Why patients with obesity often regain lost weight
A timely and effective weight-management plan can help prevent weight regain.1-3
Less than half of people with obesity reported having maintained weight loss for more than 1 year1*
Weight loss triggers multiple physiological processes that defend baseline body weight, making it difficult to maintain weight loss.4
*Results from quantitative surveys in a study of over 3,000 adult patients with a mean BMI of ≥37 kg/m² based on self-reported height and weight. Forty-four percent of people with obesity who reported a weight loss of at least 10% from their maximum weight during the previous 3 years maintained that weight loss for more than 1 year.1
A study showed that the mechanisms contributing to weight regain can persist for at least 1 year4
Study Design
The study enrolled 50 patients with overweight or obesity, with a body mass index (BMI) between 27 and 40 kg/m² who were prescribed a very-low-energy diet (500-550 kcal/day) for 8 weeks. Participants who lost 10% or more of their initial body weight by the end of week 10 were then gradually reintroduced to ordinary foods and received individual counseling from a dietitian for 1 year with the aim of weight maintenance. They were also encouraged to engage in 30 minutes of moderately intense physical activity on most days of the week. Circulating levels of appetite-regulating hormones were measured at baseline (week 0) and at weeks 10 and 62, which 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
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, which included assessments of additional dieting activities and exercise habits. The studies reported varied follow-up durations, participant retention rates, and methods for weight measurement, including self-reported weights and participation in other weight-loss programs. 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
BMI, body mass index.
DIAGNOSING OBESITY
Diagnosis is an important step in managing obesity6
INITIATING A PLAN
Pharmacotherapy may help some patients sustain weight loss7
References:
1. Kaplan LM, Golden A, Jinnett K, et al. Perceptions of barriers to effective obesity care: results from the National ACTION Study. Obesity (Silver Spring). 2018;26(1):61-69.
2. Bray GA, Kim KK, Wilding JPH; World Obesity Federation. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev. 2017;18(7):715-723.
3. Garvey WT, Mechanick JI, Brett EM, et al; Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines. 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 Eng J Med. 2011;365:1597-1604.
5. Mann T, Tomiyama AJ, Westling E, Lew AM, Samueal B, Chatman J. Medicare’s search for effective obesity treatments: diets are not the answer. Am Psychol. 2007;62(3):220-233.
6. Ciemins EL, Joshi V, Cuddeback JK, Kushner RF, Horn DB, Garvey WT. Diagnosing obesity as a first step to weight loss: an observational study. Obesity (Silver Spring). 2020;28(12):2305-2309.
7. Tchang BG, Aras M, Kumar RB, Aronne LJ. Pharmacologic treatment of overweight and obesity in adults. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. Endotext. South Dartmouth (MA): MDText.com, Inc.; August 2, 2021.
