Chapter 23: Managing Weight Loss Plateaus And Maintaining Weight Flashcards
Plateau
A period of stalled progress of 1 month or longer.
Energy Balance
The amount of calories consumed compared to the amount of calories expended.
Dietary Adherence
The degree to which an individual sticks with a diet.
Reduced Obese
Obese people who have lost weight.
Satiety
A feeling of fullness and satisfaction.
Hyperpalatable
Foods that are ultra-processed and made to be highly appealing to our senses.
Maintenance Practice
Periods of body weight plateaus where a client practices maintenance of habits and becomes used to the new body weight.
Metabolic Adaptation
A greater-than-expected decrease in energy expenditure due to weight loss.
Satiety
A feeling of fullness and satisfaction.
Energy Density
The amount of calories relative to the volume or weight of a food, often expressed in calories per gram.
Buffet Effect
The tendency for people to eat more when offered a wide variety of foods.
Optimal Foraging Theory (OFT)
Refers to how human brains assign value to food – OFT is defined by the calories gained from a food relative to how much energy and time is needed to obtain it.
Impaired Satiety Signals
A loss of effectiveness of the signals that travel to the brain and tell people they are full.
Sedentary Lifestyle
Randomized controlled trials (RCTs) show that weight regain is more likely when physical activity energy expenditure is low (1,000 calories per week) (Tate, Jeffery, Sherwood, & Wing, 2007). Low leisure time is likely to lead to weight regain (Elfhag & Rossner, 2005). Perceived barriers for carrying out physical activity are also associated with weight regain (Elfhag & Rossner, 2005). The use of activity monitors like accelerometers and pedometers can be useful in providing feedback on overall daily physical-activity levels.
Disinhibited eating
People that tend to have no restraint regarding their eating habits are more likely to regain weight (Elfhag & Rossner, 2005). While long-term maintenance allows for more flexibility than a weight-loss phase, some restraint is still necessary. Thus, continuing to practice some of the same restrained eating habits during maintenance, as what was practiced during active weight loss, can be helpful.
Dichotomous view of foods and a rigid approach to dieting
Rigid approaches are an all-or-nothing approach to dieting and allow for very little flexibility. They tend to label foods as good or bad or allowed or disallowed. Rigid approaches are associated with pre-occupation with food (Westenhoefer et al., 2013). Rigid, all-or-nothing approaches are a risk factor for periods of overeating (Linardon, 2018). Rigid control of eating behavior can increase feelings of deprivation and cravings (Meule, Westenhofer, & Kubler, 2011). Clients should avoid labeling foods in a dichotomous fashion and quality should be viewed on a continuum with some foods higher in quality (like fruits and vegetables) and some foods lower in quality (like energy-dense desserts).
Binge Eating
Binge eating includes the consumption of large quantities of food while feeling a lack of control over eating. It is associated with increased risk of weight regain and people who binge eat experience distress about their episodes (Elfhag & Rossner, 2005). If a client has issues with binge eating, seeking out professional counseling from someone with expertise in binge eating can be helpful.
Emotional eating, psychosocial stress, and low coping capacity
People who regain weight often have poor coping strategies and tend to eat in response to stressful events and emotions (Elfhag & Rossner, 2005). They may use escape-avoidance ways to cope that include eating and passively wish the problems would vanish (Elfhag & Rossner, 2005). Clients should be encouraged to find alternatives to eating for coping with stress. Clients should also be encouraged to actively problem solve when faced with challenging situations.
Lack of social support
Lack of social support or negative involvement from family, spouses, or friends are associated with regain (Elfhag & Rossner, 2005). Clients should be encouraged to seek out support wherever they can. If support from family or friends is lacking, then support groups or Internet groups may be useful alternatives.
Psychopathology
Depression or other psychiatric diagnoses may be associated with regain risk, although the research findings have not been consistent (Elfhag & Rossner, 2005). Clients should seek professional help in cases where psychopathology may be a risk factor.
Medication-induced appetite elevation
Some medications may increase appetite and lead to weight regain. For example, glucocorticoid medications can increase appetite and food reward, leading to abdominal weight gain (Serfling, Buades-Rotger, Harbeck, Kramer, & Brabant, 2018). Clients should discuss their medications and potential alternatives with their physicians.
Excessive Loss of Fat-Free Mass
The percentage of weight loss from fat-free mass during a diet is a predictor of subsequent weight regain (Vink, Roumans, Arkenbosch, Mariman, & van Baak, 2016). Exercise can be an important tool to help prevent the loss of fat-free mass.
Diet Burnout
Long-term weight maintenance takes increased effort (Kruseman, Schmutz, & Carrard, 2017). The constant required effort may lead to psychological burnout, particularly if the diet is disliked, there is a lack of flexibility, and/or there is no break from the diet. Thus, it is important to ensure a diet fits a client’s preferences and has adequate flexibility to help prevent burnout. Prescription of maintenance breaks can also be useful.
Weight Cycling
Repetitive cycles of weight loss followed by weight regain where most or all of the weight is gained back.
