealing with obesity. Focusing on the issues above will probably lead to incremental progress at best. Why? The obesity epidemic is worsening even as we keep building out our framework. Despite more public health campaigns, research, products, and services, we have nothing to show for it.
I think it’s possible we’re approaching a point of diminishing returns with our current approaches.
Continuing this path will lead to a lot of wasted resources and victim blaming. Even worse, it doesn’t get us any closer to solving our weight cycling
Doubt and Burden Lifted. Now We Can Focus on The Real Problem
This is incredibly liberating! You can stop blaming yourself. You can stop waiting for the perfect diet, exercise program, wearable, or app. You can stop believing weight loss is impossible. Everything you need to lose weight and keep it off is available now.
By clearing up this confusion, we can now focus on identifying the real problem.
Why Such a Low Success Rate?
For a long time now, the problem has not been if losing weight was possible. Weight loss happens daily on a population scale! Search for “weight loss progress pics” in your favorite search engine, social media platform, social network, or forum. Weight loss is ubiquitous.
Even better, the question is no longer if it’s possible to lose weight and keep it off in our society. The large weight loss registries around the world are massive proof of this.
The real problem is the low success rate for sustained weight loss. As we’ve discussed, only 1 out of 5 of us lose weight and keep it off. That’s a 20% success rate.
Since it is possible to achieve sustained weight loss, why is the success rate so low?
If we have all the ingredients and components for sustained weight loss, why isn't it fixed? How does the same framework allow for radically different outcomes – sustainers versus weight cyclers?
The Mystery of Weight Cycling
Let’s go back to that 80% weight regain rate. That high a rate is a big clue that the usual suspects aren’t responsible. This rate is happening even though our society provides all the components of a weight loss framework. That already tells us something else is at play.
For now we know at least two things about it:
That’s progress, but we need to keep an open mind. How can we miss something so big? In future posts, we’re going to shine a light on it.
First, we’ll look for clues from what weight cyclers do that lead them to relapse. Then, we’ll solve the mystery and identify the culprit that leads us to weight cycle over and over again.
What You Can Do Now
We’ve narrowed down our obesity problem to the low 20% success rate of people who achieve sustained weight loss. But percentages are for populations. It might just mean most people have the wrong approach.
If you’ve read my other posts, you know that breaking your weight cycling to achieve sustained weight loss is what you should focus on (rather than for instance shopping for another diet). Now let’s take the next step. Answer this question for yourself:
What are your personal causes of relapse?
What causes you to quit your weight loss efforts? For help, look at this weight cycle diagram. The better you know your own causes, the better you’ll be able to solve them. You’ll also get more out of the next article.
As always, I’d love to hear your comments.
Chris Tsai, MD
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