With more than one-third of adults in the United States considered obese, the importance of weight loss and keeping weight off are of utmost importance. Researchers looked at data from 45 different studies until they came to the conclusion that the key to keeping off weight, even for obese individuals, are programs with both a diet and exercise component.

“Long term weight loss through changes in eating and physical activity is possible, even in adults who have already acquired obesity related illness, and effective weight loss programs are now available,” the study’s researcher wrote in the study published in the British Medical Journal.

The 7,788 total participants in the studies lost five percent of their body weight with an average of 24 lbs. lost in weight. Researchers looked at their ability to keep the weight off and found that participants who were in a program with a combination of diet and exercise only, gained back 3.4 lbs. less than everyone else did after one year. Aside from the classic diet and exercise regimen, the studies also looked at participants who tried medication, lifestyle changes such as diet, physical activity, meal replacements alone and in combination of each other.

“I think it’s great that they covered so many different studies but there’s also so much variety and the long-term research isn’t there, you know — going beyond 24 months,” lead researcher Stephan Dombrowski of Newcastle University in the UK told Reuters Health.

In addition, researchers found that with the help of Orlistat, an obesity drug, participants regained 4 lbs. fewer than those who received a drug-free placebo. Currently, Orlistat is the only Food and Drug Administration-approved prescription drug to treat obesity. It works by reducing the amount of fat absorbed from certain foods. Although larger doses of Orlistat proved to show more weight loss success, it also accompanied more gastrointestinal side effects than did regular dosages.

“Weight management is hard,” Dombrowski said. “People have to realize that it’s not just the losing it — it’s for life, and if you don’t like what you’re doing, if it doesn’t work for you, you’re not going to stick with it.”

If those who are obese don’t stick with their healthy lifestyle goals, then they will significantly increase the risk of coronary heart disease; type 2 diabetes; endometrial, breast, and colon cancer; hypertension, which is high blood pressure; dyslipidemia, or high cholesterol; liver and gallbladder disease; sleep apnea; osteoarthritis; and infertility, according to the Centers for Disease Control and Prevention. Being overweight will increase many of these risks as well, which is why it’s important to stop the bad health habits as early as possible and stay committed to programs that rely heavily on diet and exercise.

“It’s really important to remember that weight management is a mind and a stomach game,” Dombrowski said. “You have to feel good about what you’re having.”

Source: Dombrowski SU, Knittle K, Sniehotta FF, et al. Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials. British Medical Journal. 2014.