A New Study Reveals the Best and Worst Behavior Patterns to Consider to Lose Weight and Keep it Off

More than half (55%) of all Americans report that they would like to lose weight, according to a January 2022 Gallup poll.

ICYMI, physical activity, not weight loss, is key to reducing health risks, and you are so much more than a number on a scale or a bogus BMI. But we understand the reality that many people would like to lose weight, and we also know that it's possible to set weight-loss goals you can achieve in healthy, balanced ways.

A new study published April 7, 2023, in the Journal of the American Heart Association set out to pinpoint just that; the best ways to lose weight and support heart health. At the same time, they were able to discover the strategies that resulted in minimal (or no) long-term weight loss.

It's time to go back to basics, this new research reveals: A healthy diet and an increase in physical activity can promote "clinically significant" weight loss (defined as 5% or more of body weight), while following fad diets, skipping meals or taking diet pills tends to result in little or no weight loss, and sometimes, eventual weight gain.

Read on to learn more about what that healthy diet pattern actually looks like long-term, plus discover the weight-loss strategies to skip if you want to see a shift on the scale and take care of your ticker.

What This Weight-Loss Study Found

To analyze the best and worst ways to lose weight, Ohio State University researchers looked at data from 20,305 American adults who participated in the National Health and Nutrition Examination Survey between 2007 and 2016. Each participant was 19 or older, with an average age of 47, and reported their average hours of sleep, smoking status, physical activity levels, weight history, weight-loss strategy and what they had eaten during the past 24 hours. The individuals also received health exams and lab tests to measure BMI, blood pressure, LDL cholesterol and blood sugar.

Using this data, the scientists were able to estimate each person's adherence to Life's Essential 8, the American Heart Association's core measures for lifestyle patterns that support and improve heart health. They were also able to assess their diet quality via the 2020-2025 Dietary Guidelines for Americans.

In the year prior to the study, 17,465 individuals had lost less than 5% of their body weight, maintained their weight or gained weight in the past year. The remaining 2,840 people reported intentional weight loss of 5% or more of their body weight.

The researchers used 5% as the threshold since it's a level that earlier research suggests is correlated with healthier cholesterol and blood pressure levels. For many in this particular study, though, a 5% weight loss didn't make a substantial difference in heart-health risk factors. Regardless of weight changes, down or up, participants tended to maintain the same heart disease risk rate. (It's important to note that genetics definitely play a role in your heart-health profile, as do some socioeconomic factors outside of your control. Plus, not all of the eight factors relate to weight directly, including smoking and sleep.)

"Clinically significant weight loss results in improvements in some health indices. People should feel hopeful in knowing that losing just 5% of their body weight is meaningful in terms of clinical improvements. This is not a huge weight loss. It's achievable for most, and I would hope that incentivizes people instead of being paralyzed with a fear of failure," senior study author Colleen Spees, Ph.D., an associate professor of medical dietetics in the School of Health and Rehabilitation Sciences at Ohio State, told Ohio State News.

While a 5% weight loss doesn't always directly relate to heart disease risk, it did appear to lower "bad" LDL cholesterol compared to those who didn't lose or those who gained weight. There were some other commonalities among the people who were able to lose that 5% and keep it off:

• Overall higher diet quality
• Closer to ideal intake of protein, refined grains and added sugars
• Moderate and vigorous physical activity (here's how often you should exercise each week, according to the World Health Organization)

This population also had a higher average BMI and fasting blood sugar level as well as fewer hours of sleep, which might be the factors that impacted this cohort's results on the Life's Essential 8 estimate.

Among those who attempted to, but did not lose 5% of their weight, the most common shared habits included:

• Skipping meals
• Using prescription diet pills
• Trying low-carb, liquid or other fad diets
• Taking laxatives or vomiting
• Smoking

"We saw that people are still gravitating to non-evidence-based approaches for weight loss, which are not sustainable. What is sustainable is changing behaviors and eating patterns," Spees said.

This is a timely topic to address, she continued, since one 2019 analysis estimates that 1 in 2 adults will meet the criteria for obesity by 2030. (Currently, the National Institutes of Health confirms that nearly 1 in 3 adults are overweight and more than 2 in 5 adults have obesity.)

"We absolutely need to be moving toward prevention," Spees continued. If medical professionals wait until their patients are at a place in which they're uncomfortable with their weight, she said, "this becomes quite overwhelming, and individuals may feel it's too late at that point."

Although this study proves that a balanced diet and physical activity can result in weight loss, some doctors translate that to advice like "eat less and move more," which is not nearly specific enough and overlooks potential systemic barriers at play, like food apartheid and lack of a safe space to exercise. Instead, Spees and her team recommend that medical professionals consider calling in a team of experts. This might entail writing "prescriptions" for regular visits with registered dietitians with training related to behavior change (so insurance can help cover the cost).

The Bottom Line

A new health study found that instead of a crash diet or "detox," scoring enough physical activity and eating a varied diet with enough protein and low in added sugars and refined grains are the two common features of those who lose a significant amount of weight.

If you are trying to lose weight, check out the #1 habit you should break to lose weight, according to a dietitian before you get started. Then hit the road with our guide for how to walk off 10 pounds.