Recovery from relapse among successful weight maintainers.

Background: Little is known about the natural history of weight change among persons who are successful at losing weight.

Objective: This study evaluated the occurrence of weight regain and recovery among 2400 persons in the National Weight Control Registry (NWCR) who had lost an average (+/- SD) of 32.1 +/- 17.8 kg and had kept it off for 6.5 +/- 8.1 y.

Design: Participants were evaluated prospectively over 2 y.

Results: The mean reported weight change from entry into the NWCR to 2 y later was 3.8 +/- 7.6 kg. At year 2, 96.4% of the sample remained > or =10% below their maximum lifetime weight. However, small regains were common, and few persons were able to re-lose weight after any weight regain. Of the participants who gained any weight between baseline and year 1 (n = 1483; 65.7%), only 11.0% returned to their baseline weight or below at year 2. Of the participants who relapsed, which was defined as a weight regain of > or =5% at year 1 (n = 575, or 25.5% of the sample), only 4.7% returned to their baseline weight or below at year 2, and only 12.9% re-lost at least half of their year 1 gain by year 2. Logistic regression showed that recovery was related to gaining less at year 1 and to smaller increases in depressive symptoms between baseline and year 1.

Conclusion: Although successful weight losers continued to maintain a large percentage of their weight losses over 2 y, recovery from even minor weight regain was uncommon.