In a national television interview with Barbara Walters in 2014, Oprah Winfrey confessed that not being able to maintain her weight loss was her biggest regret. In that interview, Walters asked Winfrey to finish the sentence, “Before I leave this Earth, I will not be satisfied until I…” 

“Until I make peace with the whole weight thing,” Oprah replied.

Losing weight is hard; keeping it off is even harder. What is unique about those who succeed? The answer is buried deep in the archives at the Weight Control and Diabetes Research Center in Providence, R.I.: the National Weight Control Registry (NWCR), the largest database ever assembled on individuals successful at long-term maintenance of weight loss. Founded in 1994, the NWCR includes more than 10,000 individuals who complete annual questionnaires about their current weight, diet and exercise habits, and behavioral strategies for weight-loss maintenance. 

Like Oprah, many of the clients you work with may be looking for peace when it comes to weight loss and maintenance. In addition to using foundational coaching skills to build and maintain professional relationships rooted in compassion, understanding, rapport and empathy, health and exercise professionals can use these same skills to share research findings from sources such as the NWCR. At appropriate times and with permission, the following behavioral strategies and diet and exercise habits from successful weight losers can be provided to clients to ensure they have the relevant information needed to work toward achievable weight-loss and weight-maintenance goals.

Here are six habits gleaned from successful weight losers that can inform inspire and motivate clients who may be struggling with achieving or maintaining a desired body weight.

Habit #1: Live With Intention

Living with intention eliminates a random approach to weight-loss maintenance in favor of a systematic and methodical approach that leads to results. The NWCR has shown that, when intention is behind weight-loss maintenance, 21% of people with overweight are successful weight losers.  

The longer people keep their weight off, the fewer strategies they need to continue keeping weight off. In other words, weight maintenance gets easier. The longer your clients persist in their intention and behave in accordance with that intention, the easier it is for that behavior to “stick” and turn into a habit.

What makes one individual persist at a specific behavior while another individual doesn’t? For starters, the persistent individual has a conscientious personality. In the most recent NWCR study published in 2020, conscientiousness was compared between successful weight losers from the NWCR and non-NWCR weight regainers. The successful weight losers were found to be more conscientious than the weight regainers and scored higher on measures of order, virtue, responsibility and industriousness. The scientists suggest that being conscientious may help individuals maintain their weight loss by improving adherence to specific behaviors.

In a review of 56 studies that contained 58 health behaviors, researchers at Université Laval in Quebec, Canada and the University of Limburg in The Netherlands found that intention remained the most important predictor of health behavior, explaining 66% of the variance. In half of the reviewed studies, perceived behavioral control (believing that you have control over your behavior) significantly added to the prediction.

Habit #2: Control Yourself

Being a successful weight loser requires a lot of self-control, delaying gratification now (e.g., dessert) for the more desirable reward later (e.g., a slimmer waistline, better health, enhanced self-esteem and happiness). 

Compared to typical unsuccessful dieters, successful weight losers are better able to resist temptation, control themselves, and push back against the environment. They restrict certain foods, weigh themselves regularly and use digital health technology.

One of the key factors of self-control is disinhibition, which literally means not being inhibited. Some inhibition is good, because it prevents people from not giving into temptation and eating whatever and how much they want. High levels of disinhibition are bad, because it leads to risky behavior. Disinhibited eating is a failure to maintain control over eating. The opposite of disinhibited eating is dietary restraint. Several NWCR studies have found that increased disinhibition leads to regaining lost weight. Other studies have found strong relationships between a lack of self-control—impulsivity—and obesity. 

Habit #3: Control Calories

Successful weight losers consume fewer daily calories than the general population. Table 1 shows the number of calories the NWCR members consume per day, along with the amount of weight they lost at the time they entered the NWCR. 

Table 1. Caloric Intake of Successful Weight Losers

Successful weight losers consume a low-calorie diet of about 1,400 calories per day, with women consuming about 1,300 and men consuming about 1,700 calories per day. By comparison, the U.S. adult population consumes an average of 2,120 calories per day (women consume about 1,820 calories per day and men consume about 2,480 calories per day). Although it is outside the defined scope of practice for health and exercise professionals to recommend a specific caloric intake or macronutrient distribution for clients, sharing this information and discussing the importance of monitoring total daily calories and macronutrient consumption can initiate a thought-provoking discussion that may result in clients making healthier choices.

Successful weight losers control calories several ways, including limiting how often they eat out at restaurants, rarely eating fast food and limiting how many calories they drink. They are also more likely than healthy-weight individuals to have plans to be extremely strict in maintaining their caloric intake, even during times of the year when it’s easy to consume calories, like during holidays. 

Habit #4: Eat a Low-fat, High-carbohydrate Diet

Successful weight losers eat a low-fat, high-carb diet. Table 2 shows the percentages of carbohydrate, fat and protein the NWCR members consume.

Table 2. Macronutrient Consumption of Successful Weight Losers

NWCR members consume an average of 25% of their calories from fat, 55% from carbohydrate and 20% from protein, with no difference in the macronutrient percentages between women and men. 

In the early 2000s, when low-carb diets were increasing in popularity, the fat content of the NWCR members’ diet increased and the carbohydrate content of their diet decreased compared to earlier years. The percentage of NWCR members consuming a low-carbohydrate diet (less than 90 grams, which is less than 25% of daily calories) increased from 5.9% in 1995 to 7.6% in 2001 to 17.1% in 2003, although it still remains low for successful weight losers, despite the popularity of low-carbohydrate diets. Even with the increasing percentage of NWCR members consuming a low-carbohydrate diet, the fat content of the diet remains far below the national average. Hardly anyone in the NWCR is consuming a very-low-carbohydrate or ketogenic diet. 

Habit #5: Eat Breakfast

Seventy-eight percent of NWCR members eat breakfast every day, while only 4% never eat breakfast. These successful weight losers lost an average of 71.3 pounds and maintained the NWCR-required minimum weight loss of 30 pounds for an average of six years. Eating breakfast every day is also common among other successful weight losers: The NWCR’s sister registry in Portugal (Portuguese Weight Control Registry) has found that daily breakfast is one of their members’ most common strategies.

Skipping breakfast is associated with consuming more total daily calories. Skipping breakfast makes people hungry and therefore more likely to eat more later in the day to compensate. Breakfast skippers also tend to weigh more than breakfast eaters, and obese individuals are more likely to skip breakfast. 

Eating breakfast is important for several reasons. When your clients get out of bed in the morning, their blood glucose is on the low side of normal. Their bodies need energy for the day’s activities. Since it has been many hours since their last meal, they need to break the fast, literally. The macronutrients they eat at breakfast will be used for their important jobs—carbohydrate will be used to replenish their blood glucose from their overnight fast to provide immediate fuel for their cells and to store muscle glycogen for later use; protein will be used to maintain the structural integrity of their cells and tissues and to transport nutrients in their blood; and fat will be used to provide energy, absorb fat-soluble vitamins and maintain their bodies’ temperature. Because your clients are in a metabolically needy state when they get out of bed, all those calories from carbohydrate, protein and fat that they eat at breakfast will be used to fulfill their bodies’ metabolic demands. Skipping breakfast only serves to deny their bodies the fuel they need.

Habit #6: Exercise (a Lot) Every Day

Successful weight losers exercise a lot every day, burning considerably more calories than the general population. Table 3 shows the number of calories the NWCR members burn per week during physical activity, along with the amount of weight they lost at the time they entered the NWCR. 

Table 3. Caloric Expenditure of Successful Weight Losers

Successful weight losers burn about 2,700 calories per week. Seventy-two percent burn more than 2,000 calories per week and 35% burn more than 3,000 calories per week.

A consistent, high level of exercise is one of the most important predictors of whether or not someone will be able to keep the weight off. A major finding of the NWCR is that a large part of regaining weight after losing it is due to the inability to maintain exercise habits for the long term.

While it may be easy or convenient to think that the reason why some people exercise and others don’t is because the ones who do have the time and resources, such as access to a gym or personal trainer, or because they simply like to exercise, the NWCR has shown that what makes a successful weight loser exercise has little to do with these factors. Whether or not someone exercises comes down to his or her commitment and the creation of, and persistence in, the habit. See habit #1. Live with intention. 

As a health and exercise professional, you are in a great position to share this information with your clients and it is up to them to recognize and connect the importance of these habits to their personal values and reasons for wanting to change their behavior. Approaching each interaction with clients from the perspective that they are the foremost experts in themselves and are resourceful and capable of change is a first step to demonstrating an unconditional positive regard for each client. Offering these six habits of successful weight losers to your clients in a way that feels like information sharing rather than a list of "must dos" respects the client's autonomy and empowers them to decide when and what to change. You are here to support your clients on their behavior-change journey, no matter where they are in the process.