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Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the set-point theory
Open accessAbstract
Background Obese persons generally regain lost weight, suggesting that adaptive metabolic changes favor return to a preset weight.Objective Our objective was to determine whether adaptive changes in resting metabolic rate (RMR) and thyroid hormones occur in weight-reduced persons, predisposing them to long-term weight gain.Design Twenty-four overweight, postmenopausal women were studied at a clinical research center in four 10-d study phases: the overweight state (phase 1, energy balance; phase 2, 3350 kJ/d) and after reduction to a normal-weight state (phase 3, 3350 kJ/d; phase 4, energy balance). Weight-reduced women were matched with 24 never-overweight control subjects. After each study phase, assessments included RMR (by indirect calorimetry), body composition (by hydrostatic weighing), serum triiodothyronine (T(3)), and reverse T(3) (rT(3)). Body weight was measured 4 y later, without intervention.Results Body composition-adjusted RMR and T(3):rT(3) fell during acute (phase 2) and chronic (phase 3) energy restriction (P: < 0.01), but returned to baseline in the normal-weight, energy-balanced state (phase 4; mean weight loss: 12.9 +/- 2.0 kg). RMR among weight-reduced women (4771 +/- 414 kJ/d) was not significantly different from that in control subjects (4955 +/- 414 kJ/d; P: = 0.14), and lower RMR did not predict greater 4-y weight regain (r = 0.27, NS).Conclusions Energy restriction produces a transient hypothyroid-hypometabolic state that normalizes on return to energy-balanced conditions. Failure to establish energy balance after weight loss gives the misleading impression that weight-reduced persons are energy conservative and predisposed to weight regain. Our findings do not provide evidence in support of adaptive metabolic changes as an explanation for the tendency of weight-reduced persons to regain weight.
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“The energy content of weight-loss maintenance diets should take into account the lower resting metabolic rate and decreased energy requirements due to body mass loss during weight loss.79,80”
From Diet in the management of weight loss (2006) · cites this paper as [80]
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“While changes in metabolic efficiency occur during weight loss, these do not fully explain weight regains.5”
From The mind your health project: a randomized controlled trial of an innovative behavioral treatment for obesity (2013) · cites this paper as [5]
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Metadata
- Authors
- Weinsier, R. L., Nagy, T. R., Hunter, G. R., Darnell, B. E., Hensrud, D. D., & Weiss, H. L.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Weinsier, Roland L
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2000-11
- Volume
- 72
- Issue
- 5
- Pages
- 1088-1094
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2140683236
- Cited by
- 208
- References
- 46
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 8 · 2020: 6 · 2019: 7 · 2018: 9 · 2017: 7 · 2016: 9 · 2015: 13 · 2014: 12 · 2013: 6 · 2012: 15
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1r01dk038491-01a1, 5r01hl032098-03)
- National Heart, Lung, and Blood Institute (HL32098)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-49779, DK38491, R01DK049779)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- weight regain, set-point theory, resting metabolic rate, caloric restriction, thyroid hormones, triiodothyronine, reverse T3, postmenopausal women, obesity, energy balance, body composition, hypometabolism
- MeSH terms
- Aged, Basal Metabolism, Body Composition, Energy Intake, Calorimetry, Indirect, Diet, Reducing, Female, Humans, Kinetics, Middle Aged, Models, Biological, Obesity, Triiodothyronine, Triiodothyronine, Reverse, Weight Gain, Weight Loss, Body Mass Index, Postmenopause
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