Functional imagery training and long-term weight maintenance strategies after weight loss

II. Functional Imagery Training: Psychological research shows that overweight individuals who use functional imagery training (FIT) lose an average of five times more weight than those who use motivational interviewing (MI) therapy alone. Within six months, FIT users reduced their waist circumference by an additional 4.3 cm and continued to lose weight after the intervention ended. FIT goes a step further than MI, utilizing multi-sensory imagery to stimulate motivational imagery in weight loss participants until it becomes a cognitive habit. Why is FIT more effective at helping weight loss? Because most people already know that weight loss requires controlling their diet and exercising, but in many cases, they lack the motivation to heed and follow this advice. Therefore, the main purpose of FIT is to encourage obese individuals to express their own views and feelings about successful weight loss, using all their senses to imagine "how much better life will be after you lose weight" and "what you can do now that you can't do," thereby motivating them to strive for this change even when faced with difficulties. III. Utilizing the Herd Effect to Establish Weight Loss Role Models. The herd effect, also known as herd behavior or conformity, refers to the phenomenon where a flock of sheep, though seemingly disorganized, wanders aimlessly. However, once a lead sheep starts running, the others follow suit. Therefore, the "herd effect" is a metaphor for the tendency of most people to conform. Weight loss can be similar. By bringing together all those trying to lose weight (using group consultations instead of one-on-one consultations and post-consultation follow-up tools to help patients build a community), individuals who are dedicated and exemplary in their weight loss efforts can serve as role models, leading others in the process. IV. Utilizing the South Wind Effect to Create a Favorable Weight Loss Environment. The French writer La Fontaine wrote a fable about the North Wind and the South Wind competing to see who could remove a traveler's coat. The North Wind first blew a cold, biting gust, but the traveler, to ward off the wind, wrapped his coat even tighter. A gentle south wind blew, bringing sunshine and warmth. Pedestrians, feeling comfortable, began to unbutton their clothes and then take off their coats. The result was clear: the south wind won. The "south wind effect" illustrates how creating a comfortable atmosphere can unleash people's enthusiasm and creativity, leading to the achievement of their goals. Creating a positive weight-loss environment will increase people's motivation and success rate. Maintaining weight after weight loss is crucial. As the saying goes, "It's easy to plan, but hard to succeed; it's easy to succeed, but hard to maintain." Planning weight loss, achieving weight loss goals, and maintaining weight loss are inseparable processes. Maintaining weight loss after treatment is equally important. The definition of maintaining weight after weight loss is not yet universally agreed upon, but most scholars consider it to be "a weight loss of more than 10% from the initial weight and maintained for at least one year" or "a weight loss of more than 5% from the initial weight and maintained for at least two years." The human body employs multiple mechanisms to regulate energy balance and maintain a relatively stable weight. Typically, most people regain 30%-35% of their lost weight within one year of completing a weight loss program, and within four years, they generally return to their pre-weight loss level. Besides cognitive-behavioral factors that can lead to rebound and weight regain, research suggests that the physiological mechanism of weight regain after weight loss may involve changes in intracellular and extracellular pressure caused by fat cell contraction after weight loss, extracellular matrix remodeling, and subsequently, weight rebound through mechanisms such as inflammatory responses and the secretion of adipokines. Therefore, weight maintenance is a major challenge and difficulty in weight management. I. Specific Requirements for Medical Personnel During the Weight Maintenance Phase After Weight Loss To maintain the effects of weight loss, medical personnel and nutritionists should provide patients with a weight maintenance plan through face-to-face or telephone follow-ups, maintain regular contact with patients (monthly or more frequently), help them engage in high-intensity physical activity (e.g., 200-300 minutes/week), regularly monitor weight changes (e.g., weekly or more frequently), and maintain a low-energy diet (essential for maintaining a lower weight). With the profound impact of the internet age on health, increasing research indicates that online interventions are effective in maintaining weight loss. Specific recommendations include: 1. Medical staff should provide weight loss participants with detailed maintenance plans. 2. Lifestyle and behavioral interventions (including diet control and/or meal replacements, physical exercise, maintaining communication among weight loss group members, etc.), combined with medication, are effective in preventing weight regain. 3. Appropriate psychological counseling should be provided to weight loss participants. 4. Online intervention is effective in maintaining weight loss results for up to two years. II. Identifying individuals who are likely to successfully maintain their weight after weight loss and providing positive encouragement and support. Multiple scientific studies have attempted to identify those who successfully maintain their weight after weight loss, understanding their characteristics and self-management methods. The results showed that those who had already achieved their weight loss goals; those with relatively high initial weight; those who continued physical activity and exercise during the maintenance phase; those who ate regularly and ate breakfast regularly; those who adhered to a low-energy diet, ate less high-fat foods, and ate more healthy foods; those who reduced the frequency of snacking; those who flexibly controlled their diet rather than strictly adhering to it during the weight maintenance phase; those who continuously monitored their own weight; those who had good ability to cope with and manage stress and negative emotions, and did not eat or binge eat due to emotions; those who had a strong motivation to lose weight, actively lost weight, and believed that they could achieve their ideal weight through their efforts; those who had a stable lifestyle; and those who maintained close contact with their doctors and adhered to close follow-up were more likely to maintain their weight. It is recommended to focus on and cultivate good habits in weight loss participants during the medical weight loss process. III. Identifying people who are prone to weight regain after weight loss and implementing multi-dimensional interventions. Some studies have also explored those who are prone to weight regain after weight loss, understanding their characteristics and the reasons for their failure. The results showed that those who passively lost weight due to pressure from family and doctors; those who did not understand the behavioral changes required during weight loss maintenance; those who did not exercise regularly and had a sedentary lifestyle; those who maintained their weight through complete fasting; those who maintained their weight through starvation dieting or blind dieting; those who repeatedly lost and gained weight (weight cycling, also known as the yo-yo dieting effect); those prone to emotional eating and stress eating; those lacking support from family and society; those with passive personalities and unmotivated problem-solving abilities; and those with low self-confidence were more likely to experience weight rebound. By simultaneously identifying and actively encouraging those who successfully maintained their weight after weight loss, and identifying those prone to weight regain, and implementing multi-dimensional interventions in diet, exercise, behavioral management, and emotional and cognitive characteristics, long-term weight maintenance for obese patients can be achieved to a greater extent. Long-term weight loss without rebound is achievable, and as time goes on (over 6 years), as habits become second nature, maintaining weight becomes easier for obese patients.