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Weight-loss relapse and regain

90% of people with obesity are unable to keep weight off long-term.1,*,† A timely and effective weight-management plan can prevent obesity from recurring.1-3

*Long-term weight loss defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 year.

Results from quantitative surveys in a study of over 3,000 adult patients with a BMI of 30 kg/m2 or more, based on self-reported height and weight.

Weight loss triggers multiple processes that defend baseline body weight and make it very difficult to maintain weight loss4

These mechanisms contributing to weight regain persist for at least 1 year.4

Graph depicting study design data of mean changes in weight following initial weight loss

Study Design

Study enrolled 50 patients with BMI of 27 to 40 kg/m2 who were prescribed a very low-calorie diet (500-550 kcal/day) for 8 weeks, followed by individual counseling from a dietitian for 1 year with the aim of weight maintenance and suggested 30 minutes of physical activity on most days of the week. Circulating levels of appetite-regulating hormones were measured at weeks 10 and 62 and were compared with baseline levels.4

A review of 14 long-term studies showed that people with obesity regained weight after weight loss achieved by dieting5

Graph depicting study design data of people with obesity regaining weight after weight loss achieved by dieting

Study Design

Study participants’ weight and diet statuses were assessed at baseline; then their weight was measured at follow-ups for up to 7 years after the diet ended. These data are from a review of 14 diet studies with long-term follow-ups. Adapted from Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare’s search for effective obesity treatments: diets are not the answer. Am Psychol. 2007;62(3):220-233.5

Guide your patients in preventing weight regain

Understanding Weight Regain: It's Not Your Fault Module
Start Module

Estimated time: 15 mins

Understanding Weight Regain: It’s Not Your Fault

Michael S. Kaplan, DO, ABOM

Weight regain can be caused by multiple factors. This module explores the factors involved and is designed to help support communication with patients about sustaining weight loss in the long term.


Chapters

1. Pathophysiologic adaptations that promote weight regain

2. Recognizing normal weight fluctuations

3. Ask the expert

4. Excess eating during holiday seasons

5. Compensation for occasional overindulgences

6. Approaches to mitigating weight regain

7. Thought question

8. Closing

9. References

Diagnosis is the first step to treating obesity

SEE HOW YOU CAN HELP

Pharmacotherapy may help some patients sustain weight loss

DISCOVER ITS ROLE

References

1. Kaplan LM, Golden A, Jinnett K, et al. Perceptions of barriers to effective obesity care: results from the National ACTION Study. Obesity. 2018;26(1):61-69.

2. Bray GA, Kim KK, Wilding JPH. Obesity: a chronic relapsing progressive disease. A position statement of the World Obesity Federation. Obes Rev. 2017;18(7):715-723.

3. Garvey WT, Mechanick JI, Brett EM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22 Suppl 3:1-203.

4. Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597-1604.

5. Mann T, Tomiyama AJ, Westling E, et al. Medicare's search for effective obesity treatments: diets are not the answer. Am Psychol. 2007;62(3):220-233.

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