Attenuating the Biologic Drive for Weight Regain Following Weight Loss: Must What Goes Down Always Go Back Up?

Melby, Christopher L.; Paris, Hunter L.; Foright, Rebecca M.; Peth, James

doi:10.3390/nu9050468

Cited by 109 publications

(102 citation statements)

References 156 publications

(183 reference statements)

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“…Weight loss complicates the maintenance of energy balance . It does so mainly by decreasing energy expenditure and by increasing appetite .…”

Section: Effects Of Weight Loss On Energy Balancementioning

confidence: 99%

“…In fact, only 20% of individuals are successful at reducing their weight by at least 10% and at maintaining the lost weight for at least 1 year . Efficient long‐term weight loss strategies are illusive, an observation that most likely stems from a number of countermeasures . Many groups, including our own, have investigated the multifaceted adaptations to weight loss that in the end likely orchestrate what looks to be a coordinated response that sabotages weight loss efforts.…”

Section: Introductionmentioning

confidence: 99%

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Compensation in response to energy deficits induced by exercise or diet

2018

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Obesity is an extremely resilient condition. Weight loss is most challenging, and weight recidivism is rampant. There is accumulating evidence highlighting that energy deficits meant to produce increased mobilization of energy stores trigger a number of somewhat persistent adaptations that together increase the drive to eat and decrease energy output. These adaptations ostensibly enable a context where the likelihood of energy compensation is heightened. In fact, energy compensation is present for both diet and exercise induced energy deficits although at different magnitudes. For the most part, the energy compensation in response to exercise induced energy deficits seems to be larger. Interestingly, energy compensation appears to be greater for longer interventions, an effect independent of whether the energy deficit is induced through diet or exercise. The latter suggests that the increased drive to eat and the reduced energy expenditure that accompany weight loss might be successfully fought off initially. However, with time there seems to be increasing erosion of the behaviours that initially opposed adaptations to weight loss and increased energy compensation progressively sets in. Under such conditions, it would seem prudent to propose weight loss targets that align with a level of behaviour modifications that can be sustained indefinitely.

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“…Weight loss complicates the maintenance of energy balance . It does so mainly by decreasing energy expenditure and by increasing appetite .…”

Section: Effects Of Weight Loss On Energy Balancementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Compensation in response to energy deficits induced by exercise or diet

2018

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“…; Melby et al. ). Thus, the more difficult aspect of weight management is for individuals to maintain the weight–reduced state long‐term (Maclean et al.…”

Section: Introductionmentioning

confidence: 98%

Comparison of surgical versus diet‐induced weight loss on appetite regulation and metabolic health outcomes

et al. 2019

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Bariatric surgery is associated with significant and sustained weight loss and improved metabolic outcomes. It is unclear if weight loss alone is the main mechanism of improved metabolic health. The purpose of this trial was to compare indices of appetite regulation, insulin sensitivity and energy intake ( EI ) between participants achieving 10 kg of weight loss via Roux‐en‐Y Gastric Bypass ( RYGB ) or dietary restriction ( DIET ); intake of a very low calorie liquid diet (800 kcal/d; 40% protein, 40% fat, 20% carbohydrate that matched the post‐ RYGB dietary protocol). Adults qualifying for bariatric surgery were studied before and after 10 kg of weight loss ( RYGB [ n = 6]) or DIET [ n = 17]). Appetite (hunger, satiety, and prospective food consumption [ PFC ]), appetite–related hormones, and metabolites (ghrelin, PYY , GLP ‐1, insulin, glucose, free fatty acids [ FFA ], and triglycerides [ TG ]) were measured in the fasting state and every 30 min for 180 min following breakfast. Participants were provided lunch to evaluate acute ad libitum EI , which was similarly reduced in both groups from pre to post weight loss. Fasting ghrelin was reduced to a greater extent following RYGB compared to DIET ( P = 0.04). Area under the curve ( AUC ) for ghrelin ( P = 0.01), hunger ( P < 0.01) and PFC ( P < 0.01) increased after DIET compared to RYGB , following 10 kg weight loss. Satiety AUC increased after RYGB and decreased after DIET ( P < 0.01). Glucose and insulin (fasting and AUC ) decreased in both groups. FFA increased in both groups, with a greater increase in AUC seen after RYGB versus DIET ( P = 0.02). In summary, appetite–related indices were altered in a manner that, if maintained, may promote a sustained reduction in energy intake with RYGB compared to DIET . Future work with a larger sample size and longer follow‐up will be important to confirm and extend these findings.

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“…Weight loss, due to dietary restriction ultimately results in a lower energy flux, which would trigger compensatory effects, such as an increase in appetite followed by an increase in body weight; a situation that usually occurs with this type of weight loss intervention [65,66]. A reduced EI in order to loose weight with an accompanying increase in PA, on the other hand, would allow individuals to maintain a lower body weight when EI returns to initial levels resulting in an energy flux level that is not significantly different from that seen prior to weight loss.…”

Section: Discussionmentioning

confidence: 99%