Increased Water Consumption: A Self-Regulatory Strategy for Long-Term Weight Loss Maintenance?

Abstract

One-third of the American population is obese (1), and of those successful at losing weight, most return to their baseline weight within three to five years (2). In an effort to increase the success of weight loss maintenance (WTLM), research has focused on strategies that promote self-regulation (3). Self-regulation strategies, such as daily self-monitoring of body weight (4), increased step count (5, 6), and increased fruit and vegetable intake (7) have proven to be effective in long-term WTLM interventions. To date, increased water consumption has not been researched as a WTLM strategy, yet it has been shown to decrease meal energy intake (8, 9) and increase weight loss among middle-aged and older adults (10). The purpose of our first investigation was to determine if self-monitoring of increased water consumption facilitates WTLM over 12 months among middle-aged to older adults, when combined with other self-regulation strategies. Our second investigation was a review of WTLM literature to determine the translation potential published interventions using the RE-AIM (Reach, Efficacy/effectiveness, Adoption, Implementation, Maintenance) framework (11) to provide recommendations for future research. Our first main finding was that weekly tracking of these self-regulatory behaviors (self-weighing, step counts, fruit/vegetable intake) for 12 months promotes effective long-term WTLM among middle-aged and older adults. However, daily self-monitoring of increased water consumption (48 fl oz/day) did not appear to provide an additional benefit. Secondly, we have identified significant gaps in the WTLM literature that may hinder the translatability of existing effective interventions. Specifically, current WTLM research is limited in reporting important external validity factors (e.g. costs, adoption, participation rate). Available WTLM literature provided a more detailed overview of Reach, Efficacy, and Implementation, yet was little information on potential adoption, costs, or sustainability. Future work in this area should address these factors to increase the translation potential of WTLM interventions in clinical or community settings.