Why is Weight Loss Maintenance Difficult

Long-term weight loss maintenance may be difficult due to a combination of physiological, environmental, and psychological factors. Proposed physiological factors contributing to weight regain include reduced resting metabolic rate and insulin and leptin resistance. However, investigations examining metabolic factors in individuals who have lost weight have not been able to consistently document changes in physiological characteristics that would explain the tendency for weight regain to occur. Environmental

factors may affect energy balance by promoting increased intake and/or reduced energy expenditure, causing weight regain to occur. The strong impact that environmental cues have on energy intake and expenditure have recently been acknowledged, as Americans are now described to be living in an "obe-sogenic environment.'' This environment provides greater exposure to a variety of highly palatable, energy-dense foods and expanding portion sizes that potentially increase intake. Additionally, the environment is filled with products of convenience and efficiency that promote decreased energy expenditure. The psychological self-control needed to override these environmental cues may be difficult for most people to sustain over long periods. Finally, during obesity treatment, weight loss can provide reinforcement for adherence to eating and activity prescriptions that promote weight loss. During weight loss maintenance, weight loss no longer occurs; therefore, there is less reinforcement of healthy eating and activity behaviors, causing motivation for sustaining these behaviors to decrease.

Weight Loss Funnel

Weight Loss Funnel

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