The association between weight maintenance and session-by-session diet adherence, weight loss and weight-loss satisfaction

Objective: The aim of this study was to assess the association between weight-loss maintenance and weight-loss satisfaction, adherence to diet and weight loss, all measured session-by-session during the weight-loss phase of cognitive behavioral therapy. Methods: The present exploratory study examined a subgroup of fifty-eight patients who participated in a randomized controlled trial and who lost at least the 10% of their baseline weight. Patients were grouped into weight-loss ‘Maintainers’ (i.e., those who maintained a weight loss of ≥ 10% of baseline body weight at 6 months after the weight-loss phase) and ‘Regainers’ (i.e., those who did not maintain > 10% weight loss at 6 months after the weight-loss phase). Body weight, adherence to diet and weight-loss satisfaction were measured session-by-session during the weight-loss phase. Results: Thirteen patients (22.4%) were classified as ‘Regainers’, and 45 (77.6%) as ‘Maintainers’. Compared to ‘Maintainers’, ‘Regainers’ had a lower adherence to diet after the initial 11 weeks, and a progressively declining weight loss and weight-loss satisfaction from week 15 or 19 of the weight-loss phase. 11-week dietary adherence and 15-week weight loss were significantly associated with weight maintenance. Similar results were obtained using the amount of weight change as dependent variable. Conclusions: Adherence to diet, weight loss and weight-loss satisfaction, measured during the late weight-loss phase, are associated with weight-loss maintenance. Level of evidence: Level III, evidence obtained from well-designed cohort or case–control analytical studies.