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Years from Randomization

Figure 1 Average weight loss achieved in the lifestyle intervention of the Diabetes Prevention Program.

Few lifestyle treatment programs provide follow-up beyond 1 or 2 years. One study reported that at 5-year follow-up 13% of participants remained >5 kg below their baseline weight. Likewise, 22% of participants were >5 kg below baseline weight at 5 years in another lifestyle intervention.

These studies may underestimate the prevalence of successful long-term weight loss because they are based on a single episode of weight loss and likely involve a selected sample who find weight loss most problematic. For example, a random digit dialing telephone survey of 500 adults in the United States found that 228 of these adults reported being overweight (body mass index >27) at their heaviest weight. Sixty-nine of the 228 individuals were currently at least 10% below their highest body weight and had maintained at least a weight loss of >10% for at least 1 year (mean weight loss was 19.1 kg, maintained for 7years). When successful weight losers were further restricted to those who reported intentional weight loss of >10% maintained for >1year, 47 (20.6%) of the 228 overweight participants met this criterion. Thus, 20% of overweight individuals appear to meet the criteria specified for "success."

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