Maintenance of Lost Weight and Long-Term Management of Obesity
Open accessAbstract
Weight loss can be achieved through a variety of modalities, but long-term maintenance of lost weight is much more challenging. Obesity interventions typically result in early weight loss followed by a weight plateau and progressive regain. This review describes current understanding of the biological, behavioral, and environmental factors driving this near-ubiquitous body weight trajectory and the implications for long-term weight management. Treatment of obesity requires ongoing clinical attention and weight maintenance-specific counseling to support sustainable healthful behaviors and positive weight regulation.
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Cites
Statistics
Claims the paper makes
56 of 107 cited sources checked · 27 supported · 0 flagged · accuracy not yet measured
- Findingown data
In the model, the simulated patient who plateaued at six months and then regained maintained more than about 70% of initial intervention effort until the plateau.
“For example, the model-calculated intervention effort for the simulated patient who experiences the weight plateau at six months followed by weight regain (Figure 2, blue curves) maintains more than ~70% of their initial intervention effort until the plateau.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [31] Polidori, 2016, How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake, Obesity (Silver Spring) source
The Results describe a weight-loss plateau after 6–8 months followed by regain, and identify Figure 3C as an index of ongoing intervention effort. The Discussion also describes persistent effort over the first six months. Our copy does not state that effort remained above approximately 70% of its initial level; its Figure 2 concerns feedback control during canagliflozin treatment, not the plateau-and-regain example. (LLM, conf=0.83)
Experimental — accuracy not yet measured
- Findingcitation
From a calorie balance perspective, a patient who maintains lost weight after the first year may eat only about 100 kcal/d less than one who regains long-term.
“From a purely calorie balance perspective, a patient who maintains lost weight after the first year of an intervention (Figure 2, orange curves) may be eating only about 100 kcal/d fewer than a patient who experiences long-term weight regain (Figure 2, blue curves).”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [27] Hall, 2011, Quantification of the effect of energy imbalance on bodyweight, Lancet source
The Introduction (page not provided) says the modelled patients who regained weight returned to their original weight-maintenance diet within the first year. The Conclusions (page not provided) give a general rule relating sustained intake changes to eventual weight changes. Neither passage establishes that a patient maintaining lost weight after year one eats about 100 kcal/day less than a patient who regains it. (LLM, conf=0.82)
Experimental — accuracy not yet measured - cites [31] Polidori, 2016, How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake, Obesity (Silver Spring) source
The Results (page unavailable) describe a weight-loss trajectory followed by slow regain: intake was within 100 kcal/day of baseline at the eight-month plateau and practically at baseline after one year. They do not compare patients who maintain weight loss after year one with patients who regain it, or establish a 100 kcal/day difference between those groups. (LLM, conf=0.83)
Experimental — accuracy not yet measured
- Interpretationcitation
Weight-loss-induced appetite signals could cause subconscious biases such as gradually increasing portion sizes.
“Thus, signals to the brain that increase appetite with weight loss could introduce subconscious biases such as portion sizes creeping upwards over time.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [37] Berthoud, 2017, Blaming the brain for obesity: integration of hedonic and homeostatic mechanisms, Gastroenterology source
In “Set point theory” (page unavailable), the paper says that underfeeding prompts adaptive changes in food intake that return body weight toward its prior level. Its discussion of mindless eating says habitual intake can occur outside awareness. It does not connect weight-loss-induced appetite signals to portion sizes gradually increasing over time. (LLM, conf=0.84)
Experimental — accuracy not yet measured
- Premisereasoning
The old guidance that modest diet changes produce steady substantial weight loss at one pound per 3500 kcal deficit is mistaken.
“Outdated guidance to physicians and their patients gives the mistaken impression that relatively modest diet changes will consistently and progressively result in substantial weight loss at rate of one pound for every 3500 kcal of accumulated dietary calorie deficit21–24.”
Quote in the paperSubstantial claim1 of 4 sources checked- cites [21] Guth, 2014, JAMA patient page. Healthy weight loss, JAMA source
- cites [22] NHLBI, 2005
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [23] 2000
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [24] NHS, 2006
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Body weight is regulated by negative feedback circuits that affect food intake.
“In addition to adaptations in energy expenditure with weight loss, body weight is regulated by negative feedback circuits that influence food intake28,29.”
Quote in the paperSubstantial claim1 of 2 sources checked
- Premisecitation
The rise in obesity prevalence over recent decades has coincided with industrialization of the food system, including more production and marketing of inexpensive, highly processed foods with supernormal appetitive properties.
“The rise in obesity prevalence over the past several decades has been mirrored by industrialization of the food system7 involving increased production and marketing of inexpensive, highly-processed foods8–10 with supernormal appetitive properties11,12.”
Quote in the paperNot a substantial claim1 of 6 sources checked- cites [7] Stuckler, 2012, Manufacturing epidemics: the role of global producers in increased consumption of unhealthy commodities including processed foods, alcohol, and tobacco, PLoS Med source
- cites [8] Swinburn, 2011, The global obesity pandemic: shaped by global drivers and local environments, Lancet source
- cites [9] Blatt, 2008
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [10] Roberts, 2008
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [11] Kessler, 2009
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [12] Moss, 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationcitation
The perception of ongoing diet maintenance despite no further weight loss may occur because appetite regulation happens in brain regions below conscious awareness.
“The patient’s perception of ongoing diet maintenance despite no further weight loss may arise because the physiological regulation of appetite occurs in brain regions that operate below the patient’s conscious awareness37.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [37] Berthoud, 2017, Blaming the brain for obesity: integration of hedonic and homeostatic mechanisms, Gastroenterology source
The ‘Neural Control of Appetite and Food Intake’ section (page not provided) says much of the brain’s processing of food intake occurs outside awareness. The Conclusions (page not provided) similarly say homeostatic processes operate outside awareness and that weight loss cannot simply be willed. The paper does not address a patient’s perception of maintaining a diet despite a weight-loss plateau or establish that unconscious appetite regulation explains that perception. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Interpretationcitation
Avoiding overeating to match increased appetite requires relatively persistent effort that grows with weight lost.
“Furthermore, a relatively persistent effort is required to avoid overeating to match the increased appetite that grows in proportion to the weight lost31.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [31] Polidori, 2016, How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake, Obesity (Silver Spring) source
- Premisecitation
Obesity interventions usually produce rapid early weight loss, then a plateau, then gradual regain.
“Obesity interventions typically result in early rapid weight loss followed by a weight plateau and progressive regain.”
- Also stated in: § Introduction · plain
“weight regain is typical1–3”
Quote in the paperSubstantial claim1 of 3 sources checked- cites [1] Loveman, 2011, The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review, Health Technol Assess source
- cites [2] Wing, 2005, Long-term weight loss maintenance, Am J Clin Nutr source
- cites [3] Wu, 2009, Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis, Obes Rev source
The Discussion reports partial long-term weight regain in both diet-only and diet-plus-exercise programmes. It does not establish the claimed typical sequence of rapid early loss, a plateau, and progressive regain. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Also stated in: § Introduction · plain
- Findingcitation
In the model, the exponential rise in calorie intake from its initially reduced level was the main factor stopping weight loss within the first year.
“However, the exponential rise in calorie intake from its initially reduced value is the primary factor that halts weight loss within the first year.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [27] Hall, 2011, Quantification of the effect of energy imbalance on bodyweight, Lancet source
The Introduction (page unavailable) says the model predicts a progressive rise in energy intake after an initial reduction and that relaxing the reduction can explain the observed weight-loss plateau within the first year. It does not describe that rise as exponential or establish it definitively as the primary factor; it says changing diet adherence is the more likely explanation for the observed plateau. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [31] Polidori, 2016, How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake, Obesity (Silver Spring) source
- Interpretationreasoning
Preventing weight regain requires about 300-500 kcal/d of increased persistent effort to counter slowing metabolism and increased appetite after weight loss.
“However, such a small difference in food intake behavior is somewhat misleading considering that prevention of weight regain requires about 300–500 kcal/d of increased persistent effort to counter the ongoing slowing of metabolism and increased appetite associated with the lost weight.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [31] Polidori, 2016, How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake, Obesity (Silver Spring) source
The Results describe persistent effort to resist increased appetite, and the Discussion says maintaining weight loss involves both increased appetite and suppressed energy expenditure. The paper estimates an appetite increase of about 100 kcal/day per kilogram lost, but does not state that preventing weight regain generally requires 300–500 kcal/day of effort; that amount depends on how much weight was lost. Page numbers were unavailable in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measured
- Study design and conductcitation
The study used a validated mathematical model of human energy balance dynamics to simulate weight loss trajectories.
“Using a validated mathematical model of human energy balance dynamics27,31, Figure 2 illustrates the energy balance dynamics underlying the weight loss time courses of two example 90 kg women who either regain (blue curves) or maintain (orange curves) much of their lost weight after reaching a plateau within the first year of a diet intervention.”
Quote in the paperSubstantial claim2 of 2 sources checked - Interpretationcitation
A slow upward drift in energy intake would be hard to detect because daily energy intake fluctuates by 20-30%.
“Such a slow drift upwards in energy intake would be difficult to detect given the large 20–30% fluctuations in energy intake from day to day38,39.”
Quote in the paperSubstantial claim1 of 2 sources checked - Premisecitation
Studies of financial rewards for weight loss or tobacco cessation yield initial benefits that wane over time.
“For example, studies of financial rewards to incentivize behavioral changes, such as weight loss or tobacco cessation, yield initial benefits that invariably wane precipitously over time80,81.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [80] Halpern, 2015, Randomized trial of four financial-incentive programs for smoking cessation, N Engl J Med source
The Results (Effectiveness and Costs of Interventions) report that roughly half of those abstinent at six months submitted negative cotinine assays at 12 months, supporting a decline in documented abstinence after incentives ended. But the paper does not support 'invariably': reward-based programs remained superior to usual care at 12 months. The Discussion also describes unsustained early benefits in weight-loss trials specifically for group-oriented versus individual-oriented payments, not financial rewards generally. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [81] Volpp, 2008, Financial incentive-based approaches for weight loss: a randomized trial, JAMA source
The Discussion reports substantial weight regain three months after the incentive phase, supporting an initial benefit that waned. But the Results say incentive participants still weighed significantly less than at baseline after seven months, so this study does not establish that benefits invariably wane precipitously. It studied weight loss, not tobacco cessation. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Premisecitation
Self-blame is associated with numerous negative health outcomes.
“(which itself is associated with numerous negative health outcomes85)”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [85] Kahan, 2017, The damaging effects of weight bias internalization, Obesity (Silver Spring) source
The paper’s Abstract links weight bias internalization—self-directed, weight-related shaming and negative attitudes—to several adverse health outcomes, including poorer self-reported health, binge eating, and maladaptive health behaviors. It does not establish the same association for self-blame generally, without the weight-related qualifier. (LLM, conf=0.85)
Experimental — accuracy not yet measured
- Interpretationcitation
Longer-term sustained motivation is more likely when patients take ownership of behavioral changes and goals and engage in them because they are deeply meaningful or enjoyable.
“longer term sustained motivation is more likely when patients take ownership of their behavioral changes and goals, and engage in them because they are deeply meaningful or enjoyable80,81.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [80] Halpern, 2015, Randomized trial of four financial-incentive programs for smoking cessation, N Engl J Med source
The Results report sustained smoking abstinence under financial-incentive programs, and the Discussion attributes a possible behavioral effect of deposits to loss aversion. Neither section addresses whether taking ownership of goals or finding a behavior meaningful or enjoyable makes long-term motivation more likely; searches for those concepts found no supporting passage in our copy. (LLM, conf=0.74)
Experimental — accuracy not yet measured - cites [81] Volpp, 2008, Financial incentive-based approaches for weight loss: a randomized trial, JAMA source
The Discussion says that sustaining weight loss after financial incentives is an outstanding question and that substantial weight was regained after the intervention. It does not address whether taking ownership of goals or finding changes meaningful or enjoyable makes sustained motivation more likely (searched: ownership, intrinsic motivation, and long-term motivation). (LLM, conf=0.75)
Experimental — accuracy not yet measured
- Premisecitation
In a survey of primary care physicians, acceptable behavioral weight loss was considered to be a loss of 21% of initial body weight.
“Physician expectations are similarly inflated: in a survey of primary care physicians, acceptable behavioral weight loss was considered to be a loss of 21% of initial body weight83.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [83] Phelan, 2009, What do physicians recommend to their overweight and obese patients?, J Am Board Fam Med source
The Weight Loss Outcomes section reports that surveyed family physicians and internists considered about 21.5% weight loss acceptable for a hypothetical patient, calculated from the patient's initial weight. The Survey section does not specify behavioral treatment for that question, so the source supports the percentage but not the claim's behavioral-treatment qualifier. (LLM, conf=0.85)
Experimental — accuracy not yet measured
- Premisecitation
For practical purposes, a calorie is a calorie for body fat and energy expenditure differences between controlled isocaloric diets varying in carbohydrate-to-fat ratio.
“and, for all practical purposes, “a calorie is a calorie” when it comes to body fat and energy expenditure differences between controlled isocaloric diets varying in the ratio of carbohydrate to fat49.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [49] Hall, 2017, Obesity energetics: body weight regulation and the effects of diet composition, Gastroenterology source
- Premisecitation
Although research is mixed, several studies show improved weight loss outcomes in patients receiving weight maintenance-specific training compared with those receiving only traditional weight loss training.
“Although the research is mixed, several studies show improved weight loss outcomes in patients receiving weight maintenance-specific training, compared with those who only receive traditional weight loss training76–79.”
Quote in the paperSubstantial claim3 of 4 sources checked- cites [76] Perri, 2008, Extended-care programs for weight management in rural communities: the treatment of obesity in underserved rural settings (TOURS) randomized trial, Arch Intern Med source
The Results report that women receiving telephone or face-to-face extended-care counseling regained less weight than the education control group after all groups completed the same initial lifestyle program. But the Methods say the control group also received newsletters and problem-solving handouts about maintaining weight loss, so it was not a comparison with patients receiving only traditional weight-loss training. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [77] Svetkey, 2008, Comparison of strategies for sustaining weight loss: the weight loss maintenance randomized controlled trial, JAMA source
- cites [78] Voils, 2017, Maintenance of weight loss after initiation of nutrition training: a randomized trial, Ann Intern Med source
The Abstract Results report significantly less weight regain with maintenance-specific training, and the Discussion compares this finding with other maintenance trials. However, this study compared the intervention with usual care, which involved no contact except study measurements—not with continued traditional weight-loss training. The cited paper therefore supports the benefit of maintenance training, but not the stated comparator. (LLM, conf=0.87)
Experimental — accuracy not yet measured - cites [79] Wing, 2006, A self-regulation program for maintenance of weight loss, N Engl J Med source
The Discussion (page not provided) reports that maintenance-specific self-regulation interventions were more effective than newsletters at maintaining weight loss. The study did not compare them with traditional weight-loss training, so it does not support the stated comparator. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Premisecitation
Meta-analyses of long-term weight loss suggest low-fat diets are slightly, if statistically, inferior to low-carbohydrate diets.
“Meta-analyses of long-term weight loss have suggested that low-fat weight loss diets are slightly, if statistically, inferior to low-carbohydrate diets53, but the average differences between diets is too small to be clinically significant54.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [53] Tobias, 2015, Effect of low-fat vs. other diet interventions on long-term weight change in adults: a systematic review and meta-analysis, Lancet Diabetes Endocrinol source
- Premisecitation
Some variability in weight loss may be due to interactions between diet type and patient genetics or baseline physiology such as insulin sensitivity.
“Some of this variability may be due to interactions between diet type and patient genetics62,63 or baseline physiology such as insulin sensitivity64–67.”
Quote in the paperNot a substantial claim4 of 6 sources checked- cites [62] Bray, 2016, The role of macronutrient content in the diet for weight management, Endocrinol Metab Clin North America source
- cites [63] Bray, 2016, NIH working group report—using genomic information to guide weight management: from universal to precision treatment, Obesity (Silver Spring) source
- cites [64] Cornier, 2005, Insulin sensitivity determines the effectiveness of dietary macronutrient composition on weight loss in obese women, Obes Res source
- cites [65] Ebbeling, 2007, Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial, JAMA source
- cites [66] McClain, 2013, Adherence to a low-fat vs. low-carbohydrate diet differs by insulin resistance status, Diabetes Obes Metab source
- cites [67] Pittas, 2005, A low-glycemic load diet facilitates greater weight loss in overweight adults with high insulin secretion but not in overweight adults with low insulin secretion in the CALERIE Trial, Diabetes Care source
The Results (page not provided) report that baseline insulin secretion interacted with diet type in predicting weight loss. But the same section reports no interaction between diet and HOMA-R, the study’s measure of insulin resistance; it therefore does not support insulin sensitivity as the specific example. The genetics portion is attributed to other citations. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Interpretationcitation
Lifestyle changes over the long term will likely improve health even without major weight loss.
“Such lifestyle changes over the long-term will likely improve the health of patients even in the absence of major weight loss96.”
Quote in the paperSubstantial claim1 of 3 sources checked- cites [94] Promotion CfNPa. Dietary Guidelines for Americans. 2015. Available at: https://www.cnpp.usda.gov/2015-2020-dietary-guidelines-americans. Accessed July 14, 2017. source
- cites [95] Promotion OoDPaH. Physical activity guidelines for Americans. 2008. Available at: https://health.gov/paguidelines/guidelines. Accessed July 14, 2017.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [96] Matheson, 2012, Healthy lifestyle habits and mortality in overweight and obese individuals, J Am Board Fam Med source
The Discussion (page not provided) associates healthy habits with lower mortality regardless of baseline BMI, supporting the expectation of a long-term health benefit. But the study did not measure whether participants changed their habits or lost weight, so it does not establish that the benefit occurs specifically without major weight loss. (LLM, conf=0.82)
Experimental — accuracy not yet measured
- Interpretationreasoning
Patients may genuinely believe they are maintaining their diet even when weight loss has stopped or weight is regained.
“It is entirely possible that patients truly believe they are sticking with their diet despite not losing any more weight or even regaining weight.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [33] Freedhoff, 2016, Weight loss diet studies: we need help not hype, Lancet source
- Premisecitation
The simple calculations behind old weight loss guidelines are flawed because they ignore declining energy expenditure as weight is lost.
“We now know that the simple calculations underlying the old weight loss guidelines are fatally flawed because they fail to consider declining energy expenditure with weight loss26.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [26] Rosenbaum, 2008, Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight, Am J Clin Nutr source
- Interpretationreasoning
Long-term weight management is extremely difficult because biology, behavior, and the obesogenic environment interact.
“Long term weight management is extremely challenging due to interactions between our biology, behavior, and the obesogenic environment.”
Quote in the paperSubstantial claim - Interpretationcitation
The overlapping physiological changes after weight loss explain the common trajectory of rapid initial loss, plateau after several months, and progressive regain.
“The overlapping physiological changes that occur with weight loss help explain the near-ubiquitous weight loss time course: early rapid weight loss that stalls after several months, followed by progressive weight regain32.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [32] Franz, 2007, Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up, J Am Diet Assoc source
- Interpretationcitation
A waning intervention effort may be due to disappointment in the degree of weight loss actually achieved, leading patients to conclude the effort is not worth the benefits.
“From a cognitive psychology perspective, a waning intervention effort may be due to disappointment in the degree of weight loss actually achieved82 leading the patient to conclude that the effort is not worth the achieved benefits84.”
Quote in the paperSubstantial claim0 of 2 sources checked - Interpretationreasoning
Even high-quality short-term interventions are unlikely to produce continued positive outcomes without ongoing intervention and support.
“Even the highest quality short-term interventions are unlikely to yield continued positive outcomes without persisting intervention and support.”
Quote in the paperSubstantial claim - Interpretationreasoning
Non-biological factors likely play a strong role in whether diet adherence is sustainable.
“Such non-biological factors likely play a strong role in determining whether diet adherence is sustainable.”
Quote in the paperSubstantial claim - Interpretationreasoning
Long-term success with a weight loss diet may depend less on biology than on food environment, socioeconomics, medical comorbidities, social support, and practical factors like cooking skills and job requirements.
“In other words, long-term success with a weight loss diet may have less to do with biology than factors such as the patient’s food environment, socioeconomics, medical comorbidities, and social support, as well as practical factors, such as developing cooking skills and managing job requirements.”
Quote in the paperSubstantial claim - Interpretationcitation
Similar mean weight loss patterns across diet groups in randomized trials strongly suggest no generalizable advantage of one diet over another for long-term calorie intake or expenditure.
“Furthermore, the similarity of the mean weight loss patterns between diet groups in randomized weight loss trials strongly suggests that there is no generalizable advantage of one diet over another when it comes to long-term calorie intake or expenditure33.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [33] Freedhoff, 2016, Weight loss diet studies: we need help not hype, Lancet source
- Interpretationreasoning
During weight maintenance there are fewer explicit rewards than during weight loss.
“Unlike with weight loss, during which the external reward of watching the scale decrease and clinical measures (e.g., lipid levels) improve can increase motivation, the extended period of weight maintenance has fewer of these explicit rewards.”
Quote in the paperSubstantial claim - Premisecitation
Important aspects of the carbohydrate-insulin model have failed experimental testing.
“Unfortunately, important aspects of the carbohydrate-insulin model have failed experimental interrogation48 and, for all practical purposes, “a calorie is a calorie” when it comes to body fat and energy expenditure differences between controlled isocaloric diets varying in the ratio of carbohydrate to fat49.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [48] Hall, 2017, A review of the carbohydrate-insulin model of obesity, Eur J Clin Invest source
- Interpretationcitation
External, superficial rewards are unlikely to support the long-term endurance needed for weight maintenance.
“External, superficial rewards are unlikely to support the long term endurance needed for weight maintenance.”
Quote in the paperSubstantial claim - Interpretationnone given
The more typical long-term weight regain pattern is characterized by decreasing effort to sustain the intervention.
“The more typical pattern of long-term weight regain is characterized by a waning effort to sustain the intervention.”
Quote in the paperNot a substantial claim - Premisecitation
Average differences between weight loss diets are too small to be clinically significant.
“but the average differences between diets is too small to be clinically significant54.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [54] Hall, 2015, Prescribing low-fat diets: useless for long-term weight loss?, Lancet Diabetes Endocrinol source
- Premisecitation
Several studies show that ongoing interaction with healthcare providers or in group settings significantly improves weight maintenance and long-term outcomes compared with treatments that end after a short period.
“Several studies show that ongoing interaction with healthcare providers or in group settings significantly improves weight maintenance and long-term outcomes, compared with treatments that end after a short period of time (Figure 3)70,71.”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
In one study, patients entering a diet and exercise program expected to lose 20-40% of starting body weight, amounts only realistically achieved by bariatric surgery.
“In one study, patients entering a diet and exercise program expected to lose 20–40% of their starting body weight - amounts that can only realistically be achieved by bariatric surgery82.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [82] Foster, 1997, What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes, J Consulting Clin Psychol source
- Premisecitation
Long-term diet trials have not shown clear average superiority of one diet over another for weight loss.
“Whereas long-term diet trails have not resulted in clear superiority of one diet over another with respect to average weight loss, within each diet group there is a high degree of individual variability and anecdotal success stories abound for a wide range of weight loss diets33.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [33] Freedhoff, 2016, Weight loss diet studies: we need help not hype, Lancet source
- Interpretationcitation
Helping patients shift their locus of motivation from weight loss alone to intrinsically meaningful areas such as health improvement can improve long-term weight and behavioral outcomes.
“Helping patients shift their locus of motivation from weight loss alone to intrinsically meaningful areas, such as health improvement, can improve long term weight and behavioral outcomes89.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [89] Silva, 2010, Using self-determination theory to promote physical activity and weight control: a randomized controlled trial in women, J Behav Med source
- May combine two claims. 26
- Classified as probably not a substantial claim. 4
May combine two claims.
FindingcitationIn the model, both example women had rapid weight and fat loss after large initial calorie intake reductions, with a modest decrease in calorie expenditure that slowed weight loss.
“In both women, large decreases in calorie intake at the start of the intervention result in rapid loss of weight and body fat leading to a modest decrease in calorie expenditure that contributes to slowing weight loss.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [27] Hall, 2011, Quantification of the effect of energy imbalance on bodyweight, Lancet source
In the Introduction’s ‘Modelling of the dynamics of weight change’ passage (page unavailable), Figure 1D describes two women given low-calorie liquid diets and says the model reproduced their differing rates of weight loss. The paper also explains that changes in energy expenditure affect weight-loss dynamics, but our copy does not specifically report rapid body-fat loss or a modest decline in expenditure that slowed weight loss in both women. (LLM, conf=0.83)
Experimental — accuracy not yet measured - cites [31] Polidori, 2016, How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake, Obesity (Silver Spring) source
The Results (page unavailable) describe a large initial reduction in energy intake, weight loss, and relatively minor changes in energy expenditure. The paper presents an average weight trajectory, not two example women, and these passages do not establish their body-fat loss. The Results and Discussion attribute the weight-loss plateau chiefly to intake returning toward baseline, rather than to the modest expenditure decrease. (LLM, conf=0.87)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationIn a meta-analysis of 29 long-term weight loss studies, more than half of lost weight was regained within two years and more than 80% by five years.
“In a meta-analysis of 29 long-term weight loss studies, more than half of the lost weight was regained within two years, and by five years more than 80% of lost weight was regained (Figure 1)4.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [4] Anderson, 2001, Long-term weight-loss maintenance: a meta-analysis of US studies, Am J Clin Nutr source
The Abstract reports 29 included studies. The Results report that participants maintained 44% of their initial weight loss at two years, meaning 56% was regained. At five years they maintained 21%, meaning 79%—not more than 80%—was regained. (LLM, conf=0.91)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationSelf-reported diet measurements are inaccurate and imprecise.
“While self-reported diet measurements are notoriously inaccurate and imprecise34–36, it may be possible to reconcile such data with objectively quantified increases in calorie intake.”
Quote in the paperSubstantial claim1 of 3 sources checkedMay combine two claims.
FindingcitationAt the model weight plateau, calorie expenditure was less than 200 kcal/d below baseline, while appetite had risen by 400-600 kcal/d and energy intake by 600-700 kcal/d since intervention start.
“In contrast to the modest drop in calorie expenditure of less than 200 kcal/d at the weight plateau, appetite has risen by 400–600 kcal/d and energy intake has increased by 600–700 kcal/d since the start of the intervention.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [27] Hall, 2011, Quantification of the effect of energy imbalance on bodyweight, Lancet source
The Introduction (page unavailable) predicts that energy intake rises after an initial dietary reduction until it meets expenditure at the weight plateau. It does not report an appetite increase of 400–600 kcal/day, an intake increase of 600–700 kcal/day, or an expenditure drop of less than 200 kcal/day at that plateau. (LLM, conf=0.88)
Experimental — accuracy not yet measured - cites [31] Polidori, 2016, How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake, Obesity (Silver Spring) source
May combine two claims.
PremisecitationLong-term maintenance of lost weight is more difficult than initial weight loss, which can be achieved by various treatment methods.
“Weight loss can be achieved through a variety of modalities, but long-term maintenance of lost weight is much more challenging.”
- Also stated in: § Introduction · plain
“Substantial weight loss is possible across a range of treatment modalities, but long-term sustenance of lost weight is much more challenging, and weight regain is typical1–3.”
Quote in the paperSubstantial claim1 of 3 sources checked- cites [1] Loveman, 2011, The clinical effectiveness and cost-effectiveness of long-term weight management schemes for adults: a systematic review, Health Technol Assess source
- cites [2] Wing, 2005, Long-term weight loss maintenance, Am J Clin Nutr source
- cites [3] Wu, 2009, Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis, Obes Rev source
- Also stated in: § Introduction · plain
May combine two claims.
PremisecitationWeight loss causes persistent endocrine adaptations that raise appetite and lower satiety, opposing further loss and long-term maintenance.
“Weight loss is accompanied by persistent endocrine adaptations30 that increase appetite and decrease satiety31 thereby resisting continued weight loss and conspiring against long-term weight maintenance.”
Quote in the paperSubstantial claim1 of 2 sources checked- cites [30] Sumithran, 2011, Long-term persistence of hormonal adaptations to weight loss, N Engl J Med source
- cites [31] Polidori, 2016, How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake, Obesity (Silver Spring) source
The Discussion (page not available) reports that weight loss increases appetite and makes long-term maintenance difficult; it also says this pattern is consistent with changes in appetite-regulating hormones. The paper does not report a decrease in satiety or establish that endocrine adaptations cause the increased appetite. In the citing sentence, the separate citation 30 is attached to the endocrine-adaptations phrase. (LLM, conf=0.85)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationFor each kilogram of weight lost, calorie expenditure falls by about 20-30 kcal/day while appetite rises by about 100 kcal/day above pre-weight-loss baseline.
“Specifically, it has been estimated that for each kilogram of lost weight, calorie expenditure decreases by about 20–30 kcal/d whereas appetite increases by about 100 kcal/d above the baseline level prior to weight loss31.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [31] Polidori, 2016, How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake, Obesity (Silver Spring) source
May combine two claims.
PremisecitationUltraprocessed foods now supply most calories consumed in the United States, and their overconsumption has been implicated as a cause of weight gain.
“Ultraprocessed foods13 now contribute the majority of calories consumed in America14 and their overconsumption has been implicated as a causative factor in weight gain15.”
Quote in the paperNot a substantial claim3 of 3 sources checked- cites [13] Monteiro, 2010, A new classification of foods based on the extent and purpose of their processing, Cad Saude Publica source
- cites [14] Martinez Steele, 2016, Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study, BMJ open source
- cites [15] Mendonca, 2016, Ultraprocessed food consumption and risk of overweight and obesity: the University of Navarra Follow-Up (SUN) cohort study, Am J Clin Nutr source
May combine two claims.
PremisecitationHigher-protein diets may help maintain weight loss, especially when the overall diet has a low glycemic index.
“Diets with higher protein may also offer benefits for maintaining weight loss58, particularly when the overall diet has a low glycemic index59.”
Quote in the paperSubstantial claim1 of 2 sources checkedMay combine two claims.
InterpretationcitationDespite modest weight losses from behavioral interventions, small weight losses can lead to impressive health improvements and risk factor reductions.
“Despite the modest weight losses associated with behavioral interventions, small weight losses can lead to impressive health improvements and risk factor reductions.”
Quote in the paperSubstantial claim2 of 3 sources checked- cites [86] Knowler, 2002, Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin, N Engl J Med source
- cites [87] Espeland, 2014, Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: the action for health in diabetes, Diabetes Care source
The Conclusions report weight loss alongside improvements in diabetes control, blood pressure, lipids, and other health measures. But the study concerns overweight or obese adults with type 2 diabetes, and its intervention combined weight loss with increased physical activity; it does not establish that small weight losses alone produce these improvements across behavioral interventions generally. (LLM, conf=0.84)
Experimental — accuracy not yet measured - cites [88] Wing, 2013, Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes, N Engl J Med source
May combine two claims.
PremisecitationWeight-loss-specific behaviors associated with long-term success include frequent self-monitoring and self-weighing, reduced calorie intake, smaller and more frequent meals or snacks, increased physical activity, consistently eating breakfast, more at-home meals, reducing screen time, and use of portion-controlled meals or meal substitutes.
“Weight-loss specific behaviors associated with long term success include: frequent self-monitoring and self-weighing, reduced calorie intake, smaller and more frequent meals/snacks throughout the day, increased physical activity, consistently eating breakfast, more frequent at-home meals compared with restaurant and fast-food meals, reducing screen time, and use of portion-controlled meals or meal”
Quote in the paperSubstantial claim1 of 4 sources checked- cites [2] Wing, 2005, Long-term weight loss maintenance, Am J Clin Nutr source
- cites [73] Pi-Sunyer, 2007, Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial, Diabetes Care source
The Introduction (page not provided) describes calorie restriction, increased physical activity, and portion-controlled diets with meal replacements; the Conclusions link the intervention to weight loss at one year. Our copy does not establish the full list as behaviors associated with long-term success: it does not report the claimed meal frequency, breakfast, at-home dining, or screen-time habits, and says the long-term impact remains unclear. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites [74] Thomas, 2014, Weight-loss maintenance for 10 years in the National Weight Control Registry, Am J Prev Med source
- cites [75] Wing, 2001, Successful weight loss maintenance, Annu Rev Nutr source
May combine two claims.
PremisecitationLow-carbohydrate, high-fat diets may cause spontaneous reduction in calorie intake and increased weight loss, especially in the short term.
“Nevertheless, low-carbohydrate, high-fat diets may lead to spontaneous reduction in calorie reduction and increased weight loss, especially over the short term50–52.”
Quote in the paperNot a substantial claim1 of 3 sources checked- cites [50] Foster, 2003, A randomized trial of a low-carbohydrate diet for obesity, N Engl J Med source
- cites [51] Gardner, 2007, Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z weight loss study: a randomized trial, JAMA source
- cites [52] Samaha, 2003, A low-carbohydrate as compared with a low-fat diet in severe obesity, N Engl J Med sourceExperimental — accuracy not yet measured
May combine two claims.
PremisecitationBoth patients and healthcare providers have unrealistic expectations for weight loss outcomes.
“Both patients and healthcare providers have wildly unrealistic expectations for weight loss outcomes.”
Quote in the paperSubstantial claim1 of 2 sources checkedMay combine two claims.
PremisecitationDiet-biology interactions for weight loss have not always been reproducible and likely explain only a fraction of individual variability.
“Unfortunately, diet-biology interactions for weight loss have not always been reproducible68,69 and likely explain only a fraction of the individual variability.”
Quote in the paperSubstantial claim1 of 2 sources checked- cites [68] Gardner, 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [69] Gardner, 2016, Weight loss on low-fat vs. low-carbohydrate diets by insulin resistance status among overweight adults and adults with obesity: a randomized pilot trial, Obesity (Silver Spring) source
May combine two claims.
PremisecitationDietary protein positively influences body composition during weight loss and has a small positive effect on resting metabolism.
“In contrast to the near equivalency of dietary carbohydrate and fat, dietary protein is known to positively influence body composition during weight loss55,56 and has a small positive effect on resting metabolism57.”
Quote in the paperSubstantial claim1 of 3 sources checked- cites [55] Leidy, 2015, The role of protein in weight loss and maintenance, Am J Clin Nutr source
- cites [56] Westerterp-Plantenga, 2009, Dietary protein, weight loss, and weight maintenance, Annu Rev Nutr source
- cites [57] Wycherley, 2012, Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials, Am J Clin Nutr source
May combine two claims.
InterpretationreasoningExcessive discrepancies between expectations and actual outcomes would be demoralizing and increase negative thoughts and self-blame, and may diminish long-term persistence for behavioral change and weight loss maintenance.
“it stands to reason that excessive discrepancies between expectations and actual outcomes would be demoralizing and increase negative thoughts and self-blame (which itself is associated with numerous negative health outcomes85), and may diminish long term persistence for continued behavioral change and weight loss maintenance.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [85] Kahan, 2017, The damaging effects of weight bias internalization, Obesity (Silver Spring) source
May combine two claims.
PremisecitationFor patients with BMI greater than 30 kg/m2, or 27-30 kg/m2 with obesity-related comorbid conditions, obesity pharmacotherapy leads to as much as 15% weight loss in responders, with weight loss maintained in several studies for several years.
“For patients with BMI greater than 30 kg/m2 (or 27–30 kg/m2 with obesity-related comorbid conditions), obesity pharmacotherapy leads to as much as 15% weight loss in responders, with weight loss being maintained in several studies for several years90–92.”
Quote in the paperSubstantial claim1 of 3 sources checked- cites [90] Allison, 2012, Controlled-release phentermine/topiramate in severely obese adults: a randomized controlled trial (EQUIP), Obesity (Silver Spring) source
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured - cites [91] le Roux, 2017, 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial, Lancet source
- cites [92] Torgerson, 2004, XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients, Diabetes Care source
May combine two claims.
PremisecitationIn the Look Ahead trial, 6% weight loss over eight years yielded improvements in cardiovascular risk factors, glycemic control, lipids, less medication usage, and reduced hospitalizations and healthcare costs.
“In the Look Ahead trial, 6% weight loss over eight years yielded improvements in a range of cardiovascular risk factors, including glycemic control and lipids, as well as less medication usage, and reduced hospitalizations and healthcare costs87,88.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [87] Espeland, 2014, Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: the action for health in diabetes, Diabetes Care source
The Conclusions (page unavailable) report improvements in diabetes-control markers and plasma lipids, as well as fewer hospitalizations, less medication use, and lower health-care costs with the intensive lifestyle intervention. They describe outcomes over 10 years, however, and do not establish that 6% weight loss over eight years yielded those benefits. The paper also notes that the intervention did not significantly reduce major cardiovascular events. (LLM, conf=0.88)
Experimental — accuracy not yet measured - cites [88] Wing, 2013, Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes, N Engl J Med source
The Results (Weight, Waist Circumference and Fitness; Cardiovascular Disease Risk Factors) report 6.0% weight loss at study end, improved HbA1c and several cardiovascular risk factors, and lower use of antihypertensives, statins and insulin. But median follow-up was 9.6 years, not eight; LDL cholesterol was lower in the control group; and the Clinical Outcomes section found no significant difference in cardiovascular events, including hospitalized angina. Our copy does not report reduced overall hospitalizations or healthcare costs. (LLM, conf=0.90)
Experimental — accuracy not yet measured
May combine two claims.
InterpretationreasoningAppetite changes likely contribute more than slowed metabolism to the weight loss plateau because the long-term calorie intake feedback circuit is stronger than the expenditure feedback circuit.
“Appetite changes likely play a more important role than slowing metabolism in explaining the weight loss plateau since the feedback circuit controlling long-term calorie intake has greater overall strength than the feedback circuit controlling calorie expenditure.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningChanges in food and physical activity environments together promote increased intake, decreased activity, and weight gain.
“Taken together, changes in the food and physical activity environments tend to drive individuals towards increased intake, decreased activity, and ultimately weight gain.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationNumerous studies show that diet, exercise, and behavioral counseling at best lead to 5-10% average weight loss, and few patients with significantly elevated initial weights achieve and maintain an ideal body weight.
“In contrast, numerous studies show that diet, exercise, and behavioral counseling, in the best of cases, only leads to 5–10% average weight loss, and few patients with significantly elevated initial weights achieve and maintain an “ideal” body weight.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S4 (based). May combine two claims.
InterpretationreasoningHelping patients recognize and restructure core beliefs and thought processes helps minimize behavioral fatigue and prevent or manage slips and lapses.
“Helping patients to recognize and restructure the core beliefs and thought processes that underlie these patterns helps minimize behavioral fatigue and prevent or productively manage slips and lapses.”
Quote in the paperNot a substantial claim- Rests on an assumption: Cycles of negative and maladaptive thoughts and coping patterns are counterproductive and demotivating.
Probably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningExpecting strict, all-out efforts and black-and-white outcomes over lifelong obesity management leads to frustration and failure.
“expecting strict, all-out efforts and clear-cut, black-and-white outcomes over the lifelong management of obesity is a recipe for frustration and failure.”
Quote in the paperNot a substantial claim- Rests on an assumption: Many tendencies that promote initial weight loss are unrealistic over the long term.
- Rests on an assumption: Expecting strict, all-out efforts and black-and-white outcomes over lifelong obesity management leads to frustration and failure.
May combine two claims.
PremisecitationWithin each diet group there is high individual variability and anecdotal success with many diets.
“within each diet group there is a high degree of individual variability and anecdotal success stories abound for a wide range of weight loss diets33.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [33] Freedhoff, 2016, Weight loss diet studies: we need help not hype, Lancet source
Classified as probably not a substantial claim. May combine two claims.
InterpretationcitationLong-term behavioral changes and obesity management require ongoing attention.
“Long term behavioral changes and obesity management require ongoing attention.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationFor patients with BMI greater than 40 kg/m2, or 35-40 kg/m2 with comorbidities, bariatric surgery is a well-studied and valuable option that leads to large, sustainable weight losses in most patients.
“For patients with BMI greater than 40 kg/m2 (or 35–40 kg/m2 with comorbidities), bariatric surgery is a well-studied and valuable option that leads to large, sustainable weight losses in most patients93.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [93] Sjostrom, 2012, Bariatric surgery and long-term cardiovascular events, JAMA source
Classified as probably not a substantial claim.
InterpretationreasoningLong-term management is improved when motivations are aligned with personal values and preferences.
“As described in the section above, long term management is improved when motivations are aligned with personal values and preferences.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationIn the Diabetes Prevention Program, 7% weight loss over six months led to a 58% reduction in development of diabetes, despite half the weight being regained over three years.
“In the Diabetes Prevention Program, 7% weight loss over six months led to 58% reduction in development of diabetes, despite half the weight being regained over three years86.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [86] Knowler, 2002, Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin, N Engl J Med source
The paper relies on this without support.
People tend to focus on what they have not achieved rather than what they have accomplished.
“People tend to focus on what they haven’t achieved, rather than what they’ve already accomplished.”
The paper relies on this without support.
Cycles of negative and maladaptive thoughts and coping patterns are counterproductive and demotivating.
“Cycles of negative and maladaptive thoughts (e.g., “What’s the point…I failed again and I’ll never lose weight!”) and coping patterns (e.g., binge eating in response to gaining a few pounds) are counterproductive and demotivating.”
The paper relies on this without support.
Many tendencies that promote initial weight loss are unrealistic over the long term.
“Many tendencies that promote initial weight loss are unrealistic over the long term.”
The paper relies on this without support.
Expecting strict, all-out efforts and black-and-white outcomes over lifelong obesity management leads to frustration and failure.
“expecting strict, all-out efforts and clear-cut, black-and-white outcomes over the lifelong management of obesity is a recipe for frustration and failure.”
The paper relies on this without support.
The laws of thermodynamics apply to human energy balance and diet composition.
“The laws of thermodynamics dictate that the energy derived from macronutrients being oxidized via the intricate biochemical pathways of oxidative phosphorylation inside cells can be equated to the values measured by combusting these fuels in a bomb calorimeter.”
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?
Studies comparing dietary composition have generally demonstrated modest effects on weight maintenance, with differences between diets attenuating over time, particularly beyond one year.
“studies comparing dietary composition (e.g., variations in protein content, carbohydrate restriction, or glycemic index) have generally demonstrated modest effects on weight maintenance, with differences between diets attenuating over time, particularly beyond one year”
From Weight maintenance after discontinuation of GLP-1 therapies (2026) · cites this paper as [61]
In “The role of diet composition” (page unavailable), the paper says long-term differences between low-fat and low-carbohydrate diets are too small to be clinically significant and finds no clear long-term superiority among diets. It also notes possible benefits of higher-protein, low-glycemic-index diets and greater short-term weight loss with low-carbohydrate diets. These passages support generally modest long-term differences, but do not establish that differences attenuate over time specifically beyond one year. (LLM, conf=0.84)
Experimental — accuracy not yet measuredHigher protein diets (1.2-1.6 g/kg of adjusted bodyweight versus standard 0.8 g/kg) may prevent metabolic adaptation.
“Higher protein diets (1.2–1.6 g/kg of adjusted bodyweight versus standard 0.8 g/kg) may prevent this type of metabolic adaptation”
From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [270]
In “The role of diet composition” (page not provided), the paper says dietary protein has a small positive effect on resting metabolism and that higher-protein diets may help maintain weight loss. It does not say they prevent metabolic adaptation or specify 1.2–1.6 g/kg of adjusted bodyweight versus 0.8 g/kg. (LLM, conf=0.84)
Experimental — accuracy not yet measuredBehavioral approaches (strengthening satisfaction with outcomes, relapse prevention training, cognitive restructuring, developing cognitive flexibility, appealing to deeper motivations, and managing expectations) are helpful for preventing weight regain.
“Some behavioral approaches to weight loss that have been shown to be helpful for preventing weight regain include strengthening satisfaction with outcomes, relapse prevention training, cognitive restructuring, developing cognitive flexibility, appealing to deeper motivations, and managing expectations”
From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [270]
The Clinical recommendations section discusses all six approaches as strategies for long-term weight management. But its overview says research on maintenance-specific training is mixed, and the “Manage expectations” subsection says evidence is mixed on whether unrealistic expectations deter success. The claim overstates the evidence by saying all six have been shown to prevent weight regain. (LLM, conf=0.84)
Experimental — accuracy not yet measuredDuring the weight maintenance phase, weight regain can occur secondary to decreased energy expenditure and increased energy efficiency, which together result in a net decrease in caloric needs.
“During the weight maintenance phase, weight regain can occur secondary to decreased energy expenditure and increased energy efficiency, which together result in a net decrease in caloric needs5–8.”
From Orforglipron for maintenance of body weight reduction: the double-blind, randomized phase 3b ATTAIN-MAINTAIN trial (2026) · cites this paper as [6]
The “Physiological responses to weight loss” section (page unavailable) reports declining energy expenditure after weight loss, and “Weight regain versus maintenance” says that preventing regain requires sustained effort against ongoing metabolic slowing and increased appetite. The copy does not identify increased energy efficiency as a separate contributor to reduced caloric needs; it also emphasizes increased appetite as an important driver of regain. (LLM, conf=0.85)
Experimental — accuracy not yet measuredNon-pharmacological interventions to reduce weight in a general population have shown only transient effect on obesity.
“Non-pharmacological interventions to reduce weight in a general population have shown only transient effect on obesity (8).”
From Reversibility of Antipsychotic-Induced Weight Gain: A Systematic Review and Meta-Analysis (2021) · cites this paper as [8]
The Introduction reports that weight regain is typical, and the section “Long term benefits require long term attention” says short-term interventions are unlikely to sustain benefits without ongoing support. But the paper also reports that continued behavioral support improves long-term weight maintenance, so “only transient effect” overstates its conclusion about non-pharmacological interventions. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Hormonal and metabolic changes induced by weight reduction result in elevated appetite and reduced metabolic rate.
“Hormonal and metabolic changes induced by weight reduction result in elevated appetite and reduced metabolic rate [13][14][15].”
From Nutritional considerations with antiobesity medications (2024) · cites this paper as [14]
Lifestyle interventions result in up to 10% mean weight loss, but weight maintenance remains a challenge, as 80% of weight loss is expected to be regained over the next 5 years.
“Lifestyle interventions (including diet, exercise and behavioural changes) are the cornerstone of obesity management with diverse benefits, but even the most intensive lifestyle interventions result in up to 10% mean weight loss (WL) and weight maintenance remains a challenge, as 80% of WL is expected to be regained over the next 5 years [4, 5].”
From What is the pipeline for future medications for obesity? (2025) · cites this paper as [4]
Many patients with obesity start with a low-fat diet, which is composed of a relatively large amount of carbohydrates, because fats contain the highest calories among macronutrients.
“Many patients with obesity start with a low-fat diet, which is composed of a relatively large amount of carbohydrates, because fats contain the highest calories among macronutrients [5,6].”
Increased appetite promotes increased energy intake and weight regain.
“Increased appetite promotes increased energy intake and weight regain4,31, and is therefore likely to have contributed to a positive energy balance and thereby the weight regain of almost 50% of the initial weight loss within one year observed in the placebo group.”
Nutrient-specific effects have been postulated, but are likely to be overwhelmed by variable behavioural responses to dietary advice.
“Nutrient-specific effects have been postulated, but are likely to be overwhelmed by variable behavioural responses to dietary advice [65].”
It is difficult for people living with obesity and type 2 diabetes to achieve and maintain long-term weight loss.
“Unfortunately, it is difficult for people living with obesity and T2D to achieve and maintain long-term weight loss [5].”
From Long-term Weight Loss in a Primary Care-Anchored eHealth Lifestyle Coaching Program: Randomized Controlled Trial (2022) · cites this paper as [5]
Environmental factors, such as easy availability of high calorie foods and limited social support, contribute to weight regain.
“Environmental factors, such as the easy availability of high calorie foods and limited social support, further contribute to weight regain [12].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [12]
Monitoring included tracking energy intake and physical activity, which enabled early detection of deviations from established targets.
“Monitoring also included tracking energy intake and physical activity, which enabled early detection of deviations from established targets [12,132].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [12]
Individuals maintaining weight loss outcomes typically engaged in 200-300 min of moderate physical activity per week, often distributed across most days.
“Individuals maintaining weight loss outcomes typically engaged in 200–300 min of moderate physical activity per week, often distributed across most days of the week [12].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [12]
Individuals maintaining weight loss outcomes consumed meals at regular intervals, which supported appetite regulation and reduced the likelihood of impulsive eating.
“These individuals consumed meals at regular intervals, which supported appetite regulation and reduced the likelihood of impulsive eating [12,132].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [12]
Their diets were generally characterized by moderate energy density and a predominance of minimally processed foods.
“Their diets were generally characterized by moderate energy density and a predominance of minimally processed foods [12,132,133].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [12]
Approximately 78% of individuals maintaining weight loss outcomes reported regular breakfast consumption.
“Approximately 78% of individuals maintaining weight loss outcomes reported regular breakfast consumption [12,132].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [12]
In groups of individuals who maintained long-term weight loss, regular physical activity was reported significantly more frequently.
“In groups of individuals who maintained long-term weight loss, regular physical activity was reported significantly more frequently [12,125,132].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [12]
More pronounced and predictable effects have been observed when physical activity is combined with dietary changes.
“More pronounced and predictable effects have been observed when physical activity is combined with dietary changes [12,132].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [12]
Individuals who maintained long-term weight loss were more likely to systematically monitor their weight and behaviors, engage in regular physical activity, and maintain a consistent pattern of eating habits.
“This population was more likely to systematically monitor their weight and behaviors, engage in regular physical activity, and maintain a consistent pattern of eating habits [12,132,133].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [12]
After significant weight reduction, about one-third, more than half, and almost all patients with obesity return to their original weight within 1, 2, and 5 years, respectively.
“Even if they achieve significant weight reduction, approximately one-third, more than half, and almost the total population with obesity return to their original weight within a year, 2 years, and 5 years, respectively [9].”
From Long-Term Efficacy and Safety of Anti-Obesity Treatment: Where Do We Stand? (2021) · cites this paper as [9]
Most guidelines strongly recommend medical treatment for patients with obesity who cannot achieve adequate weight loss from lifestyle interventions.
“Thus, currently, most guidelines on obesity control strongly recommend medical treatment for patients with obesity who cannot achieve adequate weight loss from lifestyle interventions [8, 9].”
From Long-Term Efficacy and Safety of Anti-Obesity Treatment: Where Do We Stand? (2021) · cites this paper as [9]
Anti-obesity medications have been developed mainly by reducing appetite and energy intake, promoting energy expenditure, and lowering calorie absorption.
“Numerous medications for obesity treatment have been developed mainly by exploiting the following mechanisms: (1) reducing appetite and thereby energy intake, (2) promoting energy expenditure, and (3) lowering calorie absorption [7–9].”
From Long-Term Efficacy and Safety of Anti-Obesity Treatment: Where Do We Stand? (2021) · cites this paper as [9]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Self-check results appear here once an independent check has confirmed them.
Cited works that were retracted
Works this paper cites that were later retracted, from the retraction notices publishers deposit. Major when the notice came out before this paper was published.
Cites a retracted work: 10.1001/jama.2016.20036
InfoThe cited work was retracted on 2018-12-18 (notice 10.1001/jama.2018.18136), not before this paper was published (2018-01).
Cited work 10.1001/jama.2016.20036 · retracted 2018-12-18 · notice 10.1001/jama.2018.18136 · this paper published 2018-01
“Snook, 2017, Change in percentages of adults with overweight or obesity trying to lose weight, 1988-2014, JAMA, 317, 971, 10.1001/jama.2016.20036”
Cites
1 retracted
Change in Percentages of Adults With Overweight or Obesity Trying to Lose Weight, 1988-2014
Snook, K., Hansen, A. R., Duke, C. H., Finch, K. C., Hackney, A. A., & Zhang, J. (2017) · JAMA · doi:10.1001/jama.2016.20036 · Cited by 55 · see citing works
RetractedReduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011 · cited 1× · see citing works
“In the Diabetes Prevention Program, 7% weight loss over 6 months led to 58% reduction in development of diabetes, despite half the weight being regained over 3 years.(86)”
BackgroundThe Physical Activity Guidelines for Americans
Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., George, S. M., & Olson, R. D. (2018) · JAMA · doi:10.1001/jama.2018.14854 · Cited by 9,755 · see citing works
‘Small Changes' to Diet and Physical Activity Behaviors for Weight Management
Hills, A. P., Byrne, N. M., Lindstrom, R. C., & Hill, J. O. (2013) · Obesity Facts · doi:10.1159/000345030 · Cited by 9,526 · see citing works
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Lippa, N. C., & Sanderson, S. C. (2013) · Human Heredity · doi:10.1159/000353712 · Cited by 6,093 · see citing works
The global obesity pandemic: shaped by global drivers and local environments
Swinburn, B. A., Sacks, G., Hall, K. D., McPherson, K., Finegood, D. T., Moodie, M. L., & Gortmaker, S. L. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60813-1 · Cited by 4,888 · see citing works
Self-citation2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.11.004 · Cited by 4,058 · see citing works
The Stigma of Obesity: A Review and Update
Puhl, R. M., & Heuer, C. A. (2009) · Obesity · doi:10.1038/oby.2008.636 · Cited by 3,323 · cited 1× · see citing works
“Failure to achieve and maintain substantial weight loss over the long term is then simply attributed to poor adherence to the prescribed lifestyle changes, thereby potentially further stigmatizing the patient as lacking in willpower, motivation, or fortitude to lose weight.(25) It is now known that the simple calculat…”
BackgroundCardiovascular effects of intensive lifestyle intervention in type 2 diabetes
The Look AHEAD Research Group (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1212914 · Cited by 2,908 · see citing works
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437739.71477.ee · Cited by 2,735 · see citing works
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Blundell, J. E., Baker, J. L., Boyland, E. J., Blaak, E. E., Charzewska, J., Henauw, S. D., Frühbeck, G., González‐Gross, M., Hebebrand, J., Holm, L., et al. (2017) · Obesity Facts · doi:10.1159/000455952 · Cited by 1,980 · 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 · see citing works
XENical in the Prevention of Diabetes in Obese Subjects (XENDOS) Study
Torgerson, J. S., Hauptman, J., Boldrin, M. N., & Sjöström, L. (2004) · Diabetes Care · doi:10.2337/diacare.27.1.155 · Cited by 1,915 · see citing works
A Randomized Trial of a Low-Carbohydrate Diet for Obesity
Foster, G. D., Wyatt, H. R., Hill, J. O., McGuckin, B. G., Brill, C., Mohammed, B. S., Szapary, P. O., Rader, D. J., Edman, J. S., & Klein, S. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022207 · Cited by 1,794 · see citing works
Bariatric Surgery and Long-term Cardiovascular Events
Sjöström, L., Peltonen, M., Jacobson, P., Sjöström, C. D., Karason, K., Wedel, H., Ahlin, S., Anveden, Å., Bengtsson, C., Bergmark, G., et al. (2012) · JAMA · doi:10.1001/jama.2011.1914 · Cited by 1,656 · cited 1× · see citing works
“For patients with BMI greater than 40 kg/m(2) (or 35–40 kg/m(2) with comorbidities), bariatric surgery is a well-studied and valuable option that leads to large, sustainable weight losses in most patients.(93)”
BackgroundFranz, M. J., VanWormer, J. J., Crain, A. L., Boucher, J. L., Histon, T., Caplan, W., Bowman, J. D., & Pronk, N. P. (2007) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2007.07.017 · Cited by 1,559 · cited 1× · see citing works
“The overlapping physiologic changes that occur with weight loss help explain the near-ubiquitous weight loss time course: early weight loss that stalls after several months, followed by progressive weight regain.(32) Different interventions result in varying degrees of weight loss and regain, but the overall time cour…”
BackgroundReduction in Weight and Cardiovascular Disease Risk Factors in Individuals With Type 2 Diabetes
The Look AHEAD Research Group (2007) · Diabetes Care · doi:10.2337/dc07-0048 · Cited by 1,522 · see citing works
Long-term persistence of hormonal adaptations to weight loss
Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., Kriketos, A., & Proietto, J. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1105816 · Cited by 1,449 · see citing works
S<scp>UCCESSFUL</scp> W<scp>EIGHT</scp> L<scp>OSS</scp> M<scp>AINTENANCE</scp>
Wing, R. R., & Hill, J. O. (2001) · Annual Review of Nutrition · doi:10.1146/annurev.nutr.21.1.323 · Cited by 1,382 · see citing works
Long-term weight-loss maintenance: a meta-analysis of US studies
Anderson, J. W., Konz, E. C., Frederich, R. C., & Wood, C. L. (2001) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/74.5.579 · Cited by 1,351 · cited 1× · see citing works
“1).(4) Indeed, previous failed attempts at achieving durable weight loss may have contributed to the recentdecrease in thepercentageofpeoplewithobesitywhoare trying to lose weight,(5) and many now believe that weight loss is a futile endeavor.”
BackgroundChurch, T. S., Thomas, D. M., Tudor-Locke, C., Katzmarzyk, P. T., Earnest, C. P., Rodarte, R. Q., Martin, C. K., Blair, S. N., & Bouchard, C. (2011) · PLoS ONE · doi:10.1371/journal.pone.0019657 · Cited by 1,294 · see citing works
A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity
Samaha, F. F., Iqbal, N., Seshadri, P., Chicano, K. L., Daily, D. A., McGrory, J., Williams, T., Williams, M., Gracely, E. J., & Stern, L. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022637 · Cited by 1,267 · see citing works
Medicare's search for effective obesity treatments: Diets are not the answer.
Mann, T., Tomiyama, A. J., Westling, E., Lew, A.-M., Samuels, B., & Chatman, J. (2007) · American Psychologist · doi:10.1037/0003-066x.62.3.220 · Cited by 1,208 · cited 1× · see citing works
“Indeed, previous failed attempts at achieving durable weight loss may have contributed to the recentdecrease in thepercentageofpeoplewithobesitywhoare trying to lose weight,(5) and many now believe that weight loss is a futile endeavor.(6)”
BackgroundQuantification of the effect of energy imbalance on bodyweight
Hall, K. D., Sacks, G., Chandramohan, D., Chow, C. C., Wang, Y. C., Gortmaker, S. L., & Swinburn, B. A. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60812-x · Cited by 1,165 · cited 1× · see citing works
“gov) that uses a mathematical model to account for dynamic changes in human energy balance.(27) In addition to adaptations in energy expenditure with weight loss, body weight is regulated by negative feedback circuits that influence food intake.”
MethodSelf-citationDietary Guidelines for Americans
DeSalvo, K. B., Olson, R., & Casavale, K. O. (2016) · JAMA · doi:10.1001/jama.2015.18396 · Cited by 1,067 · see citing works
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A new classification of foods based on the extent and purpose of their processing
Monteiro, C. A., Levy, R. B., Claro, R. M., Castro, I. R. R. D., & Cannon, G. (2010) · Cadernos de Saúde Pública · doi:10.1590/s0102-311x2010001100005 · Cited by 991 · see citing works
Financial Incentive–Based Approaches for Weight Loss: A Randomized Trial
Volpp, K. G., John, L. K., Troxel, A. B., Norton, L., Fassbender, J., & Loewenstein, G. (2008) · JAMA · doi:10.1001/jama.2008.804 · Cited by 923 · cited 2× · see citing works
“Whereas “white knuckling” and external, controlled motivations, such as directives from a spouse or health care provider, may lead to short-term weight loss, longer-term sustained motivation is more likely when patients take ownership of their behavioral changes and goals, and engage in them because they are deeply me…”
Backgroundle Roux, C. W., Astrup, A., Fujioka, K., Greenway, F., Lau, D. C. W., Van Gaal, L., Ortiz, R. V., Wilding, J. P. H., Skjøth, T. V., Manning, L. S., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30069-7 · Cited by 850 · see citing works
Diets with high or low protein content and glycemic index for weight-loss maintenance
Larsen, T. M., Dalskov, S.-M., van Baak, M., Jebb, S. A., Papadaki, A., Pfeiffer, A. F. H., Martinez, J. A., Handjieva-Darlenska, T., Kunešová, M., Pihlsgård, M., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1007137 · Cited by 843 · cited 1× · see citing works
“Diets with higher protein may also offer benefits for maintaining weight loss,(58) particularly when the overall diet has a low glycemic index.(59) Improved weight loss maintenance with higher protein diets might be partially mediated by protein’s greater effect on satiety compared with carbohydrate and fat(55,56) alo…”
BackgroundMartínez Steele, E., Baraldi, L. G., Louzada, M. L. D. C., Moubarac, J.-C., Mozaffarian, D., & Monteiro, C. A. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-009892 · Cited by 838 · see citing works
A self-regulation program for maintenance of weight loss
Wing, R. R., Tate, D. F., Gorin, A. A., Raynor, H. A., & Fava, J. L. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa061883 · Cited by 830 · see citing works
Toward a theory-based analysis of behavioral maintenance
Rothman, A. J. (2000) · Health Psychology · doi:10.1037/0278-6133.19.suppl1.64 · Cited by 783 · cited 1× · see citing works
“From a cognitive psychology perspective, a waning intervention effort may be due to disappointment in the degree of weight loss actually achieved,(82) leading the patient to conclude that the effort is not worth the achieved benefits.(84) Although the published data are mixed on whether unrealistic outcomes will deter…”
BackgroundSvetkey, L. P. (2008) · JAMA · doi:10.1001/jama.299.10.1139 · Cited by 748 · see citing works
Allison, D. B., Gadde, K. M., Garvey, W. T., Peterson, C. A., Schwiers, M. L., Najarian, T., Tam, P. Y., Troupin, B., & Day, W. W. (2012) · Obesity · doi:10.1038/oby.2011.330 · Cited by 711 · see citing works
Stuckler, D., McKee, M., Ebrahim, S., & Basu, S. (2012) · PLoS Medicine · doi:10.1371/journal.pmed.1001235 · Cited by 666 · see citing works
Mendonça, R. D. D., Pimenta, A. M., Gea, A., de la Fuente-Arrillaga, C., Martinez-Gonzalez, M. A., Lopes, A. C. S., & Bes-Rastrollo, M. (2016) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.116.135004 · Cited by 618 · cited 1× · see citing works
“Ultraprocessed foods(13) now contribute most of the calories consumed in America,(14) and their overconsumption has been implicated as a causative factor in weight gain.(15) Such foods are typically more calorically dense and far less healthy than unprocessed foods, such as fruits, vegetables, and fish.”
BackgroundWycherley, T. P., Moran, L. J., Clifton, P. M., Noakes, M., & Brinkworth, G. D. (2012) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.044321 · Cited by 606 · cited 1× · see citing works
“In contrast to the near equivalency of dietary carbohydrate and fat, dietary protein is known to positively influence body composition during weight loss(55,56) and has a small positive effect on resting metabolism.(57) Diets with higher protein may also offer benefits for maintaining weight loss,(58) particularly whe…”
BackgroundDietary protein, weight loss, and weight maintenance
Westerterp-Plantenga, M. S., Nieuwenhuizen, A., Tomé, D., Soenen, S., & Westerterp, K. R. (2009) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-080508-141056 · Cited by 570 · see citing works
Energy balance measurement: when something is not better than nothing
Dhurandhar, N. V., Schoeller, D., Brown, A. W., Heymsfield, S. B., Thomas, D., Sørensen, T. I. A., Speakman, J. R., Jeansonne, M., Allison, D. B., & the Energy Balance Measurement Working Group (2015) · International Journal of Obesity · doi:10.1038/ijo.2014.199 · Cited by 567 · see citing works
How accurate is self-reported dietary energy intake?
Schoeller, D. A. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.1990.tb02882.x · Cited by 559 · see citing works
NIH working group report: Innovative research to improve maintenance of weight loss
MacLean, P. S., Wing, R. R., Davidson, T. L., Epstein, L. H., Goodpaster, B. H., Hall, K. D., Levin, B. E., Perri, M. G., Rolls, B. J., ROSENBAUM, M. S., et al. (2014) · Obesity · doi:10.1002/oby.20967 · Cited by 556 · cited 2× · see citing works
“Unraveling the biological, psychosocial, educational, and environmental determinants of such individual variability will be an active area of obesity research for the foreseeable future.(45)”
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Wu, T., Gao, X., Chen, M., & Van Dam, R. M. (2009) · Obesity Reviews · doi:10.1111/j.1467-789x.2008.00547.x · Cited by 515 · see citing works
The role of protein in weight loss and maintenance
Leidy, H. J., Clifton, P. M., Astrup, A., Wycherley, T. P., Westerterp-Plantenga, M. S., Luscombe-Marsh, N. D., Woods, S. C., & Mattes, R. D. (2015) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.114.084038 · Cited by 475 · see citing works
Foster, G. D., Wadden, T. A., Vogt, R. A., & Brewer, G. (1997) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.65.1.79 · Cited by 460 · cited 1× · see citing works
“In one study, patients entering a diet and exercise program expected to lose 20% to 40% of their starting body weight, amounts that can only realistically be achieved by bariatric surgery.(82) Physician expectations are similarly inflated: in a survey of primary care physicians, acceptable behavioral weight loss was c…”
BackgroundSilva, M. N., Vieira, P. N., Coutinho, S. R., Minderico, C. S., Matos, M. G., Sardinha, L. B., & Teixeira, P. J. (2010) · Journal of Behavioral Medicine · doi:10.1007/s10865-009-9239-y · Cited by 448 · cited 1× · see citing works
“Helping patients shift their locus of motivation from weight loss alone to intrinsically meaningful areas, such as health improvement, can improve long-term weight and behavioral outcomes.(89)”
BackgroundFoster, G. D., Wadden, T. A., Vogt, R. A., & Brewer, G. (1997) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.65.1.79 · Cited by 447 · see citing works
Blaming the brain for obesity: integration of hedonic and homeostatic mechanisms
Berthoud, H.-R., Münzberg, H., & Morrison, C. D. (2017) · Gastroenterology · doi:10.1053/j.gastro.2016.12.050 · Cited by 445 · cited 1× · see citing works
“The patient’s perception of ongoing diet maintenance despite no further weight loss may arise because the physiologic regulation of appetite occurs in brain regions that operate below the patient’s conscious awareness.(37) Thus, signals to the brain that increase appetite with weight loss could introduce subconscious…”
BackgroundRosenbaum, 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 · cited 1× · see citing works
“It is now known that the simple calculations underlying the old weight loss guidelines are fatally flawed because they fail to consider declining energy expenditure with weight loss.(26) More realistic calculations of expected weight loss for a given change in energy intake or physical activity are provided by a Web-b…”
MethodPhysiological adaptations to weight loss and factors favouring weight regain
Greenway, F. L. (2015) · International Journal of Obesity · doi:10.1038/ijo.2015.59 · Cited by 431 · cited 1× · see citing works
“In addition to adaptations in energy expenditure with weight loss, body weight is regulated by negative feedback circuits that influence food intake.(28,29) Weight loss is accompanied by persistent endocrine adaptations(30) that increase appetite and decrease satiety,(31) thereby resisting continued weight loss and co…”
BackgroundEffects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance
Ebbeling, C. B., Swain, J. F., Feldman, H. A., Wong, W. W., Hachey, D. L., Garcia-Lago, E., & Ludwig, D. S. (2012) · JAMA · doi:10.1001/jama.2012.6607 · Cited by 431 · cited 1× · see citing works
“Improved weight loss maintenance with higher protein diets might be partially mediated by protein’s greater effect on satiety compared with carbohydrate and fat(55,56) along with the possibility of increased overall energy expenditure.(60) More research is needed to better understand whether these potentially positive…”
BackgroundRandomized trial of four financial-incentive programs for smoking cessation
Halpern, S. D., French, B., Small, D. S., Saulsgiver, K., Harhay, M. O., Audrain-McGovern, J., Loewenstein, G., Brennan, T. A., Asch, D. A., & Volpp, K. G. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1414293 · Cited by 379 · cited 2× · see citing works
“Whereas “white knuckling” and external, controlled motivations, such as directives from a spouse or health care provider, may lead to short-term weight loss, longer-term sustained motivation is more likely when patients take ownership of their behavioral changes and goals, and engage in them because they are deeply me…”
BackgroundTobias, D. K., Chen, M., Manson, J. E., Ludwig, D. S., Willett, W., & Hu, F. B. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00367-8 · Cited by 373 · 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 · cited 1× · see citing works
““a calorie is a calorie” when it comes to body fat and energy expenditure differences between controlled isocaloric diets widely varying in the ratio of carbohydrate to fat.(49) Nevertheless, low-carbohydrate, high-fat diets may lead to spontaneous reduction in calorie intake and increased weight loss, especially over…”
BackgroundSelf-citationWeight-loss maintenance for 10 years in the National Weight Control Registry
Thomas, J. G., Bond, D. S., Phelan, S., Hill, J. O., & Wing, R. R. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2013.08.019 · Cited by 358 · see citing works
High protein intake sustains weight maintenance after body weight loss in humans
Westerterp-Plantenga, M. S., Lejeune, M. P. G. M., Nijs, I., van Ooijen, M., & Kovacs, E. M. R. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802461 · Cited by 326 · see citing works
Effects of four maintenance programs on the long-term management of obesity
Perri, M. G., McAllister, D. A., Gange, J. J., Jordan, R. C., McAdoo, W. G., & Nezu, A. M. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.4.529 · Cited by 304 · cited 1× · see citing works
“3).(70,71) The importance of long-term intervention has been codified in the obesity treatment guidelines, which state that weight loss interventions should include long-term comprehensive weight loss maintenance programs that continue for at least 1 year.”
BackgroundLoveman, E., Frampton, G., Shepherd, J., Picot, J., Cooper, K., Bryant, J., Welch, K., & Clegg, A. (2011) · Health Technology Assessment · doi:10.3310/hta15020 · Cited by 296 · see citing works
Salt, sugar, fat: how the food giants hooked us
(2013) · Choice Reviews Online · doi:10.5860/choice.50-6793 · Cited by 289 · see citing works
Effects of a Low–Glycemic Load vs Low-Fat Diet in Obese Young Adults: A Randomized Trial
Ebbeling, C. B., Leidig, M. M., Feldman, H. A., Lovesky, M. M., & Ludwig, D. S. (2007) · JAMA · doi:10.1001/jama.297.19.2092 · Cited by 284 · see citing works
Ross Middleton, K. M., Patidar, S. M., & Perri, M. G. (2012) · Obesity Reviews · doi:10.1111/j.1467-789x.2011.00972.x · Cited by 276 · cited 1× · see citing works
“3).(70,71) The importance of long-term intervention has been codified in the obesity treatment guidelines, which state that weight loss interventions should include long-term comprehensive weight loss maintenance programs that continue for at least 1 year.”
BackgroundPerri, M. G., Limacher, M. C., Durning, P. E., Janicke, D. M., Lutes, L. D., Bobroff, L. B., Dale, M. S., Daniels, M. J., Radcliff, T. A., & Martin, A. D. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.21.2347 · Cited by 266 · see citing works
Polidori, D., Sanghvi, A., Seeley, R. J., & Hall, K. D. (2016) · Obesity · doi:10.1002/oby.21653 · Cited by 209 · cited 3× · see citing works
“Perhaps self-reported diet maintenance before and after the weight plateau is more representative of the patients’ relatively persistent effort to avoid overeating in response to their increased appetite.(31) New technologies using repeated weight monitoring can be used to calculate changes in calorie intake and effor…”
BackgroundInfluentialSelf-citationEspeland, M. A., Glick, H. A., Bertoni, A., Brancati, F. L., Bray, G. A., Clark, J. M., Curtis, J. M., Egan, C., Evans, M., Foreyt, J. P., et al. (2014) · Diabetes Care · doi:10.2337/dc14-0093 · Cited by 174 · cited 1× · see citing works
“In the Look Ahead trial, 6% weight loss over 8 years yielded improvements in a range of cardiovascular risk factors, including glycemic control and lipids, as well as less medication usage, and reduced hospitalizations and health care costs.(87,88)”
BackgroundPittas, A. G., Das, S. K., Hajduk, C. L., Golden, J., Saltzman, E., Stark, P. C., Greenberg, A. S., & Roberts, S. B. (2005) · Diabetes Care · doi:10.2337/diacare.28.12.2939 · Cited by 163 · see citing works
Increasing Adiposity: Consequence or Cause of Overeating?
Ludwig, D. S., & Friedman, M. I. (2014) · JAMA · doi:10.1001/jama.2014.4133 · Cited by 151 · see citing works
Healthy lifestyle habits and mortality in overweight and obese individuals
Matheson, E. M., King, D. E., & Everett, C. J. (2012) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2012.01.110164 · Cited by 150 · cited 1× · see citing works
“Such lifestyle changes over the long term will likely improve the health of patients even in the absence of major weight loss.(96)”
BackgroundCornier, M., Donahoo, W. T., Pereira, R., Gurevich, I., Westergren, R., Enerback, S., Eckel, P. J., Goalstone, M. L., Hill, J. O., Eckel, R. H., et al. (2005) · Obesity Research · doi:10.1038/oby.2005.79 · Cited by 140 · see citing works
Bray, M. S., Loos, R. J. F., McCaffery, J. M., Ling, C., Franks, P. W., Weinstock, G. M., Snyder, M. P., Vassy, J. L., Agurs‐Collins, T., & The Conference Working Group (2016) · Obesity · doi:10.1002/oby.21381 · Cited by 138 · see citing works
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A review of the carbohydrate–insulin model of obesity
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Self-citationMartin, C. K., Miller, A. C., Thomas, D. M., Champagne, C. M., Han, H., & Church, T. S. (2015) · Obesity · doi:10.1002/oby.21063 · Cited by 115 · see citing works
Smith, G. I., Yoshino, J., Kelly, S. C., Reeds, D. N., Okunade, A., Patterson, B. W., Klein, S., & Mittendorfer, B. (2016) · Cell Reports · doi:10.1016/j.celrep.2016.09.047 · Cited by 111 · cited 1× · see citing works
“More research is needed to better understand whether these potentially positive attributes of higher protein diets outweigh concerns that such diets mitigate improvements in insulin sensitivity that are typically achieved with weight loss using lower protein diets.(61) Whereas long-term diet trials have not resulted i…”
BackgroundOchner, C. N., Tsai, A. G., Kushner, R. F., & Wadden, T. A. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00009-1 · Cited by 110 · cited 1× · see citing works
“In addition to adaptations in energy expenditure with weight loss, body weight is regulated by negative feedback circuits that influence food intake.(28,29) Weight loss is accompanied by persistent endocrine adaptations(30) that increase appetite and decrease satiety,(31) thereby resisting continued weight loss and co…”
BackgroundHartwell, D., Jones, J., Baxter, L., & Shepherd, J. (2011) · Health Technology Assessment · doi:10.3310/hta15170 · Cited by 84 · see citing works
The fundamental flaw in obesity research
Winkler, J. T. (2005) · Obesity Reviews · doi:10.1111/j.1467-789x.2005.00186.x · Cited by 81 · see citing works
Sanghvi, A., Redman, L. M., Martin, C. K., Ravussin, É., & Hall, K. D. (2015) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.111070 · Cited by 72 · see citing works
Self-citationSmartloss: A Personalized Mobile Health Intervention for Weight Management and Health Promotion
Martin, C. K., Gilmore, L. A., Apolzan, J. W., Myers, C. A., Thomas, D. M., & Redman, L. M. (2016) · JMIR mhealth and uhealth · doi:10.2196/mhealth.5027 · Cited by 66 · see citing works
The damaging effects of weight bias internalization
Kahan, S., & Puhl, R. M. (2017) · Obesity · doi:10.1002/oby.21772 · Cited by 65 · see citing works
Self-citationWeight 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 · cited 3× · see citing works
“These mathematical model results contrast with patients’ reports of eating approximately the same diet after the weight plateau that was previously successful during the initial phases of weight loss.(33) Although self-reported diet measurements are notoriously inaccurate and imprecise, it is entirely possible that pa…”
BackgroundResultInfluentialSelf-citationWhat do physicians recommend to their overweight and obese patients?
Phelan, S., Nallari, M., Darroch, F. E., & Wing, R. R. (2009) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2009.02.080081 · Cited by 54 · cited 1× · see citing works
“Physician expectations are similarly inflated: in a survey of primary care physicians, acceptable behavioral weight loss was considered to be a loss of 21% of initial body weight.(83) In contrast, numerous studies show that diet, exercise, and behavioral counseling, in the best of cases, only leads to 5% to 10% averag…”
BackgroundHealth Behavior Change in Populations
Kahan, S. I. (2014) · Johns Hopkins University Press eBooks · doi:10.56021/9781421414553 · Cited by 52 · see citing works
Self-citationEvaluation of long-term dietary intakes of adults consuming self-selected diets
Kim, W., Kelsay, J., Judd, J., Marshall, M., Mertz, W., & Prather, E. (1984) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/40.6.1327 · Cited by 51 · cited 1× · see citing works
“from day to day.(38,39) Furthermore, a relatively persistent effort is required to avoid overeating to match the increased appetite that grows in proportion to the weight lost.”
BackgroundMaintenance of Weight Loss After Initiation of Nutrition Training: A Randomized Trial
Voils, C. I., Olsen, M. K., Gierisch, J. M., McVay, M. A., Grubber, J. M., Gaillard, L., Bolton, J., Maciejewski, M. L., Strawbridge, E., & Yancy, W. S. (2017) · Annals of Internal Medicine · doi:10.7326/m16-2160 · Cited by 50 · see citing works
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“from day to day.(38,39) Furthermore, a relatively persistent effort is required to avoid overeating to match the increased appetite that grows in proportion to the weight lost.”
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Self-citation
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6 of the 105 references couldn’t be matched to a known paper.
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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
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BackgroundThe Promise of Digital Health: Then, Now, and the Future
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“The overall weight loss market in the U.S. in 2020 was estimated at $71 billion, yet many programs elicit only marginal and temporary changes in weight, with participants often experiencing weight regain (LaRosa, 2020; Hall and Kahan, 2018).”
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“Weight loss is not substantially greater for low- than for high-carbohydrate diets in long-term trials (7, 125, 130, 131, 133, 135)”
BackgroundArd, J., Fitch, A., Fruh, S., & Herman, L. (2021) · Advances in Therapy · doi:10.1007/s12325-021-01710-0 · Cited by 297 · see citing works
“Such an environment encompasses the interrelated issues of exposure to high-density, highly caloric foods, the relatively low cost of these foods, and physical environments that limit the scope of physical activity [13].”
BackgroundSemaglutide for the treatment of overweight and obesity: A review
Bergmann, N. C., Davies, M. J., Lingvay, I., & Knop, F. K. (2023) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.14863 · Cited by 265 · see citing works
“Weight loss with behavioural interventions often plateaus at a level of 5%10% and is associated with a high risk of relapse, which may be related to metabolic adaptation.(17,51) Although weight loss of 5%-10% is linked to improvements in cardiovascular (CV) risk factors, glycaemia and quality of life, reductions in bo…”
BackgroundEvidence-based European recommendations for the dietary management of diabetes
The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), Aas, A.-M., Axelsen, M., Churuangsuk, C., Hermansen, K., Kendall, C. W. C., Kahleova, H., Khan, T., Lean, M. E. J., Mann, J. I., et al. (2023) · Diabetologia · doi:10.1007/s00125-023-05894-8 · Cited by 262 · see citing works
“Energy expenditure can be boosted by a sustained increase in physical activity, however, the individual must usually consume a diet that contains less energy than previously consumed to maintain their weight loss [47].”
Excess body weight: Novel insights into its roles in obesity comorbidities
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“53 In contrast, structural interventions address broader environmental and systemic factors, potentially leading to widespread public health improvements.”
Fitbit-based interventions for healthy lifestyle outcomes: systematic review and meta-analysis
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“For example, while individuals entering a negative energy balance first observe weight loss, they experience reductions in most—if not all—components of energy expenditure which results in a decrease in the initial energy deficit (Hall and Kahan 2018; Müller and Bosy-Westphal 2013; Rosenbaum and Leibel 2010).”
BackgroundMechanisms of weight regain after weight loss — the role of adipose tissue
van Baak, M. A., & Mariman, E. C. M. (2019) · Nature Reviews Endocrinology · doi:10.1038/s41574-018-0148-4 · Cited by 203 · see citing works
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“Many patients with obesity start with a low-fat diet, which is composed of a relatively large amount of carbohydrates, because fats contain the highest calories among macronutrients [5,6].”
BackgroundChuruangsuk, C., Hall, J., Reynolds, A., Griffin, S. J., Combet, E., & Lean, M. E. J. (2022) · Diabetologia · doi:10.1007/s00125-021-05577-2 · Cited by 204 · see citing works
“Nutrient-specific effects have been postulated, but are likely to be overwhelmed by variable behavioural responses to dietary advice [65].”
BackgroundPervasiveness, impact and implications of weight stigma
Brown, A., Flint, S. W., & Batterham, R. L. (2022) · eClinicalMedicine · doi:10.1016/j.eclinm.2022.101408 · Cited by 212 · see citing works
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“54 Health-related benefits can be gained from health behavior changes with little change in body weight, 55,56 yet health messages primarily focus on weight loss and Western thin ideals, as well as diet and fitness cultures that stigmatize people with higher body weights.”
Obesity in South and Southeast Asia—A new consensus on care and management
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“Likewise, cognitive restructuring based around realistic weight loss goals can enhance patients' behavioral skills, extending into the long term.(95) Finally, it may be necessary to extend behavioral modification strategies to interventions that require medical supervision, including intermittent or extended use of VL…”
BackgroundIn the United States, Obesity Is So Prevalent Could It Be Described as a Pandemic?Preprint
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“One of the main reasons for participant attrition with traditional dieting—that is, daily calorie restriction (CR)— is frustration with having to count calories every day (6, 7).”
BackgroundTime-restricted eating: Watching the clock to treat obesity
Ezpeleta, M., Cienfuegos, S., Lin, S., Pavlou, V., Gabel, K., Tussing-Humphreys, L. M., & Varady, K. A. (2024) · Cell Metabolism · doi:10.1016/j.cmet.2023.12.004 · Cited by 161 · see citing works
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“However, long-term efficacy is often limited [9, 10], and the patient or the clinician may incorrectly interpret this as failure on the part of the patient rather than failure of treatment.”
BackgroundTransforming obesity: The advancement of multi-receptor drugs
Kusminski, C. M., Perez-Tilve, D., Müller, T. D., DiMarchi, R. D., Tschöp, M. H., & Scherer, P. E. (2024) · Cell · doi:10.1016/j.cell.2024.06.003 · Cited by 126 · see citing works
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“However, most individuals are unable to sustain their initial weight loss achieved via lifestyle interventions alone, often regaining more than half of the weight lost within 2 years and more than 80% within 5 years [28].”
BackgroundCompeting paradigms of obesity pathogenesis: energy balance versus carbohydrate-insulin models
Ludwig, D. S., Apovian, C. M., Aronne, L. J., Astrup, A. V., Cantley, L. C., Ebbeling, C. B., Heymsfield, S. B., Johnson, J. D., King, J. C., Krauss, R. M., et al. (2022) · European Journal of Clinical Nutrition · doi:10.1038/s41430-022-01179-2 · Cited by 118 · see citing works
“Indeed, dietary targets of EBM-based recommendations have changed from calorie counting in the early twentieth century [186] to an overarching focus on dietary fat restriction in the late twentieth century [173–177, 187], to the notion that all calories are alike [2, 18, 19], to the new formulation [9], subtitled “bey…”
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Gut Hormones in Health and Obesity: The Upcoming Role of Short Chain Fatty Acids
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Exploring the Impact of Obesity on Skeletal Muscle Function in Older Age
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“8,66,67 During that time, the use of medication emerged as the primary means of treatment.”
BackgroundThe Effects of Bariatric Surgery on Islet Function, Insulin Secretion, and Glucose Control
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“As can be expected, weight loss is difficult to achieve and usually takes several years prior to being successful [14].”
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“Further, the long-term sustainability of such diets is limited; they are frequently followed by progressive weight gain (60, 61).”
BackgroundObesity in Adults: A 2022 Adapted Clinical Practice Guideline for Ireland
Breen, C., O’Connell, J., Geoghegan, J., O'Shea, D. B., Birney, S., Tully, L., Gaynor, K., O’Kelly, M., O’Malley, G., O’Donovan, C. B., et al. (2022) · Obesity Facts · doi:10.1159/000527131 · Cited by 77 · see citing works
Depression of Accumbal to Lateral Hypothalamic Synapses Gates Overeating
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“This physiological response ensures the refill of energy stores, but it can lead to difficulties in sustaining reductions in bodyweight following diets based solely on caloric restriction or fasting (Hall and Kahan, 2018; Rosenbaum et al., 2010).”
BackgroundThe Role of Lifestyle in Male Infertility: Diet, Physical Activity, and Body Habitus
Hayden, R. P., Flannigan, R. K., & Schlegel, P. N. (2018) · Current Urology Reports · doi:10.1007/s11934-018-0805-0 · Cited by 73 · see citing works
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“29 Only 10–25% of individuals who will undergo different intensity lifestyle interventions will be able to lose and maintain ≥ 10% WL long-term.”
BackgroundRemission of Type 2 Diabetes Mellitus after Bariatric Surgery: Fact or Fiction?
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Periodic and Intermittent Fasting in Diabetes and Cardiovascular Disease
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“Looking at improving diet quality in the absence of weight loss is a more sustained approach to improving health and diet-related conditions [17].”
BackgroundA critical review of weight loss recommendations before total knee arthroplasty
Godziuk, K., Prado, C. M. M., Beaupré, L. A., Jones, C. A., Werle, J. R., & Forhan, M. A. (2020) · Joint Bone Spine · doi:10.1016/j.jbspin.2020.105114 · Cited by 66 · see citing works
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“Unfortunately, obesity interventions often result in quick weight loss followed by weight regain (3), highlighting the need for effective obesity-prevention methods.”
BackgroundTirzepatide did not impact metabolic adaptation in people with obesity, but increased fat oxidation
Ravussin, E., Sanchez-Delgado, G., Martin, C. K., Beyl, R. A., Greenway, F. L., O’Farrell, L. S., Roell, W. C., Qian, H.-R., Li, J., Nishiyama, H., et al. (2025) · Cell Metabolism · doi:10.1016/j.cmet.2025.03.011 · Cited by 72 · see citing works
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Differential mechanisms affecting weight loss and weight loss maintenance
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The benefit of telemedicine in obesity care
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“A metaanalysis of 29 longterm weight- loss studies found that >50% of weight lost was regained within 2 years and >80% of weight lost was regained within 5 years (19,33).”
BackgroundSelf-citationObesity and body mass index: Past and future considerations in osteoarthritis research
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Weight Reduction with GLP-1 Agonists and Paths for Discontinuation While Maintaining Weight Loss
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“The drivers for weight regain are hypometabolism and hyperphagia in the weight-reduced state [229–231].”
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“259 Another plausible treatment approach would be one which focusses on improving cardiometabolic health.”
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“Repeated failures to achieve idealistic weight loss outcome have the potential to demoralise and perpetuate negative thoughts and self-blame that further deter weight loss success [55,56].”
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“Body-weight loss decreases pathologies associated with obesity; however, it is challenging to maintain, leading to weight regain or weight cycling [74].”
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“increased drive to eat and a reduction in energy expenditure [8], mechanisms which probably evolved to protect against starvation [9].”
BackgroundHypoxic Exercise Training to Improve Exercise Capacity in Obese Individuals
Chacaroun, S., Borowik, A., GONZALEZ, I. V.-E. Y., Doutreleau, S., Wuyam, B., Belaïdi, E., Tamisier, R., Pépin, J., Flore, P., & Vergès, S. (2020) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002322 · Cited by 47 · see citing works
Di Rosa, C., Lattanzi, G., Spiezia, C., Imperia, E., Piccirilli, S., Beato, I., Gaspa, G., Micheli, V., De Joannon, F., Vallecorsa, N., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192013040 · Cited by 47 · see citing works
“Counseling, positive reinforcement, and motivation could help patients avoid weight regain [61].”
BackgroundSantos, H. O., & Lavie, C. J. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2021.01.033 · Cited by 48 · see citing works
Brandt, C. J., Clemensen, J., Nielsen, J. B., & Søndergaard, J. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-017466 · Cited by 46 · see citing works
“For weight loss to have a positive impact on health, it needs to be sustainable and especially longterm lifestyle changes (defined as more that 12–18 months) have proven difficult.(1) One of the major challenges for lifestyle change seems to be that social relationships are often challenged by peers, who do not unders…”
BackgroundZhou, T., Wang, Y., Yan, L., & Tan, Y. (2023) · Information Systems Research · doi:10.1287/isre.2022.1191 · Cited by 46 · see citing works
The energy balance hypothesis of obesity: do the laws of thermodynamics explain excessive adiposity?
Torres-Carot, V., Suárez-González, A., & Lobato-Foulques, C. (2022) · European Journal of Clinical Nutrition · doi:10.1038/s41430-021-01064-4 · Cited by 47 · see citing works
“Often people fail to achieve any weight loss at all, and the failure is then blamed on the obese people, who are accused of either not trying hard enough or being inaccurate about how much energy they ate or spent [51, 52].”
BackgroundKuk, J., Rotondi, M., Sui, X.-M., Blair, S., & Ardern, C. (2018) · Clinical Obesity · doi:10.1111/cob.12263 · Cited by 40 · see citing works
“Furthermore, given the low success rates for obesity reduction (39, 40) and the stigma and bias experienced by those struggling with obesity (41), it may be particularly important to confirm whether obesity itself is associated with increased morbidity and mortality risk or reduced quality of life outcomes.”
BackgroundAssociation between plausible genetic factors and weight loss from GLP1-RA and bariatric surgery
German, J., Cordioli, M., Tozzo, V., Urbut, S., Arumäe, K., Smit, R. A. J., Lee, J., Li, J. H., Janucik, A., Ding, Y., et al. (2025) · Nature Medicine · doi:10.1038/s41591-025-03645-3 · Cited by 53 · see citing works
“Maintaining weight loss may require additional lifestyle modifications, behavioral therapy or adjunct pharmacologic treatments like GLP1-RA 58,59 .”
Weight Management Interventions for Adults With Idiopathic Intracranial Hypertension
Abbott, S., Chan, F., Tahrani, A. A., Wong, S. H., Campbell, F. E. J., Parmar, C. D., Pournaras, D. J., Denton, A., Sinclair, A. J., & Mollan, S. P. (2023) · Neurology · doi:10.1212/wnl.0000000000207866 · Cited by 46 · see citing works
Hedin, K. A., Zhang, H., Kruse, V., Rees, V. E., Bäckhed, F., Greiner, T. U., Vazquez-Uribe, R., & Sommer, M. O. A. (2023) · ACS Synthetic Biology · doi:10.1021/acssynbio.3c00455 · Cited by 45 · see citing works
“4 In addition, these interventions have been insufficient in some patients due to their genetics 5 or microbiota, 6 which might directly affect the severity of the disease.”
BackgroundReversibility of Antipsychotic-Induced Weight Gain: A Systematic Review and Meta-Analysis
Speyer, H., Westergaard, C., Albert, N., Karlsen, M., Stürup, A. E., Nordentoft, M., & Krogh, J. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.577919 · Cited by 44 · see citing works
Vitale, R., & Kim, Y. (2020) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2020.0048 · Cited by 43 · see citing works
“16 As people begin to lose more weight, biological responses such as declining metabolic rate and endocrine adaptations that increase appetite and decrease satiety may oppose continued weight loss and weight maintenance.”
Grembi, J. A., Nguyen, L. H., Haggerty, T. D., Gardner, C. D., Holmes, S., & Parsonnet, J. (2020) · Scientific Reports · doi:10.1038/s41598-020-58000-y · Cited by 42 · see citing works
Jensen, S. B. K., Janus, C., Lundgren, J. R., Juhl, C. R., Sandsdal, R. M., Olsen, L. M., Andresen, A., Borg, S. A., Jacobsen, I. C., Finlayson, G., et al. (2022) · Nature Communications · doi:10.1038/s41467-022-32307-y · Cited by 42 · see citing works
Obesity and hidradenitis suppurativa: targeting meta-inflammation for therapeutic gain
Mintoff, D., Agius, R., Benhadou, F., Das, A., Frew, J. W., & Pace, N. P. (2023) · Clinical and Experimental Dermatology · doi:10.1093/ced/llad182 · Cited by 39 · see citing works
Hu, E. A., Nguyen, V. L., Langheier, J., & Shurney, D. W. (2020) · Journal of Medical Internet Research · doi:10.2196/19634 · Cited by 35 · see citing works
“Previous studies have shown that long-term maintenance of weight loss is challenging as more than half of lost weight was regained within 2 years [35,36].”
BackgroundObesogenic diets induce anxiety in rodents: A systematic review and meta‐analysis
Clark, T. D., Crean, A. J., & Senior, A. M. (2021) · Obesity Reviews · doi:10.1111/obr.13399 · Cited by 35 · see citing works
“population level, greater insight into the factors that drive interactions between obesity and behavior is necessary.(8) The relationship between obesity and mental health is bidirectional.”
BackgroundMedication-Induced Weight Change Across Common Antidepressant Treatments
Petimar, J., Young, J. G., Yu, H., Rifas‐Shiman, S. L., Daley, M. F., Heerman, W. J., Janicke, D. M., Jones, W. S., Lewis, K. H., Lin, P. D., et al. (2024) · Annals of Internal Medicine · doi:10.7326/m23-2742 · Cited by 40 · see citing works
The Risk of Incident Venous Thromboembolism Attributed to Overweight and Obesity: The Tromsø Study
Frischmuth, T., Tøndel, B. G., Brækkan, S. K., Hansen, J., & Morelli, V. M. (2023) · Thrombosis and Haemostasis · doi:10.1055/s-0043-1772212 · Cited by 40 · see citing works
“36,37 Finally, it is important to address that the concept of PAF is based on the assumption of a causal association between the exposure and outcome and the premise of complete eradication of the exposure.”
BackgroundYang, H., Yang, H., Zhu, C., Fan, D., & Deng, J. (2023) · Food Hydrocolloids · doi:10.1016/j.foodhyd.2023.108946 · Cited by 38 · see citing works
Association between weight gain and knee osteoarthritis: a systematic review
Solanki, P., Hussain, S. M., Abidi, J., et al. (2022) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2022.10.023 · Cited by 38 · see citing works
Burke, L. E., Sereika, S. M., Parmanto, B., Bizhanova, Z., Kariuki, J. K., Cheng, J. S.-C., Beatrice, B., Loar, I., Pulantara, I. W., Wang, Y., et al. (2021) · Obesity · doi:10.1002/oby.23321 · Cited by 29 · see citing works
“It is not clear whether these commercially available SM tools can be helpful in following a formalized program to promote weightloss maintenance and prevent the oftenobserved postSBT weight regain (32), but these data suggest this intervention approach warrants further study.”
BackgroundMichael, D. R., Davies, T. S., Jack, A. A., Masetti, G., Marchesi, J. R., Wang, D., Mullish, B. H., & Plummer, S. F. (2021) · Scientific Reports · doi:10.1038/s41598-020-78285-3 · Cited by 36 · see citing works
Afari, N., Herbert, M. S., Godfrey, K. M., Cuneo, J. G., Salamat, J. S., Mostoufi, S. M., Gasperi, M., Ober, K. M., Backhaus, A., Rutledge, T. R., et al. (2019) · Obesity Science & Practice · doi:10.1002/osp4.356 · Cited by 37 · see citing works
“In light of the extensive literature on weight regain (48), the finding that an adjunctive intervention for disinhibited eating may have extended the period of weight-loss post-MOVE! is intriguing.”
BackgroundEndoscopic sleeve gastroplasty (ESG) for morbid obesity: how effective is it?
López-Nava, G., Laster, J., Negi, A., Fook-Chong, S. M. C., Bautista-Castaño, I., & Asokkumar, R. (2021) · Surgical Endoscopy · doi:10.1007/s00464-021-08289-1 · Cited by 37 · see citing works
Food Reward and Food Choice. An Inquiry Through The Liking and Wanting Model
Recio-Román, A., Recio-Menéndez, M., & Román-González, M. V. (2020) · Nutrients · doi:10.3390/nu12030639 · Cited by 33 · see citing works
“Even though almost two-thirds of the consumers are trying to lose weight [4], many of them fail in their goal [5,6].”
BackgroundLow-Carbohydrate High-Fat Diet: A SWOC Analysis
Nuwaylati, D. A., Eldakhakhny, B. M., Bima, A. I. H., Sakr, H. F., & Elsamanoudy, A. Z. (2022) · Metabolites · doi:10.3390/metabo12111126 · Cited by 38 · see citing works
An anti-inflammatory diet intervention for knee osteoarthritis: a feasibility study
Cooper, I., Brukner, P. D., Devlin, B. L., Reddy, A. J., Fulton, M., Kemp, J. L., & Culvenor, A. G. (2022) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-022-05003-7 · Cited by 39 · see citing works
“However, typical dietary interventions are caloric restrictive, which can hinder compliance and long-term sustainability [12].”
BackgroundA randomised controlled trial of the 5:2 diet
Hájek, P., Przulj, D., Pesola, F., McRobbie, H. J., Peerbux, S., Phillips‐Waller, A., Bisal, N., & Smith, K. M. (2021) · PLoS ONE · doi:10.1371/journal.pone.0258853 · Cited by 35 · see citing works
“Sustained dieting without such external support however is difficult for most people, as shown by a typical trajectory of weight regain [7].”
BackgroundHesseldal, L., Christensen, J. R., Olesen, T. B., Olsen, M. H., Jakobsen, P. R., Laursen, D. H., Lauridsen, J. T., Nielsen, J. B., Søndergaard, J., & Brandt, C. J. (2022) · Journal of Medical Internet Research · doi:10.2196/39741 · Cited by 31 · see citing works
“Unfortunately, it is difficult for people living with obesity and T2D to achieve and maintain long-term weight loss [5].”
Food as Medicine for Obesity Treatment and Management
Johnson, V. R., Bell-Washington, T., Chhabria, S. M., Wang, E. H.-C., Czepiel, K. S., Reyes, K. J. C., & Stanford, F. C. (2022) · Clinical Therapeutics · doi:10.1016/j.clinthera.2022.05.001 · Cited by 34 · see citing works
Torres, S., Sales, C. M. D., Guerra, M. P., Simões, M. P., Pinto, M., & Vieira, F. M. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00343 · Cited by 40 · see citing works
“Long-term vigilance is also needed (Hall and Kahan, 2018) and can be integrated in the individual follow-up sessions proposed above.”
BackgroundCorliss, H. L., VanKim, N. A., Jun, H., Austin, S. B., Hong, B., Wang, M., & Hu, F. B. (2018) · Diabetes Care · doi:10.2337/dc17-2656 · Cited by 34 · see citing works
Khalafi, M., Maleki, A. H., Ehsanifar, M., Symonds, M. E., & Rosenkranz, S. K. (2024) · Obesity Reviews · doi:10.1111/obr.13855 · Cited by 33 · see citing works
“19 57 There is, however, no comprehensive meta-analysis on the longer-term effects of IF, 58 this systematic review and meta-analysis aimed to summarize the evidence comparing IF to CON and/or CR, from randomized trials lasting at least 6 months of body composition and markers of cardiometabolic health (i.e. markers o…”
- Authors
- Hall, K. D., & Kahan, S.
- Affiliations
- National Institute of Diabetes and Digestive and Kidney Diseases (US)
- Johns Hopkins University (US)
- Corresponding author
- Hall, Kevin D.
- Venue
- Medical Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2018-01
- Volume
- 102
- Issue
- 1
- Pages
- 183-197
- ISSN
- 0025-7125 (ISSN-L)
- PMC
- PMC5764193
- OpenAlex
- W2770514262
- Cited by
- 876
- References
- 105
- Citations by year
- 2026: 119 · 2025: 146 · 2024: 151 · 2023: 123 · 2022: 133 · 2021: 108 · 2020: 64 · 2019: 15 · 2018: 17
- FWCI
- 4.27
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Medical Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH
- Nutrition Science Initiative
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- obesity, weight loss maintenance, weight regain, long-term weight management, obesity intervention, behavioral factors, environmental factors, body weight regulation, counseling
- MeSH terms
- Adaptation, Physiological, Diet, Reducing, Energy Metabolism, Health Promotion, Humans, Obesity, Self Care, Weight Gain, Risk Reduction Behavior
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