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Holiday Weight Gain: Causes and Corrective Measures

What to do if Santa brings you some extra pounds this holiday.

Key points

  • Evidence suggests that holiday weight gain persists and tends to roll over into subsequent years.
  • Holiday weight gain primarily seems to affect those already struggling with weight or who have previously lost significant amounts of weight.
  • Environment and lifestyle factors both explain why holiday weight gain occurs and suggest how to prevent and reverse this seasonal pattern.

For some, the most dreaded gift this holiday season isn't an ugly sweater. It isn't fruitcake or even a bag of coal. Instead, the worst thing for many adults to find under their Christmas tree this season are the extra pounds that Santa Claus so reliably brings to tens of millions of Americans each year.

Whether you've been good or bad in 2022, naughty or nice for Santa, chances are you'll enter 2023 a little heavier than the year before. And if you don't take steps to prevent or reverse this annual trend, these holiday leftovers may gradually metastasize from a few extra pounds into more serious health problems.

Holiday Weight Gain: The Bird's Eye View

In the year 2000, a publication in the New England Journal of Medicine1 (NEJM) appeared to correct conventional holiday wisdom. By directly measuring the body weight of 195 research participants pre-holidays (fall), during holidays, post-holidays (January-March), and the following September, the researchers dispelled the colloquial belief that Americans typically gained five pounds during the holidays. Although data from this study did support the existence of the holiday weight gain phenomenon, the amount was closer to 1 pound (.48 kilograms to be precise) than five, on average.

Perhaps the most important public health implication, however, had nothing to do with the magnitude of the holiday weight gain; it was the absence of post-holiday weight loss. Because the researchers had the foresight to re-assess the weights of participants the following fall, they were able to capture a potentially significant relationship: although the average American gained only a small amount of weight during the fall holiday season, they generally didn't lose the weight and were prone to repeat the cycle over subsequent years. From this perspective, the "obesity epidemic" in the U.S. could result from a trickle of slow, consistent weight gain instead of from sporadic surges for most adults.

Thomas Rutledge
Source: Thomas Rutledge

Holiday Weight Gain: The Ground-Level View

If a one-pound weight increase seems trivial, consider two more granular perspectives on holiday weight gain for a more detailed insight into this relationship.

First, the NEJM researchers performed secondary analyses with their data to explore holiday weight gain patterns among participant subgroups. These efforts yielded practical results that were often obscured by overall study outcomes emphasized in the media headlines.

The result of one of their secondary analyses, for example, examined weight gain patterns based on pre-holiday weight status and is summarized in the figure below. In brief, the researchers observed that holiday weight gain was a highly skewed rather than evenly distributed event, with the incidence of significant (defined as a gain of five or more pounds) weight gain occurring at a rate that was two to four times higher among people with body mass index values placing them in the overweight (BMI=25-29.9) and obese (BMI=30+) categories than among those in the normal BMI range.

Thomas Rutledge
Source: Thomas Rutledge

The NEJM researchers also looked at holiday weight gain in relation to reported physical activity levels. This analysis again offered a more precise understanding of the findings and actionable implications.

Specifically, holiday weight gain in this study was inversely related to physical activity levels over the holiday period. Holiday weight gain in this sample overwhelmingly occurred among those whose physical activity was reported as "much less active" and "somewhat less active" than normal during the holiday season. In contrast, those reporting being "somewhat more active" or "much more active" gained either negligible weight or even lost weight over the holidays.

Secondly, holiday weight gain findings were published in a 2008 paper appearing in the Journal of Consulting and Clinical Psychology2 (JCCP). This prospective study included pre-and-post holiday weights from participants in the National Weight Control Registry (NWCR; the NWCR is comprised of U.S. adults who have lost and maintained significant weight loss) and normal weight adults as controls (adults with a BMI between 18.5 and 24.9).

Two important practical results emerged from this study. The first was that the above "one-pound average holiday weight gain" observed in the NEJM paper was simultaneously accurate and potentially misleading for the JCCP sample.

In the JCCP paper, 60 to 90 percent of participants in both groups actually maintained (i.e., gained no weight from November to February) or even lost weight over the holidays. However, a subset in both groups (28.3 percent of NWCR participants and 10.6 percent of control group participants) gained weight. Thus, rather than an omnibus small weight gain effect for everyone, this study indicated that a subset of participants was particularly vulnerable to weight gain during the holidays.

Secondly, this study showed that despite both their history of weight loss and weight loss maintenance and greater expressed intentions to prevent holiday weight gain, the NWCR group was two to three times more likely to gain weight over the holidays relative to the normal weight participants. Although it is easy to criticize this latter finding as unfair, the neutral insight can be valuable: adults with a history of weight loss—including even those with years of successful maintenance—may be at increased risk for holiday weight gain and may benefit from additional pre-or-post-holiday efforts to prevent or reverse this result.

Takeaways

  1. Holiday weight gain is a real phenomenon but unevenly distributed. Instead, some of the best studies on holiday weight gain suggest that those with higher body mass index values (i.e., those meeting criteria for overweight and obesity) and even those with histories of successful weight loss are at elevated risk. People in these higher-risk categories are also most likely to benefit from pre-holiday weight gain prevention measures or post-holiday weight loss strategies.
  2. Holiday weight gain is primarily caused by modifiable environmental, lifestyle, and cultural (e.g., major holidays are also associated with weight gain in countries such as Germany and Japan3) factors. For this reason, efforts to improve holiday eating and physical activity patterns are likely to mitigate weight gain during this period or facilitate weight gain reversal post-holidays. Recall from the above studies that a subset of more physically active people even lose weight over the holidays.
  3. Even if mild to moderate holiday weight gain occurs, it doesn't have to be a big deal. The bigger health concern, in fact, isn't about the incidence or magnitude of holiday weight gain at all. It is whether the weight gain persists after the holidays to potentially become a longer-term trend that may eventually manifest in metabolic disease.

As a result, the most science-based health advice about holiday weight gain is to: a) encourage reasonable efforts to control portions and stay physically active over the holidays (especially if you're in a higher risk group); b) don't overreact or become discouraged if weight gain occurs; c) act swiftly and strategically after the holidays to resume healthy lifestyle habits and reverse any holiday weight gain.

References

1. Yanovski JA, Yanovski SZ, Sovik KN, Nguyen TT, O'Neil PM, Sebring NG. A prospective study of holiday weight gain. N Engl J Med. 2000 Mar 23;342(12):861-7. doi: 10.1056/NEJM200003233421206.

2. Phelan S, Wing RR, Raynor HA, Dibello J, Nedeau K, Peng W. Holiday weight management by successful weight losers and normal weight individuals. J Consult Clin Psychol. 2008 Jun;76(3):442-8. doi: 10.1037/0022-006X.76.3.442.

3. Helander EE, Wansink B, Chieh A. Weight Gain over the Holidays in Three Countries. N Engl J Med. 2016 Sep 22;375(12):1200-2. doi: 10.1056/NEJMc1602012.

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