The challenges of implementing behaviour changes that lead to sustained weight management

Summary Weight loss is a difficult journey often characterised by repeated faltering attempts. There are numerous approaches to weight management but they all involve changes in self‐management, eating or activity behaviour. Weight loss induces changes in physiological and emotional systems, which tend to pull people back to where they came from. At the present time, it is not clear how the rate, extent or type of weight loss impact on signalling systems that oppose weight loss. Dietary changes in behaviour appear to be more achievable for weight loss earlier in the weight loss journey, while physical activity becomes a critical adjunct to initial dietary changes for weight loss maintenance. A range of weight control behaviours characterises weight loss and weight loss maintenance. People successfully maintaining significant weight loss tend to control their appetite, do more physical activity and remain vigilant, to catch slips in behaviour that may lead to weight regain. There may be differing clusters of behaviours, which characterise weight loss compared with weight loss maintenance, and there appear to be different clusters of behaviours that characterise weight loss maintainers. To navigate from the journey of weight loss to one of habitual weight loss maintenance requires long‐term self‐management. Environments and programmes that support, nurture and facilitate long‐term behaviour change give people the capability, the opportunity and the motivation to navigate to a healthy weight.