Associations between the rate, amount, and composition of weight loss as predictors of spontaneous weight regain in adults achieving clinically significant weight loss: A systematic review and meta-regression
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Summary: Weight regain following weight loss is common although little is known regarding the associations between amount, rate, and composition of weight loss and weight regain. Forty‐three studies (52 groups; n = 2379) with longitudinal body composition measurements were identified in which weight loss (≥5%) and subsequent weight regain (≥2%) occurred. Data were synthesized for changes in weight and body composition. Meta‐regression models were used to investigate associations between amount, rate, and composition of weight loss and weight regain. Individuals lost 10.9% of their body weight over 13 weeks composed of 19.6% fat‐free mass, followed by a regain of 5.4% body weight over 44 weeks composed of 21.6% fat‐free mass. Associations between the amount (P < 0.001) and rate (P = 0.049) of weight loss and their interaction (P = 0.042) with weight regain were observed. Fat‐free mass (P = 0.017) and fat mass (P < 0.001) loss both predicted weight regain although the effect of fat‐free mass was attenuated following adjustment. The amount (P < 0.001), but not the rate of weight loss (P = 0.150), was associated with fat‐free mass loss. The amount and rate of weight loss were significant and interacting factors associated with weight regain. Loss of fat‐free mass and fat mass explained greater variance in weight regain than weight loss alone.
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Rapid weight loss including from GLP-1 RAs can potentially contribute to weight regain.
“Rapid weight loss including from GLP-1 RAs can also cause muscle and bone loss, and can potentially contribute to weight regain [93,94,95].”
From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [95]
The Results section (‘Effect of extent and rate of weight loss on weight regain’; page not provided) reports an association between faster weight loss and greater regain, but rate was no longer a significant predictor after adjustment for the amount lost. The paper does not establish that rapid weight loss causes regain or address weight loss from GLP-1 receptor agonists specifically. (LLM, conf=0.87)
Experimental — accuracy not yet measuredRapid weight loss including from GLP-1 RAs can cause muscle and bone loss.
“Rapid weight loss including from GLP-1 RAs can also cause muscle and bone loss, and can potentially contribute to weight regain [93,94,95].”
From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [95]
The Introduction (page unavailable) reports that faster weight loss has been associated with a greater proportionate loss of fat-free mass, and the 'Fat-free mass and fat mass loss as predictors of weight regain' section says protein loss may shift toward skeletal muscle. That section describes only a potential role for fat-free-mass loss in weight regain. The paper does not establish bone loss or address GLP-1 receptor agonists, and its Conclusion says the amount, but not the rate, of weight loss was associated with fat-free-mass loss. (LLM, conf=0.87)
Experimental — accuracy not yet measuredLifestyle change interventions provide an expected weight loss between 5 and 10% with the potential for significant weight regain.
“Overall it should be noted that lifestyle change interventions provide an expected weight loss between 5 and 10% [17,152] with the potential for significant weight regain [95]”
From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [95]
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“…be noted that lifestyle change interventions provide an expected weight loss between 5 and 10% [17,152] with the potential for significant weight regain [95], though as seen in the diabetes prevention program outcomes study, cardiometabolic benefits may be preserved despite weight regain [153].”
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- Authors
- Turicchi, J., O'Driscoll, R., Finlayson, G., Beaulieu, K., Deighton, K., & Stubbs, R. J.
- Affiliations
- University of Leeds (GB)
- Appetite Control and Energy Balance Group, School of Psychology University of Leeds Leeds UK
- Leeds Beckett University (GB)
- Corresponding author
- Turicchi, Jake
- ORCID
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2019-03-29
- Volume
- 20
- Issue
- 7
- Pages
- 935-946
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2928817826
- Cited by
- 37
- References
- 107
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 1 · 2023: 6 · 2022: 5 · 2021: 9 · 2020: 4 · 2019: 2
- FWCI
- 0.82
- Type
- journal article
- Language
- en
- Open access
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Leeds Beckett Repository (Leeds Beckett University) (submittedVersion)
- Funders
- University of Leeds PhD studentship
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Keywords
- weight regain, weight loss, body composition, fat-free mass, fat mass, obesity, predictors of weight loss
- MeSH terms
- Adult, Analysis of Variance, Body Composition, Humans, Weight Gain, Weight Loss, Risk Assessment
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