New preliminary research recently presented at the Society of General Internal Medicine’s annual meeting provides somewhat mixed news for those hoping to lose weight permanently.

The researchers, hailing from the University of Colorado Anschutz in Aurora, Colo., analyzed data from participants who took part in one of the longest-running weight loss programs around: the Take Off Pounds Sensibly (TOPS) program. They specifically looked at the 65,559 participants who had enrolled in the program from 2005 to 2010 and renewed their annual membership at least twice. By the end of the first year, half had accomplished significant weight loss, defined as losing more than 5 percent of their original weight. Of these successful participants who could be tracked for up to seven years after they first joined, 80 to 95 percent kept the pounds off.

“Our study demonstrates that significant weight loss can be maintained for up to seven years in a subset of individuals participating in the TOPS program,” wrote the authors. “Given the difficulty in maintaining weight loss in lifestyle modification programs for extended periods of time and that health benefits of weight loss disappear when weight is regained, maintaining long-term weight loss is a critical challenge in treating obesity and weight-related comorbidities.”

A Large Caveat

The TOPS program, run by the now non-profit organization TOPS Club Inc, was first established in 1948. The current model allows people to set up their sanctioned chapters, funded by membership fees. Rather than subscribing to any one weight loss plan, the chapters function more as support groups, with weekly meetings, weigh-ins, and educational resources and tools, both offline and on. Currently, the annual membership fee for a TOPS member is $32, with varying monthly fees depending on the chapter and an additional $32 fee for an online membership.

The rather large caveat to these findings is the program’s overall abysmal success rate. Simply put, most people who enrolled in TOPS during the study’s time period failed to stay on long term.

According to lead author Dr. Nia Mitchell, 184,396 people had joined TOPS from 2005 to 2011. That means that only one-third bothered to renew their membership past the first year, and only half of these people did so while losing any significant weight. Of the 35,651 who joined in 2005, exactly two percent stayed in TOPS and maintained their lost weight for seven consecutive years. These rates align with other research looking at the lacking long-term effectiveness of nonsurgical weight loss interventions.

And even the success seen here should be qualified. A similar 2015 analysis of the TOPS program by Mitchell and her colleagues found that the average weight loser by the first year had lost 6 percent of their original weight, while the few who had stayed in TOPS for seven years lost 8.3 percent. While there are often noticeable health benefits from mild to moderate weight loss, it’s possible that some who achieve even that amount might walk away disappointed with their efforts and subsequently stop exercising and/or dieting.

The researchers believe that further study of the TOPS program and its relatively rare success stories will allow them to identify which people are most likely to succeed at weight loss and weight loss maintenance as well as determine factors that can help improve people’s chances.

“I think our study suggests that the key to extended weight loss maintenance might be keeping participants engaged in weight loss programs. Most weight loss programs only last for a finite period of time — perhaps weekly during the weight loss phase, then monthly during the weight maintenance phase, then nothing. After the program ends, people are on their own with the hope that they can continue to practice what they learned,” Mitchell told Medical Daily. “Unfortunately, we know this does not usually work. The TOPS program expects people to continue to participate in the program weekly even when they reach their goal weight, which is unique among weight loss programs.“

Indeed, other research has found that commercial weight loss programs often have little to offer the majority of people in terms of lasting success. And a study published earlier this February found that 91 percent of such programs don’t even follow recommended medical guidelines for weight loss treatment.

Despite the study’s caveats, and the acknowledgement that long-term weight loss is rare, Mitchell and her colleagues do believe it is a worthwhile goal for higher weight people.

“In the same way it is wise to recommend smoking cessation as a viable public health intervention even though people repeatedly fail, it is wise to continue to recommend long-term weight loss as a public health intervention,” Mitchell said. “In general, health improves with long-term weight loss, and we should not stop recommending it because it is difficult.”

“The modest success that we see in long-term weight loss maintenance should motivate us to find things that work better than our current tools, and allow us to have more compassion for those who struggle with weight loss and weight maintenance,” she added.

Mitchell and her team are planning to submit their findings to a peer-reviewed journal in the near future.

Source: Mitchell N, Seyoum E, Furniss A, et al. Extended Weight Loss Maintenance for Individuals in a National Nonprofit Weight Loss Program. Society of General Internal Medicine Annual Meeting. 2016.