This study aimed to assess the impact of mental disorders on weight loss maintenance among initially successful weight losers who participated in a very-low-calorie diet program.

A total of 251 obese individuals were assessed in a prospective longitudinal study over a period of 4 years. Mental disorders and eating patterns were assessed by structured interviews at baseline and by standardized questionnaires at baseline (T₁), after 1 year (T₂) and on 3-year follow-up (T₃). Analyses were performed with an intention-to-treat method.

Based on the intention-to-treat sample, 166 successful weight losers at T₂ (weight loss ≥10%) were identified. Of those, 47 (28.3%) maintained a weight loss of ≥5% of their pretreatment weight, whereas 119 (71.7%) maintained a loss of less than 5% of their pretreatment weight at T₃. History of substance abuse/dependence disorder and grazing prior to treatment increased the likelihood of successful weight loss maintenance. High levels of cognitive control, low levels of disinhibition on 3-year follow-up and initial body mass index also were associated with successful weight loss maintenance.

Strategies that helped individuals overcome earlier mental disorders might help to establish better self-regulation and maintain high cognitive control of eating and subsequently increase the possibility of maintaining weight loss in the long run.