It’s a cruel fact of life: Losing weight is hard but keeping it off can be even harder. Studies show that most people who lose weight regain half of it within two years and about 80 percent within five years.
“Your body never forgets your highest weight and wants to get you back to it,” says UNC Health family medicine doctor Ana Morais, MD. “A 10 percent loss in body weight can lead to a 15 percent reduction in energy expenditure, meaning you burn fewer calories throughout the day including when you’re sleeping. You can gain weight even if you’re eating the same number of calories.”
Your hunger hormones aren’t going to be helpful, either. Ghrelin, which causes hunger, tends to increase after weight loss, while leptin, which helps you understand you’re full, decreases. Human bodies evolved to hunt and gather food, so if you’re losing weight, your body thinks there’s a food shortage and you need to conserve energy.
So, if you feel like your body is working against you after weight loss, you’re not wrong. But it’s not hopeless, either. Do these five things to maintain your weight loss.
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Continue exercising and eating balanced meals.
Too often, people think that their diet or exercise routine is only temporary, something they have to do until they hit that desired number on the scale. That’s why it’s so important to consider changes that you can sustainably maintain for the long-term, because you have to do them for a lifetime.
In fact, you may have to increase your movement. While public health officials recommend that adults engage in at least 150 minutes of moderate-intensity aerobic exercise per week, 200 minutes a week has been shown to be most effective for people who have lost weight and managed to keep it off, Dr. Morais says.
“A high level of physical activity is important for weight maintenance, but it’s also important for your longevity, helping your heart, muscles and bones,” Dr. Morais says. It’s OK to split up those 200 minutes into small chunks; 10 minutes walking outside or doing squats between meetings counts. “Whatever you can do regularly will help.”
You probably lost weight by taking small steps to adjust your diet, such as filling half your plate with vegetables and limiting sweetened beverages; try to maintain those habits while adding other small, manageable habits.
“One of the biggest things you can focus on is eating fewer ultraprocessed foods,” Dr. Morais says. “It takes more time until it becomes a habit, because you have to really plan your meals and grocery list. If fresh fruits or vegetables are too expensive, frozen versions are good options.”
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See your primary care provider regularly.
Your primary care provider can help if you notice the weight creeping back.
“Sometimes people gain weight and become self-conscious, so they don’t want to come in,” Dr. Morais says. “That’s exactly when we want you to come back. Let’s work together now so you don’t lose the progress from all your hard work.”
Your provider can help you identify your next health goals, because your health is more than one number on a scale. The good news: Working on other metrics, such as blood sugar, cholesterol and blood pressure, supports weight loss maintenance.
“At this point, your goal might be to gain more muscle and work on bone density so you can decrease the risk of osteoporosis,” Dr. Morais says. “If you’ve been calorie-restricted, you might need to work on eating more protein and fiber. You might need to be aiming for a little more sleep a night, or doing more to manage stress, which helps you rest and not run on fumes.”
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Talk to your doctor about the role of weight loss medication.
If GLP-1s were a part of your weight loss plan, talk to your doctor about what you need going forward.
“Many people start a medication with the goal that it will be temporary, that it will give them a jumpstart,” Dr. Morais says. But “most people regain weight once they stop the medications, because obesity is a chronic, relapsing disease. It’s not like we’ve given you a course of antibiotics and you’re healed from a disease and don’t have to think about it again.”
You may need to be on medication for the rest of your life, but you and your doctor can work together to find the right medication and the right dose. Sometimes it’s possible to lower your dose so that you can maintain weight loss.
If the long-term cost of GLP-1s is a factor, talk to your provider.
“There are alternatives—cheaper oral medications that can help keep the weight off,” Dr. Morais says. “Talk to your provider and be transparent about what’s going on, because they can help you achieve and maintain intended treatment goals while considering cost, access, tolerability, risk for adverse effects and individual preferences.”
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Be mindful about changes to your routine.
It can be easier to maintain healthy habits when you’re in a good, predictable routine, but life will not always allow that. Pay attention to any changes that happen when your daily routine shifts.
“The holiday season—from Halloween or Thanksgiving through New Year’s—is a big one where people think they’ll just get off their routine and do a January reset,” Dr. Morais says. “That’s too long. If one day was off, then the next day, try to get back to your routine.”
Summer can be tough, too, without the structure of school and activities and with more sleeping in and travel.
“We all have different life seasons,” Dr. Morais says. “Try to find reasonable, sustainable things you can stick to when your routine changes.”
If you find yourself skipping the gym entirely when you can’t do your full workout, try to commit to shorter workouts. If there’s no time to cook, try to find the best grab-and-go option you can.
“Maybe this is a season where you need to have a protein shake, ideally one with at least 30 grams protein and no more than 1 gram of sugar, to drink on the way to work, or you made a bunch of egg muffins on the weekend that your family can eat all week for breakfast,” Dr. Morais says.
“A 15-minute workout and some stretching is still a victory. Doing something keeps the momentum going, making it that much easier to build back up to your full routine later.”
Weighing yourself once a week can help you stay ahead of big changes, Dr. Morais says.
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Find your support system.
Your primary care provider can introduce you to other people who can help, such as a registered dietitian who can make sure you’re getting the nutrition you need or a personal trainer or community exercise program to help you find new ways to move your body.
There are likely other people in your life who can help, too.
“Find a buddy and check in on each other,” Dr. Morais says. “It helps to have someone to talk to about what went well, what didn’t and how you can improve in the coming week.”
You may have to talk to your partner or kids about how the healthy choices you made to lose weight have to be maintained for life.
That goes for your social life, too: Consider asking friends if they want to meet for a hike or go to a museum rather than a big meal or a night of drinks. Be honest with your friends and family about when you need a different option to support your health goals.
“A good support system is really important,” Dr. Morais says.
Questions about your weight? Talk to your doctor or find one near you.