By Nick Fuller

When people decide it’s time to lose weight, they’re usually keen to see quick results. Maybe they have an event coming up or want relief from health problems and discomfort.

But expert guidelines typically recommend slower weight loss for the treatment of obesity. This tallies with a widely held opinion that fast weight loss is more quickly regained. Slow weight loss is generally perceived as better for your health and more sustainable. Many programmes offering “the fastest way to lose weight” are considered fad diets that severely restrict calories or eliminate some foods.

But does slow and steady really win the weight-loss race? Governing bodies typically recommend a weight loss of 0.5 to 1 kilogram each week, which would be defined as slow weight loss.

So fast weight loss – also termed “rapid weight loss” – is losing more than 1 kilo a week over several weeks.

One study of 200 people randomly assigned them to fast or slow weight loss – 12 weeks versus 36 weeks – aimed at a 15 per cent reduction in weight.

The fast weight loss group was put on a very low energy diet using meal replacements, including shakes, bars and soups, three times per day. The slow weight loss group was advised on the Australian Guide to Healthy Eating with the goal to eat 500 calories less than they used for energy (creating a calorie deficit) each day. They also used one to two meal replacements daily.

Some 50 per cent of the slow weight loss group and 81 per cent of the fast weight loss group achieved 12.5 per cent or more weight loss during this time.

After this initial phase, those who had lost 12.5 per cent or more were then placed on a weight maintenance diet.

By the three-year mark, 76 per cent of those in the slow weight loss and the same percentage of those in the fast weight loss group had regained their lost weight.

So, it didn’t matter if they had lost it slow or fast, they still regained the weight.

However, another study on 101 postmenopausal women found fast weight loss resulted in better outcomes than a slow weight loss group at the three-year mark.

But there are other factors to consider, aside from weight loss, when it comes to the differing ways of losing weight – such as changes in body composition and bone mineral density.

This is best highlighted by a large meta-analysis.

While this analysis found the magnitude of weight loss was similar for both approaches, slow weight loss resulted in better outcomes than fast weight loss with respect to metabolism or how many calories we burn at rest.

Slow weight loss resulted in greater reductions in fat mass and therefore a better fat-to-muscle ratio.

Slow weight loss also seems better for bone density, because rapid weight loss results in a twice as much bone loss and puts a person at increased risk of brittle bones or osteoporosis.

When you lose large amounts of weight, your resting metabolic rate – the energy you burn at rest – will lower. Keeping your resting metabolic rate high is essential for keeping the weight off. Unfortunately, once it slows down, your resting metabolic rate doesn’t recover to the level it was pre-dieting even after you regain weight.

However, research has confirmed slow weight loss preserves your resting metabolic rate compared with rapid weight loss.

Many fast weight loss diets restrict or exclude foods required for long-term health. Carbohydrates are often banned, yet wholegrain carbohydrates are an essential source of nutrition, helping with weight loss and prevention of disease. Including meal replacements as part of a restrictive diet is also not sustainable for long.

Regardless of how you lose the weight, it’s very difficult to maintain losses. Our bodies work to keep our weight around a set point by adjusting our biological systems and imposing a series of physiological changes within the body to ensure we regain weight we lose. This stems from our hunter-gatherer ancestors, whose bodies developed this survival response to adapt to periods of deprivation when food was scarce.

Successful long-term weight loss comes down to: following evidence-based programmes, losing weight under the supervision of qualified health-care professionals, and making gradual changes to your lifestyle – diet, exercise and sleep – to ensure you form health habits that last a lifetime.

Nick Fuller is Charles Perkins Centre Research Program Leader, University of Sydney. This article is republished from The Conversation under a Creative Commons licence