Persistent metabolic adaptation 6 years after “The Biggest Loser” competition
Open accessAbstract
Objective: To measure long‐term changes in resting metabolic rate (RMR) and body composition in participants of “The Biggest Loser” competition. Methods: Body composition was measured by dual energy X‐ray absorptiometry, and RMR was determined by indirect calorimetry at baseline, at the end of the 30‐week competition and 6 years later. Metabolic adaptation was defined as the residual RMR after adjusting for changes in body composition and age. Results: Of the 16 “Biggest Loser” competitors originally investigated, 14 participated in this follow‐up study. Weight loss at the end of the competition was (mean ± SD) 58.3 ± 24.9 kg ( P < 0.0001), and RMR decreased by 610 ± 483 kcal/day ( P = 0.0004). After 6 years, 41.0 ± 31.3 kg of the lost weight was regained ( P = 0.0002), while RMR was 704 ± 427 kcal/day below baseline ( P < 0.0001) and metabolic adaptation was −499 ± 207 kcal/day ( P < 0.0001). Weight regain was not significantly correlated with metabolic adaptation at the competition's end ( r = − 0.1, P = 0.75), but those subjects maintaining greater weight loss at 6 years also experienced greater concurrent metabolic slowing ( r = 0.59, P = 0.025). Conclusions: Metabolic adaptation persists over time and is likely a proportional, but incomplete, response to contemporaneous efforts to reduce body weight.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Weight loss interventions may not be sustainable and potentially lead to greater risk in the long term.
“weight loss interventions may not be sustainable and potentially lead to greater risk in the long term [55,56,57,58,59].”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [57]
The Discussion (page unavailable in our copy) reports substantial weight regain six years after The Biggest Loser and persistent metabolic slowing, supporting concern about maintaining weight loss. But participants remained lighter on average and were relatively successful at long-term maintenance; the paper does not establish that weight-loss interventions generally lead to greater long-term risk. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe sustainability of weight loss interventions has been questioned, and weight cycling has been identified as an independent risk factor for cardiovascular disease.
“the sustainability of weight loss interventions has been questioned [55,56,57], and weight cycling has been identified as an independent risk factor for cardiovascular disease [58,59]”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [57]
Adaptive thermogenesis can persist for months or years after weight loss.
“This metabolic adaptation can persist for months or years after weight loss”
From Weight maintenance after discontinuation of GLP-1 therapies (2026) · cites this paper as [41]
Semaglutide and tirzepatide act in the central nervous system to reduce food intake and body weight.
“Semaglutide (approved in 2021 for chronic weight management) and tirzepatide (approved in 2023 for chronic weight management) are AOMs that act in the central nervous system to reduce food intake and body weight [19].”
From Nutritional considerations with antiobesity medications (2024) · cites this paper as [19]
The Methods describe a six-year follow-up of Biggest Loser participants, and the Discussion addresses resting metabolic rate, hunger, and weight regain. Neither those passages nor searches for semaglutide, tirzepatide, central nervous system action, and anti-obesity medications found support for the attributed drug mechanism. (LLM, conf=0.75)
Experimental — accuracy not yet measuredThe magnitude of metabolic adaptation did not show a clear association with the amount of weight regained, suggesting that reductions in energy expenditure may occur independently of long-term weight changes in some individuals.
“The magnitude of metabolic adaptation did not show a clear association with the amount of weight regained, suggesting that reductions in energy expenditure may occur independently of long-term weight changes in some individuals [63].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [63]
At the end of the 30-week Biggest Loser intervention, mean metabolic adaptation reached approximately 275 kcal/day, and during the 6-year follow-up it was approximately 500 kcal/day, despite substantial weight regain in most participants.
“At the end of the 30-weeks intervention, mean metabolic adaptation reached approximately 275 kcal/day, and during the 6-year follow-up it was approximately 500 kcal/day, despite substantial weight regain in most participants.”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [63]
In participants of the Biggest Loser competition, 6-year follow-up showed an average weight regain of approximately 70%, with a subset regaining weight above baseline.
“The 6-year follow-up data of participants in the biggest loser competition demonstrated an average weight regain of approximately 70%, with a subset of the participants regaining weight above their baseline weight before the competition [119, 120].”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [119]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F., & Turner, R. C. (1985) · Diabetologia · doi:10.1007/bf00280883 · Cited by 31,502 · see citing works
Toprak, Ö., Kurt, H., Sarı, Y., Şarkış, C., Us, H., & Kırık, A. (2017) · Kidney & Blood Pressure Research · doi:10.1159/000468530 · Cited by 29,769 · see citing works
A new predictive equation for resting energy expenditure in healthy individuals
Mifflin, M., St Jeor, S., Hill, L., Scott, B., Daugherty, S., & Koh, Y. (1990) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/51.2.241 · Cited by 2,544 · cited 2× · see citing works
“Despite all our subjects having class III obesity at baseline, the coefficients of the best-fit RMR regression equation above were similar to those previously published using data from subjects with less severe obesity (11-13).”
MethodResultTHE BIOLOGY OF HUMAN STARVATION
Keys, A., BROŽEK, J., & Henschel, A. (1951) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1951.tb56499.x · Cited by 2,053 · see citing works
The Biology of Human Starvation: Volume I
KEYS, A., BROŽEK, J., HENSCHEL, A., MICKELSEN, O., & TAYLOR, H. L. (1950) · doi:10.5749/j.ctv9b2tqv · Cited by 2,039 · see citing works
Long-term weight loss maintenance
Wing, R. R., & Phelan, S. (2005) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/82.1.222s · Cited by 1,941 · cited 1× · see citing works
“In comparison, it has been estimated that 20% of overweight individuals maintain at least 10% weight loss after 1 year of a weight loss program (32).”
BackgroundEight-year weight losses with an intensive lifestyle intervention: The look AHEAD study
The Look AHEAD Research Group (2014) · Obesity · doi:10.1002/oby.20662 · Cited by 842 · cited 1× · see citing works
“Only 37% of the lifestyle intervention arm of the Diabetes Prevention Program maintained at least 7% weight loss after 3 years (33), and 27% of the intensive lifestyle intervention arm of the Look AHEAD trial maintained 10% weight loss after 8 years (34).”
BackgroundCunningham, J. (1991) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/54.6.963 · Cited by 607 · see citing works
Achieving Weight and Activity Goals Among Diabetes Prevention Program Lifestyle Participants
The Diabetes Prevention Program Research Group (2004) · Obesity Research · doi:10.1038/oby.2004.179 · Cited by 529 · see citing works
Rosenbaum, M., Hirsch, J., Gallagher, D. A., & Leibel, R. L. (2008) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/88.4.906 · Cited by 444 · see citing works
Prediction of resting energy expenditure from fat-free mass and fat mass
Nelson, K., Weinsier, R., Long, C., & Schutz, Y. (1992) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/56.5.848 · Cited by 371 · see citing works
Adaptive thermogenesis in humans
Rosenbaum, M., & Leibel, R. L. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.184 · Cited by 349 · see citing works
Speakman, J. R., Levitsky, D. A., Allison, D. B., Bray, M. S., de Castro, J. M., Clegg, D. J., Clapham, J. C., Dulloo, A. G., Gruer, L. D., Haw, S. J., et al. (2011) · Disease Models & Mechanisms · doi:10.1242/dmm.008698 · Cited by 316 · see citing works
Relative dilution spaces of 2H- and 18O-labeled water in humans
Racette, S. B., Schoeller, D. A., Luke, A. H., Shay, K., Hnilicka, J. M., & Kushner, R. F. (1994) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1994.267.4.e585 · Cited by 316 · see citing works
Meta-analysis of resting metabolic rate in formerly obese subjects
Astrup, A., Gøtzsche, P. C., van de Werken, K., Ranneries, C., Toubro, S., Raben, A., & Buemann, B. (1999) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/69.6.1117 · Cited by 296 · see citing works
Hall, K. D., Bemis, T., Brychta, R., Chen, K. Y., Courville, A., Crayner, E. J., Goodwin, S., Guo, J., Howard, L., Knuth, N. D., et al. (2015) · Cell Metabolism · doi:10.1016/j.cmet.2015.07.021 · Cited by 280 · cited 1× · see citing works
“which assumes that protein oxidation contributes 15% to the energy expenditure (6).”
BackgroundSelf-citationMüller, M. J., Enderle, J., Pourhassan, M., Braun, W., Eggeling, B., Lagerpusch, M., Glüer, C., Kehayias, J. J., Kiosz, D., & Bosy‐Westphal, A. (2015) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.109173 · Cited by 272 · see citing works
Metabolic Slowing with Massive Weight Loss despite Preservation of Fat-Free Mass
Johannsen, D. L., Knuth, N. D., Huizenga, R., Rood, J. C., Ravussin, E., & Hall, K. D. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-1444 · Cited by 254 · see citing works
Self-citationDulloo, A. G., & Jacquet, J. (1998) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/68.3.599 · Cited by 215 · see citing works
Weinsier, R. L., Nagy, T. R., Hunter, G. R., Darnell, B. E., Hensrud, D. D., & Weiss, H. L. (2000) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/72.5.1088 · Cited by 208 · cited 1× · see citing works
“This was surprising given the relative stability of body weight before the follow-up measurements compared with the substantial negative energy balance at the end of the competition which is known to further suppress RMR (15,16).”
BackgroundThe effect of rate of weight loss on long-term weight management: a randomised controlled trial
Purcell, K., Sumithran, P., Prendergast, L. A., Bouniu, C. J., Delbridge, E., & Proietto, J. (2014) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(14)70200-1 · Cited by 201 · see citing works
Froidevaux, F., Schutz, Y., Christin, L., & Jéquier, E. (1993) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/57.1.35 · Cited by 195 · see citing works
Body Composition Measured by Dual‐energy X‐ray Absorptiometry Half‐body Scans in Obese Adults
Rothney, M. P., Brychta, R. J., Schaefer, E. V., Chen, K. Y., & Skarulis, M. C. (2009) · Obesity · doi:10.1038/oby.2009.14 · Cited by 195 · see citing works
Self-citationAdaptive thermogenesis with weight loss in humans
Müller, M. J., & Bosy‐Westphal, A. (2013) · Obesity · doi:10.1002/oby.20027 · Cited by 181 · see citing works
Astrup, A. V., & Rössner, S. (2000) · Obesity Reviews · doi:10.1046/j.1467-789x.2000.00004.x · Cited by 178 · see citing works
Clinical significance of adaptive thermogenesis
Major, G., Doucet, É., Trayhurn, P., Astrup, A. V., & Tremblay, A. (2007) · International Journal of Obesity · doi:10.1038/sj.ijo.0803523 · Cited by 170 · see citing works
Nackers, L. M., Ross, K. M., & Perri, M. G. (2010) · International Journal of Behavioral Medicine · doi:10.1007/s12529-010-9092-y · Cited by 166 · see citing works
Long-term Effects of Dieting on Resting Metabolic Rate in Obese Outpatients
Wadden, T. A. (1990) · JAMA · doi:10.1001/jama.1990.03450060053028 · Cited by 146 · see citing works
Knuth, N. D., Johannsen, D. L., Tamboli, R. A., Marks–Shulman, P. A., Huizenga, R., Chen, K. Y., Abumrad, N. N., Ravussin, É., & Hall, K. D. (2014) · Obesity · doi:10.1002/oby.20900 · Cited by 144 · see citing works
Self-citationThe effect of rate of weight loss on long‐term weight regain in adults with overweight and obesity
Vink, R. G., Roumans, N. J. T., Arkenbosch, L. A. J., Mariman, E. C. M., & van Baak, M. A. (2016) · Obesity · doi:10.1002/oby.21346 · Cited by 128 · cited 1× · see citing works
“Rapid weight loss, such as that experienced by “The Biggest Loser” participants, is sometimes claimed to increase the risk of weight regain, but recent studies have failed to support this idea since weight loss rate per se was not observed to affect long-term weight regain (35,36).”
BackgroundBosy‐Westphal, A., Schautz, B., Lagerpusch, M., Pourhassan, M., Braun, W., Goele, K., Heller, M., Glüer, C.-C., & Müller, M. (2013) · International Journal of Obesity · doi:10.1038/ijo.2013.1 · Cited by 123 · see citing works
(1996) · PubMed · Cited by 122 · see citing works
Knuth, N. D., Johannsen, D. L., Tamboli, R. A., Marks–Shulman, P. A., Huizenga, R., Chen, K. Y., Abumrad, N. N., Ravussin, É., & Hall, K. D. (2016) · Obesity · doi:10.1002/oby.21634 · Cited by 115 · see citing works
Self-citationAdaptive thermogenesis can make a difference in the ability of obese individuals to lose body weight
Tremblay, A., Royer, M.-M., Chaput, J.-P., & Doucet, É. (2013) · International Journal of Obesity · doi:10.1038/ijo.2012.124 · Cited by 108 · see citing works
Tremblay, A., Pelletier, C., Doucet, É., & Imbeault, P. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802527 · Cited by 86 · see citing works
(1991) · PubMed · Cited by 85 · see citing works
Schoeller, D. A., & Jefford, G. (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0801851 · Cited by 69 · see citing works
Effects of intentional weight cycling on non-obese young women
Kajioka, T., Tsuzuku, S., Shimokata, H., & Sato, Y. (2002) · Metabolism · doi:10.1053/meta.2002.29976 · Cited by 60 · see citing works
Zheng, H., Mumphrey, M. B., Townsend, R. L., Morrison, C. D., Münzberg, H., Ye, J., & Berthoud, H. (2016) · Obesity · doi:10.1002/oby.21400 · Cited by 57 · see citing works
Diet versus exercise in “the biggest loser” weight loss competition
Hall, K. D. (2013) · Obesity · doi:10.1002/oby.20065 · Cited by 37 · see citing works
Self-citationvan Strien (1996) · doi:10.1002/(sici)1098-108x(199601)19:1
Flagged first, then by citations
Cited by
Sorted by citations
Davies, M., Færch, L., Jeppesen, O. K., Pakseresht, A., Pedersen, S. D., Perreault, L., Rosenstock, J., Shimomura, I., Viljoen, A., Wadden, T. A., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00213-0 · Cited by 1,419 · see citing works
Metabolism disrupting chemicals and metabolic disorders
Heindel, J. J., Blumberg, B., Cave, M., Machtinger, R., Mantovani, A., Mendez, M. A., Nadal, A., Palanza, P., Panzica, G., Sargis, R., et al. (2017) · Reproductive Toxicology · doi:10.1016/j.reprotox.2016.10.001 · Cited by 1,101 · see citing works
Obesity Pathogenesis: An Endocrine Society Scientific Statement
Schwartz, M. W., Seeley, R. J., Zeltser, L. M., Drewnowski, A., Ravussin, E., Redman, L. M., & Leibel, R. L. (2017) · Endocrine Reviews · doi:10.1210/er.2017-00111 · Cited by 727 · see citing works
Obesity energetics: body weight regulation and the effects of diet composition
Hall, K. D., & Guo, J. (2017) · Gastroenterology · doi:10.1053/j.gastro.2017.01.052 · Cited by 367 · see citing works
Self-citationProgress and challenges in anti-obesity pharmacotherapy
Bessesen, D. H., & Van Gaal, L. F. (2018) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(17)30236-x · Cited by 347 · see citing works
Changes in energy expenditure with weight gain and weight loss in humans
Müller, M. J., Enderle, J., & Bosy-Westphal, A. (2016) · Current Obesity Reports · doi:10.1007/s13679-016-0237-4 · Cited by 267 · see citing works
Polidori, D., Sanghvi, A., Seeley, R. J., & Hall, K. D. (2016) · Obesity · doi:10.1002/oby.21653 · Cited by 209 · see citing works
Self-citationAlbury, C., Strain, W. D., Brocq, S. L., Logue, J., Lloyd, C., & Tahrani, A. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30102-9 · Cited by 170 · see citing works
Nordmo, M., Danielsen, Y. S., & Nordmo, M. (2020) · Obesity Reviews · doi:10.1111/obr.12949 · Cited by 169 · see citing works
Lifestyle modifications for preventing and treating heart failure
Aggarwal, M., Bozkurt, B., Panjrath, G., Aggarwal, B., Ostfeld, R. J., Barnard, N. D., Gaggin, H., Freeman, A. M., Allen, K., Madan, S., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.08.2160 · Cited by 162 · see citing works
Hyperinsulinemia: A cause of obesity?
Erion, K. A., & Corkey, B. E. (2017) · Current Obesity Reports · doi:10.1007/s13679-017-0261-z · Cited by 161 · see citing works
Busetto, L., Bettini, S., Makaronidis, J., Roberts, C. A., Halford, J. C. G., & Batterham, R. L. (2021) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2021.01.002 · Cited by 159 · see citing works
Christoffersen, B. Ø., Sanchez‐Delgado, G., John, L. M., Ryan, D. H., Raun, K., & Ravussin, E. (2022) · Obesity · doi:10.1002/oby.23374 · Cited by 142 · see citing works
“Metabolic adaptation may persist many years after weight loss (37), and it is believed to be a relevant barrier to weight- loss maintenance.”
BackgroundFragiadakis, G. K., Wastyk, H. C., Robinson, J. L., Sonnenburg, E. D., Sonnenburg, J. L., & Gardner, C. D. (2020) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqaa046 · Cited by 138 · see citing works
Melby, C., Paris, H., Foright, R., & Peth, J. (2017) · Nutrients · doi:10.3390/nu9050468 · Cited by 136 · see citing works
Mechanisms of Weight Loss After Obesity Surgery
Akalestou, E., Miras, A. D., Rutter, G. A., & le Roux, C. W. (2022) · Endocrine Reviews · doi:10.1210/endrev/bnab022 · Cited by 136 · see citing works
Nutritional considerations with antiobesity medications
Almandoz, J. P., Wadden, T. A., Tewksbury, C., Apovian, C. M., Fitch, A., Ard, J. D., Li, Z., Richards, J., Butsch, W. S., Jouravskaya, I., et al. (2024) · Obesity · doi:10.1002/oby.24067 · Cited by 134 · see citing works
“Hormonal and metabolic changes induced by weight reduction result in elevated appetite and reduced metabolic rate [13 – 15].”
BackgroundSohail, M. U., Yassine, H. M., Sohail, A., & Thani, A. A. A. (2019) · Review of Diabetic Studies · doi:10.1900/rds.2019.15.35 · Cited by 128 · see citing works
Reveal, Don’t Conceal: Transforming Data Visualization to Improve Transparency
Weissgerber, T. L., Winham, S. J., Heinzen, E. P., Milin-Lazovic, J. S., Garcia-Valencia, O., Bukumiric, Z., Savic, M. D., Garovic, V. D., & Milic, N. M. (2019) · Circulation · doi:10.1161/circulationaha.118.037777 · Cited by 101 · see citing works
Solbrig, L., Jones, R., Kavanagh, D., May, J., Parkin, T., & Andrade, J. (2017) · Internet Interventions · doi:10.1016/j.invent.2016.12.003 · Cited by 86 · see citing works
Treatment of obesity in older persons—A systematic review
Haywood, C., & Sumithran, P. (2019) · Obesity Reviews · doi:10.1111/obr.12815 · Cited by 84 · see citing works
Food Cues and Obesity: Overpowering Hormones and Energy Balance Regulation
Belfort-DeAguiar, R., & Seo, D. (2018) · Current Obesity Reports · doi:10.1007/s13679-018-0303-1 · Cited by 84 · see citing works
Brewer, J. A., Ruf, A., Beccia, A. L., Essien, G. I., Finn, L. M., Lutterveld, R. V., & Mason, A. E. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.01418 · Cited by 82 · see citing works
English, W. J., & Williams, D. B. (2018) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2018.06.003 · Cited by 82 · see citing works
Papamargaritis, D., le Roux, C. W., Holst, J. J., & Davies, M. J. (2024) · Cardiovascular Research · doi:10.1093/cvr/cvac176 · Cited by 73 · see citing works
Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects
Biobaku, F., Ghanim, H., Monte, S. V., Caruana, J. A., & Dandona, P. (2020) · Journal of the Endocrine Society · doi:10.1210/jendso/bvaa049 · Cited by 68 · see citing works
Beneficial Effects of Intermittent Fasting: A Narrative Review
Song, D.-K., & Kim, Y.-W. (2023) · Journal of Yeungnam Medical Science · doi:10.12701/jyms.2022.00010 · Cited by 69 · see citing works
Why weight loss maintenance is difficult
Evert, A. B., & Franz, M. J. (2017) · Diabetes Spectrum · doi:10.2337/ds017-0025 · Cited by 63 · see citing works
Metabolic adaptation is an illusion, only present when participants are in negative energy balance
Martins, C., Roekenes, J., Salamati, S., Gower, B. A., & Hunter, G. R. (2020) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqaa220 · Cited by 65 · see citing works
Weight loss diet studies: we need help not hype
Freedhoff, Y., & Hall, K. D. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31338-1 · Cited by 56 · see citing works
Self-citationThe Gut Microbiome, Energy Homeostasis, and Implications for Hypertension
Riedl, R. A., Atkinson, S. N., Burnett, C. M. L., Grobe, J. L., & Kirby, J. R. (2017) · Current Hypertension Reports · doi:10.1007/s11906-017-0721-6 · Cited by 58 · see citing works
Weight Reduction with GLP-1 Agonists and Paths for Discontinuation While Maintaining Weight Loss
Reiss, A. B., Gulkarov, S., Lau, R., Klek, S. P., Srivastava, A., Renna, H. A., & De Leon, J. (2025) · Biomolecules · doi:10.3390/biom15030408 · Cited by 58 · see citing works
Mastaitis, J. W., Gomez, D., Raya, J. G., Li, D., Min, S., Stec, M., Kleiner, S., McWilliams, T., Altarejos, J. Y., Murphy, A. J., et al. (2025) · Nature Communications · doi:10.1038/s41467-025-59485-9 · Cited by 53 · see citing works
“In addition, many patients do not stay on these treatments for more than a year and can rapidly regain much of their body weight, with almost all of the regained weight due to fat 3,6,10,36 .”
Thom, G., Dombrowski, S. U., Brosnahan, N., Algindan, Y. Y., Rosario Lopez-Gonzalez, M., Roditi, G., Lean, M. E. J., & Malkova, D. (2020) · European Journal of Clinical Nutrition · doi:10.1038/s41430-020-0568-9 · Cited by 49 · see citing works
Coskun, T., Wu, Q., Schloot, N. C., Haupt, A., Milicevic, Z., Khouli, C., & Harris, C. (2025) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(25)00092-0 · Cited by 57 · see citing works
Is Glucagon Receptor Activation the Thermogenic Solution for Treating Obesity?
Conceição-Furber, E., Coskun, T., Sloop, K. W., & Samms, R. J. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.868037 · Cited by 48 · see citing works
Does adaptive thermogenesis occur after weight loss in adults? A systematic review
Nunes, C. L., Casanova, N., Francisco, R., Bosy-Westphal, A., Hopkins, M., Sardinha, L. B., & Silva, A. M. (2022) · British Journal of Nutrition · doi:10.1017/s0007114521001094 · Cited by 44 · see citing works
Kessler, C. (2021) · Nursing Clinics of North America · doi:10.1016/j.cnur.2021.08.001 · Cited by 43 · see citing works
Tam, C. S., Redman, L. M., Greenway, F., LeBlanc, K. A., Haussmann, M. G., & Ravussin, E. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-1814 · Cited by 42 · see citing works
Theodorakis, N., Kreouzi, M., Pappas, A., & Nikolaou, M. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms252413438 · Cited by 43 · see citing works
Kerns, J. C., Guo, J., Fothergill, E., Howard, L., Knuth, N. D., Brychta, R., Chen, K. Y., Skarulis, M. C., Walter, P. J., & Hall, K. D. (2017) · Obesity · doi:10.1002/oby.21986 · Cited by 40 · see citing works
Turicchi, J., O'Driscoll, R., Finlayson, G., Beaulieu, K., Deighton, K., & Stubbs, R. J. (2019) · Obesity Reviews · doi:10.1111/obr.12849 · Cited by 37 · see citing works
Drummen, M., Tischmann, L., Gatta-Cherifi, B., Fogelholm, M., Raben, A., Adam, T. C., & Westerterp-Plantenga, M. S. (2020) · The Journal of Nutrition · doi:10.1093/jn/nxz281 · Cited by 34 · see citing works
Metabolic adaptation delays time to reach weight loss goals
Martins, C., Gower, B. A., & Hunter, G. R. (2022) · Obesity · doi:10.1002/oby.23333 · Cited by 32 · see citing works
The physiological effects of weight-cycling: A review of current evidence
Sanaya, N., Janusaite, M., Dalamaga, M., & Magkos, F. (2024) · Current Obesity Reports · doi:10.1007/s13679-023-00539-8 · Cited by 31 · see citing works
Hintze, L. J., Messier, V., Lavoie, M.-È., Brochu, M., Lavoie, J.-M., Prud'homme, D., Rabasa-Lhoret, R., & Doucet, É. (2018) · Physiology & Behavior · doi:10.1016/j.physbeh.2018.03.014 · Cited by 31 · see citing works
Weight loss increases skeletal muscle mitochondrial energy efficiency in obese mice
Ferrara, P. J., Lang, M. J., Johnson, J. M., Watanabe, S., McLaughlin, K. L., Alan Maschek, J., Verkerke, A. R. P., Siripoksup, P., Chaix, A., Cox, J. E., et al. (2023) · Life Metabolism · doi:10.1093/lifemeta/load014 · Cited by 26 · see citing works
Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment
Sannidhi, D., Abeles, R., Andrew, W., Bonnet, J. P., Vitale, K., Niranjan, V., Gulati, M., Pauly, K., Moran, R., Alexander, L., et al. (2025) · Nutrients · doi:10.3390/nu17142382 · Cited by 29 · see citing works
“This is what can cause the weight regain experienced by as many as two thirds of participants in dietary interventions for weight loss [29,30].”
Weight cycling and its effects on muscle mass, sarcopenia and sarcopenic obesity
Zamboni, M., Giani, A., Fantin, F., Rossi, A. P., Mazzali, G., & Zoico, E. (2025) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-025-09963-8 · Cited by 24 · see citing works
Anti-obesity drug therapy in clinical practice: Evidence of a poor prescriptive attitude
Squadrito, F., Rottura, M., Irrera, N., Minutoli, L., Bitto, A., Barbieri, M. A., Cicala, G., Mecchio, A., Pallio, G., Marino, S., et al. (2020) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2020.110320 · Cited by 22 · see citing works
Targeting skeletal muscle mitochondrial health in obesity
Pileggi, C. A., Hooks, B. G., McPherson, R., Dent, R. R. M., & Harper, M.-E. (2022) · Clinical Science · doi:10.1042/cs20210506 · Cited by 21 · see citing works
Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review
Żurawski, T., & Bartosiewicz, A. (2025) · Nutrients · doi:10.3390/nu18010012 · Cited by 18 · see citing works
CagriSema drives weight loss in rats by reducing energy intake and preserving energy expenditure
Jacobsen, J. M., Halling, J. F., Blom, I., Moreno Martinez, J., Hald, B., Pedersen, K., Fels, J. J., Snitker, S., Secher, A., Lundh, S., et al. (2025) · Nature Metabolism · doi:10.1038/s42255-025-01324-8 · Cited by 15 · see citing works
Herbert, S., & Woolf, K. (2023) · Nutrients · doi:10.3390/nu15245069 · Cited by 15 · see citing works
“Yet studies that modified dietary patterns without a caloric deficit [72–85, 87, 108] Furthermore, the sustainability of weight loss interventions has been questioned [55–57], and weight cycling has been identified as an independent risk factor for cardiovascular disease [58,59].”
BackgroundCadegiani, F. A., Diniz, G. C., & Alves, G. (2017) · BMC Obesity · doi:10.1186/s40608-017-0147-3 · Cited by 15 · see citing works
Overstated metabolic adaptation after “the biggest loser” intervention
Kuchnia, A., Huizenga, R., Frankenfield, D., Matthie, J. R., & Earthman, C. P. (2016) · Obesity · doi:10.1002/oby.21638 · Cited by 12 · see citing works
von Haehling, S., Sato, R., Langer, H., Khan, M. S., Coats, A. J. S., Evans, W., Heymsfield, S., & Anker, S. D. (2025) · Journal of Cachexia, Sarcopenia and Muscle · doi:10.1002/jcsm.70147 · Cited by 10 · see citing works
Weight maintenance after discontinuation of GLP-1 therapies
Moiz, A., Filion, K. B., Knäuper, B., Tsoukas, M. A., Brazeau, A.-S., Zolotarova, T., Lelièvre, A., & Eisenberg, M. J. (2026) · EClinicalMedicine · doi:10.1016/j.eclinm.2026.103992 · Cited by 4 · see citing works
- Authors
- Fothergill, E., Guo, J., Howard, L., Kerns, J. C., Knuth, N. D., Brychta, R., Chen, K. Y., Skarulis, M. C., Walter, M., Walter, P. J., & Hall, K. D.
- Affiliations
- National Institutes of Health (US)
- Washington DC VA Medical Center (US)
- Towson University (US)
- Corresponding author
- Hall, Kevin D.
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2016-05-02
- Volume
- 24
- Issue
- 8
- Pages
- 1612-1619
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC4989512
- OpenAlex
- W2346401028
- Cited by
- 672
- References
- 41
- Citations by year
- 2026: 52 · 2025: 64 · 2024: 51 · 2023: 56 · 2022: 64 · 2021: 79 · 2020: 76 · 2019: 59 · 2018: 78 · 2017: 61 · 2016: 31 · 2014: 1
- FWCI
- 48.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- metabolic adaptation, resting metabolic rate, weight loss, weight regain, body composition, The Biggest Loser, long-term follow-up, energy expenditure
- MeSH terms
- Adult, Basal Metabolism, Body Composition, Body Weight, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Morbid, Weight Loss, Absorptiometry, Photon, Body Mass Index
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
