In the National Weight Control Registry in the United States , the maintenance of a 5.5-kg weight loss over 5.5 years was achieved through the combination of a balanced diet and sustained physical activity (40min/day). Another study  confirms that combining a diet and exercise is more effective than dieting alone. Moreover, physical activity can equally help maintain the weight lost [8, 9].
In addition, it is recognized today that diets poor in fats are more effective in maintaining weight loss over a long period of time . On the contrary, a diet rich in fat induces overconsumption and weight gain through a feeling of non-satiety and the highly caloric content of fats .
Overall, patients who have undertaken repeated diets quickly regain the kilos they have lost. When facing the yo-yo phenomenon, eating disorders should be investigated. This is associated with a feeling of restriction, nibbling or compulsions, and has the effect of making patients feel guilty and reducing their self-esteem. Behavioral work, combined with a hypocaloric diet and a program of physical activity, allows weight loss to be maintained . It involves only a small loss of weight but helps alleviate eating disorders, depression and anxiety. A prospective study with a 5-year follow-up  confirms that this multidisciplinary approach is entirely beneficial in the long term. Fifty percent of patients maintained their weight loss, and even continued to lose weight. Lately, Wadden et al.  confirmed that the combination of medication and group lifestyle modification resulted in more weight loss than either medication or lifestyle modification alone.
In conclusion, there is no miracle diet, whatever the current fashion would have us believe. The best diet is one that the patient can follow in the long term. Therefore, it is necessary to draw up dietary advice which is adapted to the individual, combined where possible with teaching about physical activity and, perhaps, cognitive-behavioral therapy. It is important to rule out diets which are too strict and restrictive if we are to avoid eating disorders and weight regain. However, the 3F formula - Fat-Free and Fit - is known to be the most effective approach in the long term for all our patients.
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