Adherence
Greater initial weight loss (achieved via Very Low Energy Diets or pharmacotherapy) improves long-term weight maintenance, provided it is followed by a 1-2 year integrated lifestyle intervention.
If you are starting a weight loss program, aim for a significant initial loss (e.g., using a very low-calorie diet or prescribed medication) as a 'kickstart.' However, this only works if you immediately transition into a structured, long-term (1-2 year) lifestyle program that includes diet education, behavior therapy, and exercise. The speed of the initial loss is not the problem; the lack of a maintenance plan is.
In conclusion, we find evidence to suggest that a greater initial weight loss as the first step of a weight management programme may result in improved sustained weight maintenance.
Why this rating
Supported by multiple randomized trials (VLED, pharmacotherapy) and post-hoc analyses, though some differences were not statistically significant.
Source
Lessons from obesity management programmes: greater initial weight loss improves long‐term maintenance
Arne Astrup et al. · Obesity Reviews · 2000
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