Authors’ Response

Abstract

We appreciate the opportunity that Ikeda, Gaesser, Berg, and Clark have given us to emphasize the very important public health and health care provider message that modest weight loss is not only beneficial but also achievable for overweight and obese patients (1Blackburn G.L. Waltman B.A. Expanding the limits of treatment—New strategic initiatives.J Am Diet Assoc. 2005; 105: S131-S135Google Scholar). We hope our article will serve as an incentive for overweight individuals to continue their efforts at weight loss and weight maintenance. While weight loss maintenance is challenging, it is not impossible, and we need to give our patients, friends, and family the motivation and encouragement they need to achieve a healthful lifestyle. In “Expanding the Limits of Treatment—New Strategic Initiatives” (1Blackburn G.L. Waltman B.A. Expanding the limits of treatment—New strategic initiatives.J Am Diet Assoc. 2005; 105: S131-S135Google Scholar), the citation we used to substantiate the statistic that Ikeda and colleagues mention is, in fact, taken from a nationally representative sample of American adults (2McGuire M.T. Wing R.R. Hill J.O. The prevalence of weight loss maintenance among American adults.Int J Obes Relat Metab Disord. 1999; 23: 1314-1319Google Scholar). McGuire and colleagues used a random digit dial telephone survey to determine the point prevalence of weight loss maintenance in the general US population. From the survey, they concluded that a “large proportion of the American population has lost ≥10% of their maximum weight and has maintained this weight loss for at least 1 year.” This is also the National Heart, Lung, and Blood Institute’s definition of successful long-term weight loss (3National Institutes of Health; National Heart, Lung, and Blood InstituteClinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. National Institutes of Health, Besthesda, MD2000Google Scholar). Furthermore, among those who had tried to lose weight and achieved a 10% weight loss, 25% to 27% had maintained it for 5 years or more. McGuire and colleagues provide additional citations in support of their conclusion that weight loss maintenance is not impossible; this is further supported by a more recent Centers for Disease Control and Prevention report indicating that intentional weight loss is associated with lower mortality rates (4Gregg E.W. Gerzoff R.B. Thompson T.J. Williamson D.F. Intentional weight loss and death in overweight and obese U.S. adults 35 years of age and older.Ann Intern Med. 2003; 138: 383-389Google Scholar). Finally, we hope these results will allow the readers to reject the notion that weight loss maintenance is impossible. Following the principles of cutting calories, choosing quality foods, and exercising daily can facilitate modest weight changes while reducing the risk of chronic disease.