Mastering Maintenance: 3 Strategies for Long-Term Success

We've all heard the saying, "Losing weight is easy, but keeping it off is hard," and it can feel pretty discouraging. If you've put in the hard work to transform your body and mindset, you might be worrying about how to tackle the maintenance phase. Should I stop or decrease my medication? What changes should I make to my routine?

In this episode, I break down what maintenance really looks like. We’ll cover three key areas: building a sustainable routine, using a "bumper rail" system for accountability, and making regular check-ins to stay on track. Plus, we’ll clarify how medication fits into your maintenance plan and when you might need to make changes. Join me now to feel confident about your next steps and learn how to keep your progress going strong!


Audio Stamps

00:57 - Dr. Rentea addresses one of the most frequently asked questions from patients about how to navigate the maintenance phase of treatment.

01:57 - We hear the importance of maintaining sustainable habits developed during weight loss and avoiding practices that are not enjoyable or sustainable long-term.

05:52 - Find out how a “bumper rail system” can help manage weight maintenance by effectively  addressing small fluctuations.

07:52 - Maintenance requires ongoing effort and awareness. Dr. Rentea suggests regular check-ins and adjustments to stay on track.

09:43 - Dr. Rentea discusses medication strategies for weight maintenance.


Quotes

“What you're doing on the way down, you've got to keep doing it.” - Matthea Rentea MD

“The people that are successful long term, they're creating processes and systems, they're starting small scale enough, they keep adding things, and it's not a ton of effort. Otherwise they wouldn't keep doing it.” - Matthea Rentea MD

“For maintenance, you have to keep those things up. It might change the way in which you do it, but in some capacity you still need to do it.” - Matthea Rentea MD

“One of the things I really want to recommend is that you don't do things you're not willing to stick to.” - Matthea Rentea MD

“Our body gets smart to the changes that are happening. Just because you're in maintenance doesn't mean that there might not be more effort required at different times.” - Matthea Rentea MD

“There needs to be continued awareness. If you look at the national health registry, people that kept their weight off for 10 plus years are in some capacity tracking their weight.” - Matthea Rentea MD

“You've got to love what you're doing because you have to keep doing it and then be willing to switch it up a little bit.” - Matthea Rentea MD

All of the information on this podcast is for general informational purposes only. Please talk to your physician and medical team about what is right for you. No medical advice is being on this podcast.

If you live in Indiana or Illinois and want to work with doctor Matthea Rentea, you can find out more on www.RenteaClinic.com

Transcript

Speaker: 0:29

Welcome back to another episode of the podcast. Today we're going to talk about maintenance, and I can't believe that it has taken me this long to talk about it. The other day on Instagram, I put up a question. I say, Hey, what, what topics or questions do you have that you want me to answer on the podcast? And another fellow physician who I absolutely love online as well, she said, maintenance. Can you talk more about that? And, I love when people respond when I ask a question, you know, I don't, it's interesting. I don't do things on social like to boost engagement. It's like, I genuinely want to know so that I can make the content for you all. Right. So anyway, so I'm very appreciative today to talk about maintenance and I can't believe I haven't talked about it before. Cause I think I was so kind of tunnel vision focused on the challenges and the problems. But, but this is, this is actually such a fun thing when it occurs because this is actually the number two question that I get asked the most when I'm working with patients. They say, well, what happens at maintenance? People don't know, do I stop the med? Do I decrease the med? Like what happens? Logistically, we're going to talk through that aspect. And then I just want to talk through some Completely obvious, but just saying it from a physician's mouth, the fact that like, for example, what you're doing on the way down, you've got to keep doing it. Right. And so I, I want to just start there. One of the challenges with fat loss is that it's incredibly challenging on the body. And so people, in the name of really wanting to get this done and, and being desperate for different reasons, whether it's their metabolic health, whether it's aesthetically, they want to look a certain way. They want certain capabilities of their body, you know, functionally to be able to do more things. I could go on and on. They will take measures that diet culture has really normalized where they're doing things that they don't like, that that's not sustainable. If you ask them at this moment, do you want to keep doing this? They're just like, Absolutely not. Right? Without using other words. Absolutely not. And so I want you, I want you just today to take inventory. Are there things that you're doing that you just really resent, you don't like? Now there's a difference between, I mean, you might not always like eating veggies, but you know, you can get them to taste kind of good. You know that they really help your gut. You feel better when you do it. That's different than being like, I'm going to ask myself to eat lima beans, and, and there's something about that, like the taste receptors when I eat that, where my body actively recoils. I am personally not a lima bean fan, so I'll eat them if they're served, but I'm not, they're not at the top of my list, and I bring this up because that's not required for you to have success, it's not required for long term success, so the first thing that you can help yourself out with is really just inventorying, am I doing things that, that are not sustainable, the way you're going to know that is like the energy expenditure is always through the roof. So the people that are successful long term, they're just creating processes and systems, and they're starting small scale enough, and they keep adding things, and it's not a ton of effort, otherwise they wouldn't keep doing it. So they figured out different, you know, meal grocery delivery, where it's like, okay, the wheat gets crazy, but it shows up at their doorstep. I did that the same way. Past week again, I, we like the episodes that I'm making right now are kind of at the tail end of us having moved. And it just got crazy. The main thing was I spent so many hours kind of putting stuff away around the house. I just didn't have time to go to the store anymore. And I knew that that was happening because I could have taken the time out, doesn't take that long to go to the store, I could have done it, but I just decided it is more worth my time to real quick for, I, I really like on Amazon just that it links to Whole Foods, I don't care that it's more expensive, and that they save your order and you just click, click, click, click, click, and it, I knew, okay, Monday morning it will show up at the door, and then that way I can keep cleaning, I can stay in flow, and I can help myself out in that capacity. And so, the, the point kind of coming back to this, these things have to be sustainable. Sustainable. The options have to be in your house. You have to like eating them. Like the other night I ate at a really late random time and yes, I had my protein and stuff, but part of what I got in that grocery cart were some strawberries and I always have Lily's dark chocolate chips and I melted some of the dark chocolate chips in the microwave and then I dipped some of those strawberries in there. I really. So I really felt I needed it with the level of kind of just stress and trying to juggle everything and kind of re get integrated into a new place. That was what I needed, but the point is it was a little bit of a healthier option and I literally planned ahead and so this is going to be part of being able to maintain the weight that you've lost. Can you stick with those things? Are those foods always going to be in the house? The exercise regimen that you're doing, are you going to let it flex with the stage you're at? So I have a lot of parents in my clinic, and something that they have to grapple with is over the summer, kids are out of school. And so, even if your kids are doing camps or summer school or other things, the flow changes when you have to get them to things. Maybe during the year when they're in school all year, you're actually able to get to fitness classes, but now you're not. And so, for maintenance, you have to keep those things up. It might change the way in which you do it, but in some capacity you still need to do it. One of the things I really want to recommend is that you don't do things you're not willing to stick to. The other second thing for maintenance is that I really recommend that you have a bumper rail system. And here's what I mean by that. When I have patients, a lot of the time when they get to maintenance, they will, in my clinic, They might go to a version of seeing me a lot less, right? Maybe it's every three months, maybe it's just as needed, maybe every six months. We figure out what that looks like for them based on how they're feeling. And one of the things I really say to them is, I want you to, with maintenance, remember it's not one number, it's a range. And I'll tell them, look, you know, if your weight goes up by five pounds or we decide whatever it is based on what the history up to that point has looked like. And if it gets over that point, I want them to let me know sooner. So I want you to have some safeguards, some bumper rails, some alarms in place for yourself, because remember it is only. It's always easier to do a quick course correction than it is like a massive overhaul. Like it's really hard if you haven't seen me in a year and you come back and you're like half the weight's back. By the way, that's no problem. That's fine. I mean, weight is all relative. There's going to be lots of fluctuations in our time, in our, in our lifetime, a hundred percent, but it's always easier when there's a little bit of something that's happened to work on it. Right. verse when you, when it's just like, again, you're like, everything's out of control. There's like no starting place, right? So don't do things you're not willing to do for life and then have a system in place where maybe you put, for example, like on the calendar, you put once a month, just check in with weight, kind of compare last month to this month. Maybe there's a slow creep happening and you're not aware of it. And so in some capacity, maybe we just like. In the note section of our phone, you keep once a month what your weight is and then you can see if the pattern is changing. Know that some weight regain is actually normal. I talk to patients about this. Up to 10 to 20 percent can be normalized. And I, I actually see that a lot less with the meds. That's if you think traditional weight loss. I just don't see it with the anti obesity medications. I see people be able to maintain to where they get to, which is just amazing, right? And we, we have data at this point four years out on, on semaglutide, which is ozempic, will go be four years out that the weight's maintained. That's phenomenal. But anyway, getting back to kind of maintenance here. So those are, those are two main things to think about. And then the third thing to think about is that, you know, I said the things you are doing you have to keep doing. Sometimes if you take that into account along with the fact that our body gets smart to the changes that are happening, sometimes you need to change the things or increase the things you're doing. And so realize just because you're in maintenance doesn't mean that there might not be more effort required at different times. And that's why I'm really a fan of you in some capacity, whether it's. It's looking at, you know, how long, how fast can I run, inches, the scale, my labs, doing a little inventory, I have a, a sca, like a scale that you could score yourself in one of the courses that I did, where it was like, okay, what's your sleep qualities? I think it was zero to seven. We had like a weird scale. It was zero to seven. It was like, seven. sleep fatigue level, food thoughts. It was like all these different areas and it was sort of like an inventory of where you were at. So in some capacity there needs to be continued awareness. If you look at the national health registry, people that kept their weight off, 10 plus years, they are in some capacity tracking their weight. They're doing usually about an hour walk per day. Again, this is on average, it might look different for you and it might be different, but the point is there's accountability in some capacity. They're not just kind of like, I lost the weight and now I never again think about it. So, so just realize we want to keep doing the things that we're doing. We might need to switch it up and that, it's some type of a bumper rail system so that you can, you can know kind of if things are starting to go in the wrong direction or you can, you know, Check in if it is a problem. Remember, it's not a problem. For example, you go on vacation, you gain a few pounds, you literally, when you get back home, we've had episodes about this where you literally get right back to the things that support you. Give yourself a week, you'll be right back to where you were. There is no way in a week or two that you can gain all these pounds of fat. It's literally not possible unless you're making yourself ill every single day. So just remember you ate more carbs, you have some fluid retention, you have more glycogen in your muscle. Just keep keep perspective with that, right? But let's talk about the second aspect here, which is with maintenance, what do you do with the medication? And the answer is, oh, it is so varied. I wish there was a, I wish there was a one size fits all and I could answer that. Every patient is going to be different. So some people, the dose that they needed to get to where they are, they need to keep that same dose. And that is fine. There is nothing wrong with that. Remember we have over 20 years of data at this point. And if that is something that you need, remember this is a chronic medical condition. You're So when we say chronic, it's very relapsing, remitting, meaning you can be like, I'm good. I, I want to titrate off of this and I'm going to be just fine. We do see the weight re come back because it's a treatment, not a cure. So a lot of people will need to stay at the same dose and you will know this because you will be at that max amount at some point and you won't be able to lose more anymore. You're just all, despite all the things that you're trying, your body has said, this is where I want to live. And so you know that you're going to need to keep on that dose. The people where I decrease the dose, they are those that they usually never even got to the main dose or the max dose, or maybe they got to the max dose, but they kept losing then, and so we, we naturally need to cut back the dose because we don't want them to keep losing. Okay, the other people where we can cut back the dose with maintenance are. are those that are really dedicated on the whole way down, as well as at that point, because you can start at any point with really making sure to either maintain or gain muscle mass. And so if you are doing that, your basal metabolic rate is higher. You are supporting the fact that you can eat more, that you're circumventing that metabolic adaptation. And so if you have been doing that, my patients that are doing the strength training and they're getting the protein intake, oftentimes we can cut back the dose of the medicine. Keep in mind, if you're going to do that, you might need to revert to some volume eating. When you were on a higher dose of the medicine, you could get away maybe with eating less and just, you know, just getting protein and very little other things. But keep in mind as you back down the dose of the medicine that you might need more volume eating. So you're getting like, let's say maybe two yogurts that have, that have a good amount of protein instead of a smaller volume, something else. So keep in mind, that's totally fine. We can up the veggies, we can do other things. So, Your nutrition and other things might need to change. They might need to, I say revert, but it might need to flex up to a volume eating plan, instead of it being the opposite. Remember, the challenges are different based on how long you've been on the med, based on what your results are, based on if you're down titrating the med, things like that. So, those people, Because I do have these where they just keep losing and so we decrease the med. The only time I entirely get rid of the medication is if someone is wanting to get pregnant. Again, that's a conversation between me, them, and, if they're working with a fertility doctor, do we, There's lots of nuance there. That's something that I definitely talk one on one. Don't talk on the podcast about that. But number two would be someone that they never actually had a weight struggle until very recently. So they are someone that. You know, they, they had a kid and before that, let's say for 25 years of their life, they never struggled with weight. And they just, after they're, let's say they're done breastfeeding, all those things, they find that they can't get the 50 pounds off and they're about, you know, they're like a year out and that person. Likely after we lose the weight, might not actually need to stay on the medicine. They don't have the same leptin and insulin resistance as someone that might have since youth had PCOS and a lot of other medical conditions that are really blocking them from being able to keep that weight off long term and their weight set point is naturally higher based on where they have gotten at that point. So I'm going to end this conversation here. I think there could be so much more that I could say about maintenance, but again, I just want to reiterate, you've got to love what you're doing because you have to keep doing it and then willing to switch it up a little bit. And I think your biggest friend is awareness in some capacity that, that bumper rail system of being like, am I within these bounds? And if not, what changed? So a lot of the times. Actually, you kept doing all the things and the weight's going up. It means you're, you're getting into metabolic adaptation, which is your body is trying to, again, it's trying to get you back to that starting weight. Again, I do not see this as much on the medication, but I do see this with just lifestyle alone. And so again, then you might need to kind of crank it up in different capacities, but you will know that prior to having a total regain. All right, I'm going to leave it here. I want to ask again, if you have not left a review, leave a review and make sure that you share this episode if you think that it would be helpful to someone. And we will talk soon.