What approaches are effective for weight-loss (as recorded from the National Weight Control Registry)?

From: The American Journal of Clinical Nutrition

Journal rating:
rating: 98%
Study Quality:
rating: 55%

Overall Reliability

Article Quality:
rating: 25%
rating: 0%


  • Over 4000 individuals from the National Weight Control Registry


  • The paper is a systematic review / meta analysis of all relevant trials.
  • This means that the data from all similar trials has been grouped to form an overall outcome.


  • National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 years.
  • To maintain their weight loss, members reported high levels of physical activity (approximately 1 hr per day), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends).
  • Weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2–5 years, the chance of longer-term success greatly increases.
  • Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success.


  • 89% reported using both diet and physical activity for weight loss; only 10% reported using diet only, and 1% reported using exercise only for their weight loss.
  • The most common dietary strategies for weight loss were to restrict certain foods (87.6%), limit quantities (44%), and count calories (43%). Approximately 25% counted fat grams, 20% used liquid formula, and 22% used an exchange system diet. Thus, there is variability in how the weight loss was achieved (except that it is almost always by diet plus physical activity).


Editors Notes

  • The perception of the general public is that no one ever succeeds at long-term weight loss. This belief stems from Stunkard and McLaren-Hume’s 1959 study of 100 obese individuals, which indicated that, 2 y after treatment, only 2% maintained a weight loss of 9.1 kg (20 lb) or more.