Sustained Weight Loss, is it Possible?
Feb 03, 2025
Can Sustained Weight Loss Occur, and if so, How?
I’m going to hit you with some research, but don’t worry, I’ve taken the time to summarise key takeaways…
A high-quality study that evaluates the long-term success of popular weight loss diets; 2020 systematic review and network meta-analysis published in The British Medical Journal by *Johnston and a team of associates titled "Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis," and analyzed 121 randomized controlled trials, covering 21,942 participants, to compare the effects of 14 well-known diets.
Key Findings:
Short-Term Results (6 months): Most diets, especially low-carb and low-fat approaches, led to modest weight loss (around 4–5 kg) and temporary improvements in cardiovascular markers.
Long-Term Results (12 months): The initial benefits started to fade, with weight loss dropping by about 1–2 kg from the six-month mark. By one year, most of the cardiovascular improvements had disappeared.
Takeaway:
While different diets can lead to short-term weight loss and health benefits, the study shows that these effects generally aren’t sustained long-term. This highlights the real challenge—adherence. Instead of chasing trendy diets, long-term success comes from developing sustainable, realistic eating habits that fit into daily life.
If Weight Loss is Your Goal:
For anyone looking to lose weight, the research is clear: most diets work in the short term but fail to deliver lasting results. Low-carb, low-fat, and other structured diets can lead to initial weight loss (around 4–5 kg in six months), but by a year, much of that progress is lost. The main issue isn’t whether a diet works—it’s whether it’s sustainable.
Instead of chasing restrictive plans like keto or carnivore, a better approach is focusing on long-term habits: balanced nutrition, adequate protein, fiber-rich foods, and hitting targets for more optimal and flexible nutrition rather than focussing on eliminating or restricting. Regular exercise, sleep, and stress management also play key roles. Addressing obstacles to these practices becoming consistent will be more valuable than simply trying harder, or setting sights on more extreme or complex approaches.
Ultimately, adherence matters more than the specific diet. The best “diet” is one you can stick to for life—one that supports health, energy, and personal preferences while fitting into your daily routine. Sustainability beats perfection every time. So keep the diet and exercise simple, and focus your energy on addressing the practical and emotional barriers to consistency through coaching or therapy.
Marcus Kain - Nutrition Coach, Strong Not Starving Founder
*You can access the original 2020 systematic review (along with responses and peer review details) by Johnston et al., titled "Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis," directly on The British Medical Journal's website: https://www.bmj.com/content/369/bmj.m696
*Bradley C. Johnston is a Canadian epidemiologist and nutritionist known for his work in evidence-based medicine and nutrition research. He has held academic positions at institutions such as Texas A&M University and McMaster University. Johnston has authored numerous systematic reviews and meta-analyses, focusing on the efficacy and safety of various dietary interventions and their impact on health outcomes. His research often emphasises the importance of methodological rigor and transparency in nutritional science. Johnston is the director of www.evidencebasednutrition.org