Staying Slim After Injury

Losing weight and keeping it off can be tough. Compound that with the challenges of dealing with an injury or pain. People often say things like “Since my knees started hurting, I packed on weight” and “After my back injury, I gained a bunch of weight” and so on.

Many people believe that weight gain is inevitable after injury or pain, since one “can’t” exercise anymore.

There are two issues with this sort of black and white thinking. First, there is probably a way to modify and continue exercise. Second, there are many other factors related to keeping weight off. This article will address the second part-the factors related to keeping weight off, also known as “weight loss maintenance”.

With over 40% of U.S. adults being overweight or obese, there has been ample research in this area (1). Varkevisser et al in 2018 performed a systematic review (a study of studies) of over 8,000 articles on weight loss maintenance (1). They examined all the factors that would predict weight loss maintenance (or lack thereof i.e. regaining weight).

They identified these following factors as most predictive of keeping weight off*:

-Monitoring weight

-Self-monitoring eating

-Increased physical activity

-Portion control

-Cutting “unhealthy” foods (sweets/junk food, fried food, fast food)

-Decreased energy intake**

-Increased consumption of fruits and vegetables

-Decreased consumption of sugar sweetened beverages, juice

-Decreased fat intake

Note that only 1 of these factors is related to physical activity. Now this doesn’t mean that exercise and physical activity don’t matter. It simply means that there are other factors we can influence as well.

Also, note that there is no reference to a single “best diet”, rather these are general strategies that work whether or not you follow a specific diet. Many patterns of eating can work to stay slim.

So how do these factors translate into practice? Here are some example tools and behaviors I use with clients:

Example Tools and Behaviors
Recording weight twice per week and taking the average as your weekly weight**
Using hand portions like these or a calorie calculator like this to adjust daily intake**
Keeping a food log like this**
Getting 1 hour of physical activity per day (2).  Logging activity could be as simple as writing in a journal or using an activity planner like this
Having “unhealthy foods” as a treat for special occasions.   An example strategy is not keeping these foods regularly at home**
Consuming whole foods that are lower in fat.  Examples could be choosing leaner proteins (chicken breast, 90/10 ground beef, fish, etc)**
Having alcohol and soda as a treat for special occasions.  An example strategy is not keeping soda or alcohol on hand at home**
Purchasing fruits and vegetables that require minimal preparation.  Some examples include apples, oranges, bananas, cucumbers, carrots etc**


This is a bird’s eye view strategy for staying slim after injury-each person will have unique considerations when applying.

Injury or pain does not condemn one to regain weight. In addition to continuing exercise (in a modified way), we have many other strategies to maintain that hard won weight loss.

________________________________________________________________________________________________

*These were not the only relevant factors. There were other factors, but they had weaker evidence or had insufficient evidence. I’ve focused on the factors with the strongest levels of evidence here. 

**Decreased energy intake is critical and is the net effect of most if not all of these nutritional factors. For example, decreasing consumption of sweetened beverages, decreased fat intake, and cutting unhealthy foods all have the net effect of decrease total energy intake.

References:

1. Varkevisser, R., van Stralen, M. M., Kroeze, W., Ket, J., & Steenhuis, I. (2019). Determinants of weight loss maintenance: a systematic review. Obesity reviews : an official journal of the International Association for the Study of Obesity20(2), 171–211. https://doi.org/10.1111/obr.12772

2. Brown Medical School/The Miriam Hospital Weight Control & Diabetes Research Center. (n.d.).  The National Weight Control Registry. Retrieved January 04, 2021, from http://www.nwcr.ws/research/

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