A 2016 study by the National Institutes of Health (NIH) shows that while most people who lose a significant amount of weight (10-percent or more of their original weight) tend to regain it, those who were successful in maintaining a weight loss were vigilant in maintaining lifestyle changes that led to the weight loss.

“One reason maintenance is so difficult is that your body isn’t seeing that weight loss as a good thing,” said Domenica M. Rubino, M.D., director, Washington Center for Weight Management. “It’s not just will power, it’s biology. It’s your hormones telling your brain that your body is really not full. There are medications that target the parts of the brain that are involved in cravings and feelings of hunger.”

The reasons that maintaining a significant weight loss can be challenging range from inactive lifestyles, unhealthy diets and the side effects of medication to mental health issues and metabolic disorders, says Colleen Sanders, assistant professor of Nursing at Marymount University.

“The best recommendation for maintaining weight loss is making lifestyle changes and sticking with them,” said Sanders. “Surgery and weight loss medications will achieve weight loss, but if lifestyle choices are not made then weight is typically regained. Diet and exercise will foster weight loss, but once a healthy weight is achieved there has to be healthy eating and routine exercise to maintain that weight.”

Avoid fad diets and instead make lifestyle changes that can be maintained long-term, advises Nick Sborz, instructor of physical education at Northern Virginia Community College.

“Consistency is [necessary] and a better approach is going to include multiple strategies,” he said. “One of those is to increase your physical activity. [Type], amount and intensity will vary from person to person, but for some it will include walking, riding a biking, walking hills or swimming. For others … some form of strength training. Recommendations vary, but should be close to 150-minutes of moderate intensity activity or 75-minutes of high intensity activity each week.”

The dietary changes needed for weight loss and maintenance can be daunting, continued Sborz. “This is probably the most difficult thing to change, he said. “… [F]or long-term success, try not to be perfect. I like the 90/10 rule. If 90 percent of the time I do my best to make better, healthier choices then 10 percent of the time I can eat what I enjoy.”

Keeping track of food intake, counting calories and fat grams and avoiding skipping meals are strategies those in the NIH study credited with weight loss maintenance. “… [W]e need to eat and drink less sugar,” said Sborz. “Sugar is a big reason why people don’t see the results they are looking for. Eat more real food and less [processed] food. Generally speaking, to be considered real, food is must contain five ingredients or less. Focus on good quality carbohydrates [like] whole grains, fruit, beans and vegetables, which can provide additional nutrients to help you maintain a healthy weight.

Exercise is one of the most important aspects of maintaining your weight, adds Rubino. “People have to understand that obesity is a chronic disease,” she said. “You can’t just take medicine and not exercise and eat whatever you want. The medicines help, but you’re not going to be able to go back to living your life the way you did before you lost weight. The medicine works in conjunction with diet and exercise. There are no quick fixes, there’s no magic.”