Why keeping the weight off is so difficult1,2

Patients with obesity are working against their own physiology to maintain the weight they lost3

After weight loss:

  • metabolic adaptation leads to decreases in resting metabolic rate and increases in energy intake3,4 
  • hunger and satiety hormones are triggered, decreasing satiety and increasing appetite3,5

Weight regain is not an issue of behavior alone4

A review of 14 long-term studies showed that people with obesity regained weight after weight loss achieved by dieting.1

Chart showing long-term studies on weight regain
Chart showing long-term studies on weight regain

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.1 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;622(3):220-233.

 

“…the high rate of relapse among obese people who have lost weight has a strong physiological basis and is not simply the result of the voluntary resumption of old habits.”3

Also in The Science of Obesity:

     

     

References:

  1. 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;622(3):220-233.
  2. MacLean PS, Wing RR, Davidson T, et al. NIH working group report: innovative research to improve maintenance of weight loss. Obesity (Silver Spring). 2015;23(1):7-15.
  3. 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.
  4. Lam YY, Ravussin E. Analysis of energy metabolism in humans: a review of methodologies. Mol Metab. 2016;5(11):1057-1071.
  5. Suzuki K, Jayasena CN, Bloom SR. Obesity and appetite control. Exp Diabetes Res. 2012. doi:10.1155/2012/824305.