TOPS: A Sensible, Long-term Weight Loss Program

by Amy Hendel, P.A. Health Writer

Ah, the joys of losing weight.

While it can feel really good to drop 10, 20 or more pounds, keeping the pounds off can be nearly impossible. That’s why phrases such as “weight-cycling” and “yo-yo dieting” exist, because maintaining a healthy weight for a sustained period of time, or for life, is an extraordinary challenge. A new study suggests that the national long-term program known as TOPS (Take Off Pounds Sensibly) has a pretty good track record of helping millions of individuals to lose weight for good, using sensible strategies.

We know that modest weight loss can offer health benefits. It can reduce the risk of prediabetes, reduce the likelihood that prediabetes will progress and develop into Type 2 diabetes, lower blood pressure and improve sleep quality, while also limiting knee and ankle pain associated with carrying excess weight. Of course, if you gain the weight back again, all these wonderful health benefits typically disappear.

What is TOPS?Take Off Pounds Sensibly has been in existence for close to seven decades and operates under the straightforward tag line, “Helping millions to take off pounds sensibly since 1948.”

They don’t use celebrity endorsements and they don’t have a massive ongoing advertising effort. They also don’t guarantee weight loss. In fact, they make a big effort to tell you that they can’t “do it for you.” They do offer a sensible approach to weight loss goals with tools, education, support and an emphasis on self-accountability.

TOPS is headquartered in Milwaukee, Wisconsin, and was founded by Esther S. Manz, a mother of five. She participated in a childbirth support group before the delivery of her fifth child and realized the same group support model could be used for weight loss. TOPS members lost 300 tons last year. Individuals who have significant weight loss are given the royal treatment, literally, with “crowning of kings and queens” each year since 1957.

You choose a local chapter of TOPS to join, or if there isn’t one, you can start a new group. First visits are free and the yearly membership in the U.S. is $32 ($36 in Canada), plus nominal local chapter dues of about $5 a month. There is also an online membership option ($32) for individuals who don’t like face-to-face meetings.

TOPS doesn’t sell anything. The diet plan is based on a food-exchange system that offers lists of foods divided into six categories: starches (carbs), meat (protein), fruits, vegetables, fats, and dairy. The purpose of the exchange list is to allow you the flexibility to swap out foods within a single category.

If you don’t eat meat, then you can swap it out for fish, eggs, or another protein. An English muffin (based on total calories) may be equal to a slice of traditional bread or a half cup of cooked pasta. TOPS also utilizes the MyPlate tool to help with visual cues for portion sizes.

Decades ago, Weight Watchers also used a similar food exchange system until it began to develop its own food products, and more recently the points system.

New study on TOPS and long-term weight loss

Researchers from the University of Colorado Anschutz Medical Campus collected data from TOPS to show the positive outcomes from long-term participants in this national weight loss program.

The researchers looked at 65,000 TOPS participants who joined from 2005 to 2010. During the first year of participation (2005), nearly half the subjects had lost a significant amount of weight. Of those who continued to participate for another year, nearly 80 percent kept off the initial weight loss. With continued participation during the next several years, roughly 90 percent of the subjects who stayed in the program maintained their weight loss.

The researchers concluded that continued participation after weight loss was the major key to maintaining the weight loss. Just losing weight is not a sufficient guarantee that you can keep it off.

With obesity now identified as a disease, it appears from the TOPS model that ongoing support is a necessary component to keep the person “in remission,” once significant weight loss has occurred. Weight creep is almost inevitable in this disease because temptation is so rampant and feeding habits are so ingrained.

The rate of recidivism in obesity is quite high despite the current arsenal of treatments (diet, exercise, drugs and surgery). Recognizing that there is an affordable weight loss program that offers a sensible, sustainable diet and ongoing support should provide hope to those who struggle with obesity. It is crucial to note, however, that sustained weight loss depends largely on the ability of the person to stay committed to TOPS for the long-term, and possibly for the rest of his or her life.

Amy Hendel, also known as The HealthGal, is a Physician Assistant, nutritionist and fitness expert. As a health media personality, she's been reporting and blogging on lifestyle issues and health news for more than 20 years. Author of The 4 Habits of Healthy Families, her website offers daily health reports, links to her blogs, and a library of lifestyle video segments.

Amy Hendel, P.A.
Meet Our Writer
Amy Hendel, P.A.

Known as "The HealthGal", Amy Hendel P.A. is a medical and lifestyle reporter, nutrition and fitness expert, health coach and brand ambassador. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, find her on Twitter @Healthgal1103 and on Facebook @TheHealthGal. Check “Daily Health News” at Her personal mantra? “Fix it first with food, fitness, and lifestyle.”