The effect of rate of weight loss on long‐term weight regain in adults with overweight and obesity

Vink, Roel G.; Roumans, Nadia J. T.; Arkenbosch, Laura A. J.; Mariman, Edwin C. M.; van Baak, Marleen A.

doi:10.1002/oby.21346

Cited by 128Obesity, Physical Activity, DietDiet and metabolism studiesBariatric Surgery and Outcomes

The effect of rate of weight loss on long‐term weight regain in adults with overweight and obesity

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Vink, Roel G., Roumans, Nadia J. T., Arkenbosch, Laura A. J., Mariman, Edwin C. M., van Baak, Marleen A.·2016·Obesity

DOI 10.1002/oby.21346

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Abstract

Objective: To investigate the effect of rate of weight loss, with similar total weight loss, on weight regain in individuals with overweight and obesity. Methods: Fifty‐seven participants (BMI: 28‐35 kg/m 2) underwent a dietary intervention (DI). They were randomized to a low‐calorie diet (LCD; 1250 kcal/day) for 12 weeks (slow weight loss) or a very‐low‐calorie diet (VLCD; 500 kcal/day) for 5 weeks (rapid weight loss) (weight loss (WL) period) followed by a 4‐week weight‐stable (WS) period and 9 months follow‐up. Body weight and body composition (BodPod) were determined at study start and after each period. Results: Weight change was similar in both groups after WL (LCD: −8.2 kg and VLCD: −9.0 kg, P = 0.24). Weight regain after follow‐up was not significantly different between groups (LCD: 4.2 kg and VLCD: 4.5 kg, P = 0.73). Percentage fat‐free mass loss (%FFML) was higher in the VLCD‐group compared to the LCD‐group after DI (8.8% and 1.3%, respectively, P = 0.034) and was associated with weight regain during follow‐up in the whole group (r = 0.325, P = 0.018). Conclusions: The present study showed that, with similar total weight loss, rate of weight loss did not affect weight regain. However, %FFML after DI was associated with weight regain.

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Follow-ups after the intervention has ended are important, as the effect of lifestyle modification tends to vanish, and an intentional weight loss may be followed by an unhealthy weight gain in the majority of participants in behavioural trials.
“Equally important are follow-ups after the intervention has ended, as the effect of lifestyle modification tends to vanish, and an intentional weight loss may be followed by an unhealthy weight gain in the majority of participants in behavioural trials 19 .”
From The CHANGE trial: no superiority of lifestyle coaching plus care coordination plus treatment as usual compared to treatment as usual alone in reducing risk of cardiovascular disease in adults with schizophrenia spectrum disorders and abdominal obesity (2016) · cites this paper as [19]

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“The composition of the weight lost with obesity treatment has been suggested to play a role in weight regain, with a larger proportion of calorie restriction-induced weight loss due to loss of fatfree mass (%FFML) being associated with more weight regain [29, 30].”
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Resting Energy Expenditure and Metabolic Adaptation in Adolescents at 12 Months After Bariatric Surgery
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“First, it raises the possibility that following dieting-induced weight loss, the loss of FFM as a factor for weight regain (9) can be attributed not only to the diminished resting metabolic rate resulting from a lower energy cost for maintenance of a lower FFM, but also to the impact of the deficit in FFM in enhancing…”
Background
Estimating real cell size distribution from cross-section microscopy imaging
Lenz, M., Roumans, N. J. T., Vink, R., van Baak, M. A., Mariman, E. C. M., Arts, I. C. W., de Kok, T. M. C. M., & Ertaylan, G. (2016) · Bioinformatics · doi:10.1093/bioinformatics/btw431 · Cited by 25 · see citing works
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The (dys)regulation of energy storage in obesity
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Myokines in Appetite Control and Energy Balance
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“found that the percentage of weight loss comprising FFM correlated with regain after an 8–9 kg weight loss [37].”
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Plasma Levels of Triglycerides and IL-6 Are Associated With Weight Regain and Fat Mass Expansion
Qiao, Q., Bouwman, F. G., van Baak, M. A., Roumans, N. J. T., Vink, R., & Mariman, E. C. M. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac198 · Cited by 23 · see citing works
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Association between Fat-Free Mass Loss after Diet and Exercise Interventions and Weight Regain in Women with Overweight
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“(average BMI, 31 kg·m−2) (18) and Turicchi et al.”
BackgroundResultInfluential
Impact of daily fasting duration on body composition and cardiometabolic risk factors during a time-restricted eating protocol: a randomized controlled trial
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Mining high average-utility sequential rules to identify high-utility gene expression sequences in longitudinal human studies
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Stimulated Insulin Secretion Predicts Changes in Body Composition Following Weight Loss in Adults with High BMI
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A computational model of postprandial adipose tissue lipid metabolism derived using human arteriovenous stable isotope tracer data
O’Donovan, S. D., Lenz, M., Vink, R., Roumans, N. J. T., de Kok, T. M. C. M., Mariman, E. C. M., Peeters, R., van Riel, N. A. W., van Baak, M. A., & Arts, I. C. W. (2019) · PLoS Computational Biology · doi:10.1371/journal.pcbi.1007400 · Cited by 21 · see citing works
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Interventions to Promote the Utilization of Physical Health Care for People with Severe Mental Illness: A Scoping Review
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“However, this is an important factor, since changes in physical health often improve gradually and behavioral changes tend to vanish [106,107].”
Background
The challenge of weight loss maintenance in obesity: a review of the evidence on the best strategies available
Barrea, L., Salzano, C., Pugliese, G., Laudisio, D., Frías-Toral, E., Savastano, S., Colao, A., & Muscogiuri, G. (2022) · International Journal of Food Sciences and Nutrition · doi:10.1080/09637486.2022.2130186 · Cited by 20 · see citing works
“After 2 years, the successful group maintained their reduced values after weight loss, whereas the unsuccessful group showed a regain (Vogels and Westerterp-Plantenga 2007).”
BackgroundResultInfluential
A Systematic Review and Meta-Analysis of the Effect of Caloric Restriction on Skeletal Muscle Mass in Individuals with, and without, Type 2 Diabetes
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“In contrast with these assertions, the several studies included in this review that reported post-VLCD changes in body composition largely demonstrated that increases in both FM and MM occur [51,65,67,71,83].”
Are we giving too much weight to lean mass loss?
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“Severe caloric restriction may be less favorable than moderate caloric restriction, as larger deficits typically induce faster weight loss but may compromise lean mass retention [155 — 157].”
The Obesity Amelioration Effect in High-Fat-Diet Fed Mice of a Homogeneous Polysaccharide from Codonopsis pilosula
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Stratifying cellular metabolism during weight loss: an interplay of metabolism, metabolic flexibility and inflammation
Tareen, S. H. K., Kutmon, M., de Kok, T. M. C. M., Mariman, E. C. M., van Baak, M. A., Evelo, C. T., Adriaens, M. E., & Arts, I. C. W. (2020) · Scientific Reports · doi:10.1038/s41598-020-58358-z · Cited by 17 · see citing works
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From famine to therapeutic weight loss: Hunger, psychological responses, and energy balance‐related behaviors
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A protein-supplemented very-low-calorie diet does not mitigate reductions in lean mass and resting metabolic rate in subjects with overweight or obesity: A randomized controlled trial
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Hypothalamic neuronal-glial crosstalk in metabolic disease
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“Whilst inherently simplistic, clinical interventions have resoundingly failed capacity to promote the remission of obesity over the long term, with most patients regaining the majority of lost weight, irrespective of the rate at which that weight is lost 17,18 .”
Combined Analysis of Stress‐ and ECM‐Related Genes in Their Effect on Weight Regain
Roumans, N. J. T., Wang, P., Vink, R., van Baak, M. A., & Mariman, E. C. M. (2018) · Obesity · doi:10.1002/oby.22093 · Cited by 15 · see citing works
“Participants and study design The present study was performed in a subcohort of our larger clinical trial as described previously (13), from which only the verylow-calorie diet (VLCD) intervention was selected.”
MethodSelf-citation
Biopsychology of human appetite — understanding the excitatory and inhibitory mechanisms of homeostatic control
Casanova, N., Finlayson, G., Blundell, J. E., & Hopkins, M. (2019) · Current Opinion in Physiology · doi:10.1016/j.cophys.2019.06.007 · Cited by 15 · see citing works
Adipose tissue contribution to plasma fibroblast growth factor 21 and fibroblast activation protein in obesity
van Baak, M. A., Vink, R., Roumans, N. J. T., Cheng, C., Adams, A. C., & Mariman, E. C. M. (2019) · International Journal of Obesity · doi:10.1038/s41366-019-0433-x · Cited by 15 · see citing works
Self-citation
The effects of gradual vs. rapid weight loss on serum concentrations of myokines and body composition in overweight and obese females
Bagheri, R., Ashtary‐Larky, D., Elliott, B., Willoughby, D. S., Kargarfard, M., Alipour, M., Lamuchi-Deli, N., Kooti, W., Asbaghi, O., & Wong, A. (2021) · Archives of Physiology and Biochemistry · doi:10.1080/13813455.2021.1874020 · Cited by 14 · see citing works
Physical Activity, Weight Loss, and Weight Maintenance in the DiOGenes Multicenter Trial
van Baak, M. A., Hul, G. B. J., Astrup, A. V., & Saris, W. H. M. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.683369 · Cited by 15 · see citing works
Adipocyte abundances of CES1, CRYAB, ENO1 and GANAB are modified in-vitro by glucose restriction and are associated with cellular remodelling during weight regain
Qiao, Q., Bouwman, F. G., van Baak, M. A., Roumans, N. J. T., Vink, R., Coort, S. L., Renes, J., & Mariman, E. C. M. (2019) · Adipocyte · doi:10.1080/21623945.2019.1608757 · Cited by 14 · see citing works
“Yoyo study (registration number: NCT01559415 [53],).”
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Association between Fat-Free Mass Loss, Changes in Appetite, and Weight Regain in Individuals with Obesity
Martins, C., Nymo, S., Coutinho, S. R., Rehfeld, J. F., Hunter, G. R., & Gower, B. A. (2023) · Journal of Nutrition · doi:10.1016/j.tjnut.2023.03.026 · Cited by 13 · see citing works
Logical modelling reveals the PDC-PDK interaction as the regulatory switch driving metabolic flexibility at the cellular level
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An alternative approach to obesity treatment: intermittent fasting
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Adipose Tissue Meal‐Derived Fatty Acid Uptake Before and After Diet‐Induced Weight Loss in Adults with Overweight and Obesity
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MethodInfluentialSelf-citation
Physiological and psychological determinants of long‐term diet‐induced type 2 diabetes (T2DM) remission: A narrative review
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The less weight loss due to modest food restriction drove more fat accumulation in striped hamsters refed with high–fat diet
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“After commencing treatment and as per usual care, patients met with a multidisciplinary team member at weeks 4, 8, 16, 32, 52 and 78.”
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The nurse's role in providing strategies and advice on weight management
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A closer look at weight loss interventions in primary care: a systematic review and meta-analysis
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“The notion that rapid (vs. gradual) weight loss leads to greater weight regain has been debunked (38, 39).”
Background
Effect of diet-induced weight loss on angiopoietin-like protein 4 and adipose tissue lipid metabolism in overweight and obese humans
van der Kolk, B. W., Vink, R., Jocken, J. W. E., Roumans, N. J. T., Goossens, G. H., Mariman, E. C. M., van Baak, M. A., & Blaak, E. E. (2018) · Physiological Reports · doi:10.14814/phy2.13735 · Cited by 8 · see citing works
Self-citation
Profiling Cellular Processes in Adipose Tissue during Weight Loss Using Time Series Gene Expression
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Self-citation
Why do people overeat? Hunger, psychological eating and type 2 diabetes
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Unprocessed red meat in the dietary treatment of obesity: a randomized controlled trial of beef supplementation during weight maintenance after successful weight loss
Magkos, F., Rasmussen, S. I. I., Hjorth, M. F., Asping, S., Rosenkrans, M. I., Sjödin, A. M., Astrup, A. V., & Geiker, N. R. W. (2022) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqac152 · Cited by 9 · see citing works
The comparison of total energy and protein intake relative to estimated requirements in chronic spinal cord injury
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“In persons without SCI, the loss of FFM and inadequate dietary protein intake are associated with weight gain and regain (17,18) .”
Background
Baseline Metabolic Variables Do Not Predict Weight Regain in Premenopausal Women
Martins, C., Gower, B. A., & Hunter, G. R. (2020) · Obesity · doi:10.1002/oby.22780 · Cited by 7 · see citing works
“Moreover, losing weight fast has also been shown to be associated with better WL maintenance (28-31), even though the evidence remains controversial (31,32).”
Background
The energy budget and fat accumulation in striped hamsters (Cricetulus barabensis) during post-lactation
Yu, J.-X., Deng, G.-M., Xu, J., Cao, J., & Zhao, Z. (2020) · Comparative Biochemistry and Physiology Part A Molecular & Integrative Physiology · doi:10.1016/j.cbpa.2020.110755 · Cited by 6 · see citing works
Increases in physical activity are associated with a faster rate of weight loss during dietary energy restriction in women with overweight and obesity
Casanova, N., Beaulieu, K., Oustric, P., O’Connor, D., Gibbons, C., Blundell, J. E., Finlayson, G., & Hopkins, M. (2022) · British Journal Of Nutrition · doi:10.1017/s000711452200023x · Cited by 6 · see citing works
Long‐term preservation of lean mass and sustained loss of fat mass after completion of an intensive lifestyle intervention in older adults with obesity and type 2 diabetes
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Absolute Weight Loss, and Not Weight Loss Rate, Is Associated with Better Improvements in Metabolic Health
Kuk, J. L., Christensen, R. A. G., & Wharton, S. (2019) · Journal of Obesity · doi:10.1155/2019/3609642 · Cited by 6 · see citing works
Unexpected clues emerge about why diets fail
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ZoomForward2022: European Congress on Obesity
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Cold exposure prevents fat accumulation in striped hamsters refed a high-fat diet following food restriction
Huo, D.-L., Bao, M.-H., Cao, J., & Zhao, Z. (2022) · BMC Zoology · doi:10.1186/s40850-022-00122-z · Cited by 5 · see citing works
“However, subsequent studies found that the weight was rapidly regained when food was reintroduced ad libitum [5, 12, 13], most likely due to compensatory body fat accumulation resulting from a positive energy balance [14–17].”
Background
The impact of exercise on fat free mass reduction during very low energy diet-induced weight loss in adults with overweight or obesity: A systematic review and meta-analysis
Lowrie, F. J., Rahimi, M. M., Hogan, C. M., Tran, D. L., Marshall, N. S., Phillips, C. L., Gordon, C. J., Yee, B. J., & Machan, E. A. (2025) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2025.10.001 · Cited by 6 · see citing works
LONG-TERM TIME IN TARGET RANGE FOR BODY MASS INDEX (BMI) AND DIABETES INCIDENCE: INSIGHTS FROM CHARLS
Chu, C., Zhang, Y., Deng, F., & Zhang, L. (2025) · Nutrition and Diabetes · doi:10.1038/s41387-025-00404-8 · Cited by 4 · see citing works
“Although BMI is a relatively stable parameter in the short term (e.g., within hours or days), it can still exhibit meaningful changes over extended periods (e.g., months or years) [26, 27].”
L-carnitine infusion does not alleviate lipid-induced insulin resistance and metabolic inflexibility
Bruls, Y. M. H., den Kamp, Y. J. M. O., Esther Phielix, E., Lindeboom, L., Havekes, B., Schaart, G., Moonen‐Kornips, E., Wildberger, J. E., Hesselink, M. K. C., Schrauwen, P., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0239506 · Cited by 4 · see citing works
“Body mass and body volume were assessed using air-displacement plethysmography (ADP) using the Bod Pod (Cosmed, Rome, Italy) according to the manufacturer’s instructions and as described previously [23, 24].”
Quelle alimentation proposer aux patients présentant une stéatohépatite non-alcoolique ?
André-Dumont, S., & Lanthier, N. (2022) · Nutrition clinique et metabolisme · doi:10.1016/j.nupar.2021.11.001 · Cited by 4 · see citing works
Is weight cycling clinically harmful?
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Diet Composition, Glucose Homeostasis, and Weight Regain in the YoYo Study
van Baak, M. A., Roumans, N. J. T., & Mariman, E. C. M. (2021) · Nutrients · doi:10.3390/nu13072257 · Cited by 4 · see citing works
Self-citation
Losing and «maintaining» body weight is a well-known inequity in the prevention of chronic noncommunicable diseases
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Percent Body Fat and Weight Status of Youth Participating in Pediatric Weight Management Programs in the Pediatric Obesity Weight Evaluation Registry
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Effects of rapid weight loss on the body composition and pathophysiological mechanisms involved in obesity
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“According to a previous report, when weight loss from very low calorie diets (500 kcal/day) and low calorie diets (1,250 kcal/day) dietary interventions was com‐ pared, the rate of lean mass loss was smaller with low calorie diets, even though the rate of weight loss was the same [26].”
Assessment of the Clinical Condition and Way of Patients’ Nutrition before and after Laparoscopic Sleeve Gastrectomy
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“FFM loss is connected with weight regain due to decreased resting metabolic rate [38,39].”
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Predicting weight-loss using differential equations (PRELUDE)
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Association between Fat-Free Mass Loss, Changes in Appetite, and Weight Regain in Individuals with Obesity
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Authors: Vink, R. G., Roumans, N. J. T., Arkenbosch, L. A. J., Mariman, E. C. M., & van Baak, M. A.
Affiliations: Maastricht University Medical Centre (NL)
Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Centre<sup>+</sup> Maastricht The Netherlands
Corresponding author: Vink, Roel G.
ORCID: Roumans, Nadia J. T.
Mariman, Edwin C. M.
Venue: Obesity
Publisher: Wiley
Published: 2016-01-27
Volume: 24
Issue: 2
Pages: 321-327
ISSN: 1930-7381 (ISSN-L)
1930-739X
DOI: 10.1002/oby.21346
OpenAlex: W2293836648
Cited by: 128
References: 34
Citations by year: 2026: 3 · 2025: 10 · 2024: 10 · 2023: 8 · 2022: 18 · 2021: 15 · 2020: 14 · 2019: 21 · 2018: 8 · 2017: 10 · 2016: 9 · 2015: 1
FWCI: 15.87
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Obesity (publishedVersion)
PubMed (publishedVersion)
Research Publications (Maastricht University) (publishedVersion, other-oa)
Research Publications (Maastricht University) (submittedVersion, other-oa)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Physiology › Diet and metabolism studies
Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords: weight regain, overweight, very low calorie diet, hypocaloric diet, dietary intervention, fat-free mass loss, body composition
MeSH terms: Adult, Body Composition, Body Weight, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Recurrence, Time Factors, Weight Gain, Weight Loss, Caloric Restriction

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The effect of rate of weight loss on long‐term weight regain in adults with overweight and obesity

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