Phases of Obesity Weight Loss and Regain

New Study Identifies a Six-Phase Cycle Associated with Weight Loss and Regain in Individuals with Obesity

People with obesity who are struggling to lose weight go through six common phases that are accompanied by a set of shared beliefs, experiences, attitudes and emotions, according to recent research findings. Classified as a disease by the American Medical Association in 2013, obesity impacts nearly 80 million adults in the United States. , This research uncovered a Weight-Loss Cycle paradigm that helps explain the chronic nature of obesity. The six phases include1:

1. Defining Moment: Feel energized and motivated to lose weight. Defining moment can be triggered by: frustration to find clothes that fit properly, seeing a picture of oneself, embarrassment at not fitting on a bus or plane seat, or being diagnosed with a weight-related health condition. It is at this stage that the person makes the decision to focus on weight loss.
   2. Consideration: Feel hopeful and determined. Assess which weight-loss method is appropriate based on recommendations from family, friends, media (TV, magazines) and health care professionals.
   3. Momentum: Feel confident and excited. Strive to maintain a specific regimen and work hard to maintain discipline. Proud of weight-loss accomplishments and positive feedback from family and friends.
   4. Plateau: Feel anxiety, uncertainty and frustration as life gets in the way of weight-loss efforts. Confidence erodes, and frequent missteps result in weight no longer coming off.
   5. Collapse: Feel tired and unable to continue the effort. Feel a sense of relief that the pressure to lose weight is off.
   6. Fatigue: Feel exhausted and unwilling to focus any mental energy on weight-loss efforts. Eventually regain the weight that was lost, and more.

The Weight-Loss Cycle characterizes the oft-repeated emotional and psychological journey of study participants' efforts to lose weight, and aligns with previous research on the physiological struggle to maintain that weight loss. It is known that obesity changes how the body uses food and the energy it produces. As a result, for up to 12 months after weight loss, the body turns up the signals that trigger appetite, which can potentially cause overeating and, consequently, prevent some people from maintaining the weight loss they have achieved.

Supporting this scientific explanation of the body's propensity to regain lost weight in people with obesity is a recent retrospective, longitudinal study presented at the annual meeting of the Endocrine Society. Including over 175,000 cases of patients with obesity, this study revealed that regardless of initial weight loss, after two years, participants in the modest, moderate and high weight-loss groups (40.0%, 35.9%, and 18.6%, respectively) regained more than 50% of their weight loss.