Pounds, permanently

LOST: 30

FOUND: A new, enjoyable lifestyle

The National Weight Control Registry offers insight on how to keep the weight off after you lose it.


Like the old joke about quitting smoking, weight loss is easy: You've done it hundreds of times. What's hard is keeping the pounds off. So hard, in fact, there's a common belief that almost no one succeeds.

Rena Wing and James Hill know better.

They know there are plenty of people out there who continue to maintain their new weight, and they know how those people do it. They knew, even at the height of the Atkins craze, that you can eat carbohydrates and not gain weight. They know the losers who are successful almost always end up enjoying the new lifestyle they have adopted as well as their new look - even when they didn't expect to.

Wing and Hill are co-founders of the decade-old National Weight Control Registry, a research study of more than 5,000 individuals who have lost at least 30 pounds and kept it off for at least a year. (If that description fits you, see the box on Page 6D for information on how to join.)

On average, participants in the study lost about 67 pounds and have kept them off almost six years. Wing and Hill call them successful losers. They offer hope to those whose weight creeps back up every time they shed unwanted pounds. Almost everyone in the database has tried to lose weight before and either failed or regained the weight - often more than once - before finding a strategy that worked.

"This time it sort of clicked, which suggests it's not something in their personality or biology [that helped them succeed]," says Wing, professor of psychiatry and human behavior at Brown Medical School and director of the school's Weight Control and Diabetes Research Center. "When we ask what made a difference, they usually say, `This time I was just more committed.' "

The researchers have learned that people lose weight in a variety of ways, but most of the registry's successful losers keep it off the same way, says Hill, who is a professor of pediatrics and medicine at the University of Colorado and director of the Center for Human Nutrition, which is funded by the National Institutes of Health.

When he gives talks about weight-loss maintenance, he emphasizes four strategies gleaned from registry data:

Exercise. Most participants exercise 60 to 90 minutes a day. It may have started off as a chore, but now they enjoy it. It can be walking, and it doesn't have to be continuous.

Weigh yourself regularly. Most successful losers get on the scale daily or at least weekly. They use it as a tool to keep things from getting out of hand. If their weight inches up a little, they can cut back on their calories before it gets to be a problem.

Eat a low-fat, high-carbohydrate diet. Even if the participants lost weight using a high-protein, low-carbohydrate diet like Atkins, most don't use it to maintain their weight loss.

"You can lose weight on a low-carb diet," says Hill, "but you can't live your life that way."

Eat breakfast. The researchers were surprised to find that most successful losers eat a healthy breakfast, and they do so seven days a week.

Toxic world

Wing and Hill's newest research project is called LITE, Living in a Toxic Environment (the toxic environment being such things as TV). They are looking for subjects.

"We are trying to find out if in order to live in this toxic environment, do all normal people have to eat very carefully and exercise a lot?" says Wing.

They plan to compare 200 successful losers with 200 people who have always been thin. The subjects will be sent a device, something like a pedometer, to wear for one week. It accurately records physical activity levels and intensity. An independent observer will call three times that week to record what the subjects have eaten.

So far, the researchers have produced 16 original publications and several review articles using data from the registry. They speak at conferences around the country, and they and their conclusions have been quoted in hundreds of newspaper and magazine stories.

Wing and Hill are well respected in the professional nutritional community, says Mark Kantor, an associate professor of nutrition and food science at the University of Maryland. The research study is valuable, he believes, because "it's an attempt, even if it's not perfect, to show that it's not inevitable that people who lose weight will gain it back again.

"Just that information itself can serve an important purpose."

Success stories

The registry was an idea that Wing and Hill came up with over lunch at a conference in 1993, or maybe 1994. Neither can quite remember. The more the two colleagues talked about starting a database of successful losers, the more interesting it seemed.

Hill mentioned the idea to a Orange County, Calif., reporter who was interviewing him about a completely different topic. The registry concept made its way into the newspaper story, and hundreds of letters came to Hill in response.

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