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Wednesday, December 02, 2009

I would like to reopen the issue of expanding support for maintainers here at Spark People.

I've already lost over 100 lbs and gained it back once in my life, and this time I am playing for keeps. Twice in one lifetime is ENOUGH.

I want to stack the deck as well as I can toward success in maintenance, the way I have stacked it toward success in weight removal.

Ideally this would include tools, incentives, and reminders all timed to coincide with the stages of maintenance - continuing out to 60 months, analogous to the excellent structure provided here for phases of weight loss. And some way to find the other people who have been where I am and are where I am, for mutual support in sticking to the plan.

I have sent a message to Chris, Coach Jen, and Coach Dean, but they've probably been too busy to answer. Time is slipping by, and I would like to know from the rest of the community if I'm the only one here who is concerned about this.

The maintenance issue is deep and difficult. Statistically only 5% to 20% of people manage to keep a large weight loss off (depending on how you define "keeping the weight off"). I myself once before lost over 100 lbs and gained it back (plus 100 more). Training in maintenance mentality needs to start before someone reaches goal and needs to continue from 2-5 years afterward (according to the literature).

If Spark People can show an improvement for weight loss maintenance better than these statistics, the site will have a significant edge over other competing resources.

We need to make maintenance more supported, visible and celebrated here. More than occasional articles about regain, and a few teams about maintenance. The "Maintaining Your New Weight" Lifestyle Center page is good to have, but it is not enough.

There is a lot of scientific information available about which specific behaviors and strategies are associated with weight loss maintenance. The National Weight Control Registry has published about weight maintenance interventions they've designed.

Spark People would be an ideal place to implement such a program. The site already has many of the necessary features already in place - personal interactions for mutual support, tools for nutrition and fitness tracking, and the "stickiness" necessary to keep people coming back and staying with the program.

I've written a blog summarizing the main behaviors associated with weight loss maintenance, based on a recent paper from the NWCR:

(This post also contains links to other resources like the maintenance chapter of the Hacker's Diet, a link to the Second Helping online magazine, etc.)

These specific behaviors need to be highlighted, encouraged, and celebrated. Spark Streaks and countdowns to 5 years of maintenance from initial goal weight would help a lot.

We need a maintenance program that is based on hard science. Someone from Spark People could approach the NWCR about whether they'd be interested in helping design a weight loss maintenance program for us. I have even offered to assist with this, given my background in scientific / academic research.

Am I the only one here who sees a need for something like this? Getting the weight off simply is not enough. I need help KEEPING it off!
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I received an email from SparkGuy Chris.

He said they have put this down as a project to work on. He suggested building a "days at goal" tracker and then have rewards based on that. He said they also want to build out SparkAmerica/SparkEarth fitness minutes challenges since consistent fitness is such an important part of maintenance.

He asked if I had any specific additional thoughts.

Below are some specific suggestions I made. If you have any specific ideas for how to facilitate maintenance, it sounds like now is a good time to email them to him.
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I'd LOVE to see Spark Streaks implemented for days at goal, weeks at goal, months at goal, etc. all the way up to 60 months (five years).

Spark Streaks would be ideal to encourage the behaviors that have been statistically associated with weight maintenance:

1) activity levels of over 200 minutes per week (at least for women in the cited study)
2) high levels of dietary restraint, such as:
- a) deliberately taking small helpings
- b) avoiding certain foods
- c) counting calories
3) having lower levels of depressive symptomology
4) controlling overeating

I'd also like to see "success gallery" icons marking the time spent at maintenance (all the way up to 5 years).

The "Maintaining Your New Weight" Lifestyle Center page is good, but it could be improved.

I'd love to see links to articles addressing these key predictors of successful long-term maintenance, highlighting them specifically:

1) longer duration of weight loss maintenance (more than 2 years)
2) dietary consistency
3) less fast food consumption
4) less TV viewing
5) more frequent breakfast consumption
6) lower levels of depressive symptoms and dis-inhibited eating

Some of the articles already there could be enhanced. For example, Nichole wrote a nice article summarizing the efficacy of daily weigh-ins. But how about including a link to resources that calculate a weighted moving average of daily weights, such as physicsdiet.com or the Hacker's Diet online log?

(Ultimately I'd like to see a Hacker's Diet-type weighted moving average option built into Spark People's weight charts, but that might not be such an easy addition. See the Hacker's Diet Spark Team for more info: teams.sparkpeople.com/ha

Mike Kramer wrote a nice article summarizing his "unscientific" survey among maintainers, but there is actual scientific data (like that listed above) that could be referenced in this regard as well.

How about a subset of the motivational weight loss pages highlighting people who have maintained for more than 2 years? (2-5 years is the term most scientific articles mention)

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Another update:

BETHEFLAME has pointed out that there is a new Spark Poll asking about maintenance support:

If you have opinions, that might be a good place to voice them, too!
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Member Comments About This Blog Post
    Thank you for posting this (and yeah, it's a few years later but you know why I'm here).

    If SP wants us to be in the 5%, dammit, where are they?
    2496 days ago
  • GEINAHG0757
    While I have found my way to a "normal" BMI - right now - I am absolutely TERRIFIED that this will not last. It never has before. It is very admirable of you to recommend to SP that they expand their Maintenance program. If this site is to be truly successful, it is going to have to address this.
    I have not found the right nutritional path as you have. I "lurk" your blogs - taking (well, borrowing) ideas that you suggest. Some of them I have incorporated into my diet and I thank you for that. Cannot.do.tofu...just.can't!
    Congrats on your journey so far. You LOOK so vital, healthy and just plain HAPPY. May whatever power that guides continue to do so...
    2973 days ago
  • SHEILA1505
    Hi there - looks like SP might be listening! This morning I noticed a link to Maintenance - so maybe just maybe we'll get the support and recognition that we need.

    Well done with the under 25 BMI too! Awesome

    Peace and Joy
    Have a good Christmas
    2985 days ago
  • SHEILA1505
    I hit my target last year - full of motivation and Yay Way to Go stuff - but maybe I got complacent and then woke up 6 months later with several miserable pounds back on board. This time I have added this community to my back-up infrastructure and am looking forward to the January BootCamp to keep the energy levels up. I can't say that the Nutrition Trackers helped in any way as they don't seem to allow for intolerances etc. but the friendships certainly help. Thanx everyone!

    It probably was a head thing - but isn't everything? My head gets it - but Yes - we do still need encouragement, support, information and rewards. We all need to know we are appreciated and our efforts are worth while.

    Bring it on!

    2986 days ago
    I really respect your amazing success and took a look at your food intake to see how you did it. Now I can see why you might be really concerned with maintenance! You must be doing what is right for your body, even though the numbers look extreme to me. Are you consulting with a reputable and modern dietitian? I hope so, I know that many Americans get that much protein but I worry about your kidneys. Yes, I worry... sorry if that irritates you at all, I just wanted to let you know that I care. Take care on your journey, I wish you all the health and happiness in the world.

    Update: I'm glad to hear you've researched high-pro diets, it obviously works for you and that's like 98% of the battle isn't it?! I studied to become a dietitian but I learned that a lot of them are not up-to-date with new research. Your research and knowledge of your own body is probably a lot more accurate for your needs than most professionals in the field! All the best and I hope to hear more about your journey through next year (as I hopefully track my progress too =). Happy Holidays!
    2987 days ago

    Comment edited on: 12/20/2009 2:39:41 PM
    Thank you for sharing and for providing so much information on which others could contribute. I am 22 lbs away from my goal and have lost 64 lbs so far. I have done the weight loss thing before and gained it back plus.
    It scares me to death (only figuratively) with regards to how I am going to handle it, and what I need to do to maintain.
    I have already been chatting with a friend who is maintaining and I told her I plan on leaning on her A LOT!! I will try and brainstorm some ideas and send them your way. Thanks again. emoticon
    2992 days ago
    I so agree with you. At 80+ pounds down and 20+ to go, I am already feeling the lack of support that was given with the initial phases. I like your suggestions very much, and I'll try to think of anything else that might occur to me. Thanks so much for bringing this up!
    2992 days ago
    Thanks ! I need all the help I can get
    2994 days ago
    I totally agree with MSTUBBE and I am speaking from personal experience of having lost a great deal of weight and gained it back plus many more pounds. So I can be honest about it. The truth is the programs are telling the truth...you do need to continue with what you did to lose the weight. The problem is, most people don't do it. I totally agree that there is a psychological component that MUST be addressed for success. I know for a fact that is why I am successful this time. I have changed my lifestyle and I know I cannot go back to how I used to eat EVER! Unfortunately, it's a truth the most will not accept or cannot accept. And I'll tell you, all the support in the world won't help you if YOU are not willing to change forever. In the end, it is up to each individual person and I would really encourage anyone struggling to work on the mindset because you will never have permanent success otherwise. (well, at least, that's what I feel based on my own struggles).

    2996 days ago

    It *is* confusing, isn't it?! You'd THINK keeping the weight off would be just doing the same things that helped you lose weight. And most weight loss programs tell you exactly that.

    But the fact is that only about 5% of people actually manage to stay close to their goal weight in the long term, and up to 20% only manage to keep about 10% of their starting weight off, that means 80% gain it ALL back, or even add some.

    So what the weight loss programs are telling us, the standard lines about "doing what you did to lose the weight" clearly isn't working. And there is research out there showing it. There are subtle differences, and they are important. Both in the psychology and in the mechanics of the process.

    So, unfortunately maintenance is a whole other can of worms, and in my experience much harder than losing weight. You can see some of the collected resources and comments in my original blog on the subject...
    2997 days ago
    I'm confused... I get that once you reach your weight loss goal you want to maintain that weight loss but losing 100 lbs or more takes a lot of time... right? So why wouldn't you continue to live the lifestyle that got you to where you are when you reach your weight loss goal?
    2997 days ago
    Yes, I think Spark needs something like this. People will also need to learn how to maintain for life--& will need support because life can really get ya sometimes. I think you sound like a well educated person on the topic--maybe they should put you in charge. I know it would be helpful for people to see how people are successfully keeping their weight off & coping with life while doing it. I've often wondered why they did not have it...I had lost from 200 to 150 & kept it off 5 years before my pregnancy that left me half dead & 300 pounds & I already wanted to read & study up & learn from the examples of others, to help remind me where I used to be & I was hoping someone there had done it without exercising like crazy. This time, I am physically unable to do the amount of exercise I did before to maintain & am now challenged to gain more control over my portions--forever, it's not easy for me. I know it would help people who are maintaining when they hit personal & medical crisis moments. Ever seen anyone try to stay at their goal weight for life while taking steroids for pain management? That is not easy & would benefit all people because at one point in our lives, we are all gonna be on medications & many cause weight gain---I'd like to know the best way to do the best you can when dealing with it. Thanks.
    2997 days ago
    DDORN kindly sent me here, too, and I'm so glad he did! I am eager to get on board for Maintenance!

    2998 days ago
  • GETTO140
    Another spark member, DDORN, pointed me to this blog.

    This is an excellent blog with some really great ideas. I need a "how to maintain" guide, because I don't want to go back where I was either! I did reach my original goal, however, I bumped it to 140 when I saw the pounds coming off on a regular basis. Staying down is not so easy, really. It's a daily, mindful process. I help other people here, but could use some of this kind of help and motivation from others who are trying to maintain.

    2998 days ago
    I have reached 1.5 year at goal. It is so scary. Seeing that weight fluctuation of 1-2 pounds during my weekly weigh in is very scary! Did I really gain weight? What did or didn't I do this week that was so different? Am I slipping back to the old habits? It is
    2999 days ago
    Thanks for the mention of Second Helping!

    In terms of the "keeping it off is harder thing" -- if you talk with mountain climbers, or read of the chilling (ooh! really horrible pun) account of Mt. Everest climbs, there's an ongoing theme. If you put all your energy into climbing up the mountain, how will you get down?

    Life, post-weight is kind of like this, learning to climb down the mountain and settle into "the new normal." With all the emphasis on weight loss -- and rightly so -- there's comparatively less on life-after-weight loss. The methodology of it, and the reality of what it means to "catch your mind up to your body."

    With all the "weight loss success story hype" so popular in the media, post-weight life can be a lot harder than it looks. It's an tremendous adjustment, and one that goes criminally unacknowledged.

    As for SP teams, I definitely recommend the "Over the Hump" team -- for me, a lot of the "what am I going to do with my life now?" questions started happening toward the latter half of my weight loss. And there's the awesome team, At Goal and Maintaining.

    2999 days ago

    Comment edited on: 12/8/2009 9:57:26 PM
    thank you~!!!!!
    2999 days ago
    hven't gotten there yet, but great to see it is coming. We all need this to be address
    2999 days ago
    I love the weighted average idea. I have been doing this on paper by hand because the chart here doesn't show enough detail. Even when you reach goal your weight varies a little bit each day due to hormones, constipation, etc so one weekly measurement is not as helpful.
    I have been at my goal weight for a year and find I can't yet not record my food. How can we transition to eating intuitively? How about when the low calories we were eating to lose are causing our bodies to panic and gain weight. I recently found I had to eat more to stop a regain. When I read that most people are eating 1200-1400 calories and I am having to eat 1700 to maintain it confuses me, we definitely need more support.
    2999 days ago
    I'm thinking about my maintenance phase already and I've only lost one third of my goal weightloss!

    I thought I'd lost you on PhysicsDiet, but then I thought "those numbers look familiar". I bet she changed her name. emoticon
    3000 days ago
    Maintaining has always been my problem too.

    When I get to goal this will be the third time I have lost a significant amount of weight to get to a goal. Losing the weight, once I make up my mind, is not usually the problem. It's keeping it off. I have better tools now, and a better mindset that I'm working on, but I agree, having a maintenance component is a great idea.
    3000 days ago
    3000 days ago
    I need maintenacnce more than anything. I reached my goal and decided to lose a little more. Just beacuse I am afraid of the future. Now I have no enthusiasm. I have kept within my nutrition and exercise guideleines but I just feeol deflated. I reached my goal over Thanksgiving.
    3000 days ago
    Really well thought out. Thank you.

    I know those who are still struggling to lose probably wouldn't agree with this but the losing was the easy part. Once I was in the losing mind-set I didn't really have a problem sticking to the program. Sure a few hiccups but no real problems. Maintenance is much harder for me.

    I hope your suggestions are implemented quickly.
    3000 days ago
    Rock on! I am six pounds from goal, and trying to work out maintenance issues. I want to keep this lovely body. Thanks for a timely blog post!

    -- Hilary
    3000 days ago
    In the meantime, you could start a team. If you do let me know.
    3001 days ago
    Great ideas.. glad someone (you) started something. ; )
    3001 days ago
  • FRANMA76
    I completely agree. I'm a WW member, and have already found that other than weigh ins and an empathetic leader, there are no real clear cut guidelines, or much of a "what to expect"...I'd like to see some articles addressing how you cope when the message from the scale is suddenly say the same...and the mental game of keeping on tracking, controlling portions, all of it.

    I've always heard it's hard, but it's still a shock.
    3001 days ago
    As I'm closing in on goal I find myself wondering about maintenance. I'm not gaining this weight back. I want to know others who are in the same boat, doing the same things, striving for the same goals.

    Expanded support for maintainers...Expanded support for large weight loss (i.e. half our former selves)...tools, tricks, groups.

    I'll have that please.
    3001 days ago
  • ROBIE143
    My problem is not losing but maintaining. I have lost and gained over 500lbs in my life.Very scary,.Finaly at age 54 I figured it out.Jan 1 of09 I started my plan, no carbs,sugar,or flour.It is not a diet It's a wsy of eating.Sugar makes me eat everything in site.I have no problem eating this wayand now I'm a size 6 and very happy.I know if I eat this way I will stay thin and happy.Now I need to move,I can't find a workout I want to do more than once. Help
    3001 days ago
    Thanks for your research and your initiative in bringing this to our attention and to that of the SP organization. SP has provided a service we can never repay and I, for one, will be eternally grateful to them.

    The facts, however, are crystal clear: most of us are in a viscious cycle of weight loss and weight gain. Truthfully, SP's assistance in helping us learn to maintain our weight would be even more life-changing than the intial (and probably temporary) weight loss.

    Try to visualize the ripple effect of hundreds of thousands of fewer people suffering from diabetes, high blood pressure, heart disease, physical limitations, etc. Imagine the improved lives, the improved work productivity, the vastly lowered health costs -- the list is endless.

    I encourage SP to offer additional tools to cement the progress achieved by those reaching weight goals. The alternative is to watch the revolving door of losing and gaining, not only of pounds, but also of good health, fitness, self-esteem and Hope.

    3001 days ago
    You are right on with your suggestions. I am glad to hear Chris & Company agree. I started SP one month ago and my biggest concern out of the blocks is future maintenance.

    I’m in the honeymoon phase of this lifestyle. My hubby commented regarded documenting that surely I won’t have to keep it up once I get “good” at this. He is usually right but this time could not be more wrong! I will continue tracking.

    Self-perception is a tricky issue. We cannot depend on it—therefore, we must measure.

    Thanks for all your great posts.

    3001 days ago
    I have emailed you about this! I am on my way to goal again after a "problem" few years that I had. I think another intervention that needs to be in place is a comprehensive relapse plan. That was one thing that kept me at a normal BMI from 2003-2006. My normal BMI is 200 pounds less than my highest weight. I have lost over 100 more than twice, but have spent more than 20 years maintaining at least 100 pounds of that weight off. I don't get accolades or credit for the 100 that stayed off, because of the fact that I have only spent 3 years at goal. During that 3 year period I felt "bullet proof" with my maintenance plan. I am a member of the NWCR and a health care professional.
    3002 days ago
    Great ideas. I'm not at goal yet, but maintaining after I reach my goal is very important and I will need strategies so I don't gain again
    3002 days ago
  • NANCY-
    Excellent, I'm already working with maintenance in mind.
    3002 days ago
    This is great! emoticon
    3002 days ago
    Yes, yes, yes, yes, yes!

    I was just corresponding with a spark buddy about how much more difficult it is to stay with it when the accolades stop coming, and it's all about staying where you are instead of getting someplace new.

    I really applaud your effort to strengthen the research base, and resourcing for maintainers.
    3002 days ago
    I haven't quite reached a good weight to maintain, but when I view my weight tracking, I always regard it as a trend,and individual weigh-ins may sometimes just be blips.

    I liked your recommendations. There could be 1-year, 2-year, 3-year, 4-year, 5-year and 5+years badges to appear under the member avatar.
    3002 days ago
    Maintenance is really the hard part... I agree totally. Firsltly, it's not hard to loss weight when you're 200 lbs, but harder as you get smaller. And then it takes so much less to maintain the lower weight. What I found is

    A) I think I'm sabatoging myself to not get to goal so that I'm always in the weight loss mode and I concentrate on losing weight. I lost 60 lbs over a year ago and I've kept most of it off... but I still have about 10 or so to go.. and I can't seem to get there.

    B) I've joined WW's, as well as SP, because they do have a maintenance program and motivation to stay at goal... free membership.

    I think it would be great to have some extra tools for maintenance on SP, but honestly, I don't know how much more it would help me. In the end, only we can do it or not do it.

    3002 days ago
    Thank you for taking such an interest in maintenance and acting on it. I too struggle to stay at my current weight. I found Sparks at the end of my weight loss journey but at the right time to help me reach goal weight. I still continue to track what I eat and my exercise as a means of not loosing control and going back to my old ways of eating. So I love some of your suggestions and would welcome them!
    3002 days ago
    3002 days ago
    I think you have some great ideas. I think special trackers and streaks for people who are maintaining would be great. The should be incentives and rewards for staying within a final target weight range and continuing to track nutrition and exercise.

    Also, I think it's important to keep in mind that people who have lost weight through SparkPeople and are now maintaining are a HUGE asset to the community. They are great motivators and can help with answering questions and share their own experiences with overcoming obstacles. So, keeping maintainers interested in SparkPeople by providing additional tools and incentives for them to continue using the site is in the best interest of everyone.
    3002 days ago
    I found that getting involved in the Community Team has really helped me with maintenance and achieving new goals. Thanks for the blog!
    3002 days ago
    God/s know its definitely needed.
    3002 days ago
  • BILL60
    3002 days ago
    You make a great point. I've heard other people say that some of the monitoring on sparkpeople becomes a bit awkward when you're trying to maintain, such as the weight loss tickers. It'd be nice to see these kinds of things updated.

    I also think that you're right that efforts to keep people who are in maintenance involved in Sparkpeople should pay off. It'll give them more tools to stay healthy, and a pool of people who've been through the whole process to answer questions and offer encouragement to newer members.

    Everyone who loses weight in a healthy way on this site improves their own lives and health, makes it more likely that their friends and family will seek to improve their health, and generally helps to direct more of our dollars toward companies that produce healthy food and less toward the companies that make junk foods. It's a win for everybody (except the junk food companies, but I don't feel sorry for them). Everything we can do to make the process more effective and lasting is a good thing!
    3002 days ago
    Wow, great idea! I am still in the weight loss phase, but I know from experience that weight maintenance is a difficult task. Thanks for taking the initiative.
    3002 days ago
    I agree, I reached my goal about 2 years ago now, but the work isn't over.
    3002 days ago
  • TRABOLD8567
    3002 days ago
    Great and informative blog! I can't wait until this becomes a REAL issue for me instead of speculative. Thanks for being proactive.
    3002 days ago
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    Disclaimer: Weight loss results will vary from person to person. No individual result should be seen as a typical result of following the SparkPeople program.