ABSTRACT
Most adults who lose weight will regain more than half of their lost weight within 3 years of completing treatment. Indeed, the failure to maintain weight reduction represents the single greatest barrier to the successful management of obesity. In this chapter, we describe various biological, bio-behavioral, environmental, and psychological contributors to the regaining of lost weight, and we review findings from recent randomized clinical trials testing a variety of interventions designed to improve long-term weight-loss outcomes. Our review provides evidence of the effectiveness of two distinct approaches for weight loss maintenance, structured extended-care programs and novel pharmacological interventions. Structured programs of extended care provided by trained interventionists, delivered via face-to-face sessions, telephone contacts, or electronic health record communications can help participants to sustain lifestyle changes in diet and exercise and thereby reduce the regaining of lost weight. An alternative approach involving the sustained use of semaglutide (a glucagon-like peptide-1 receptor agonist), which targets hormonal signals associated with appetite and satiety, produces large, short- and long-term weight losses with minimal adverse side effects. Collectively, these findings provide evidence that with appropriate intervention, the prevention of weight regain following weight loss is indeed achievable.
