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Biology's response to dieting: the impetus for weight regain.
Am J Physiol Regul Integr Comp Physiol. 2011 Sep; 301(3):R581-600.AJ

Abstract

Dieting is the most common approach to losing weight for the majority of obese and overweight individuals. Restricting intake leads to weight loss in the short term, but, by itself, dieting has a relatively poor success rate for long-term weight reduction. Most obese people eventually regain the weight they have worked so hard to lose. Weight regain has emerged as one of the most significant obstacles for obesity therapeutics, undoubtedly perpetuating the epidemic of excess weight that now affects more than 60% of U.S. adults. In this review, we summarize the evidence of biology's role in the problem of weight regain. Biology's impact is first placed in context with other pressures known to affect body weight. Then, the biological adaptations to an energy-restricted, low-fat diet that are known to occur in the overweight and obese are reviewed, and an integrative picture of energy homeostasis after long-term weight reduction and during weight regain is presented. Finally, a novel model is proposed to explain the persistence of the "energy depletion" signal during the dynamic metabolic state of weight regain, when traditional adiposity signals no longer reflect stored energy in the periphery. The preponderance of evidence would suggest that the biological response to weight loss involves comprehensive, persistent, and redundant adaptations in energy homeostasis and that these adaptations underlie the high recidivism rate in obesity therapeutics. To be successful in the long term, our strategies for preventing weight regain may need to be just as comprehensive, persistent, and redundant, as the biological adaptations they are attempting to counter.

Authors+Show Affiliations

University of Colorado Anschutz Medical Campus, Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, Center for Human Nutrition, Denver, Colorado, USA. paul.maclean@ucdenver.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Review

Language

eng

PubMed ID

21677272

Citation

Maclean, Paul S., et al. "Biology's Response to Dieting: the Impetus for Weight Regain." American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, vol. 301, no. 3, 2011, pp. R581-600.
Maclean PS, Bergouignan A, Cornier MA, et al. Biology's response to dieting: the impetus for weight regain. Am J Physiol Regul Integr Comp Physiol. 2011;301(3):R581-600.
Maclean, P. S., Bergouignan, A., Cornier, M. A., & Jackman, M. R. (2011). Biology's response to dieting: the impetus for weight regain. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, 301(3), R581-600. https://doi.org/10.1152/ajpregu.00755.2010
Maclean PS, et al. Biology's Response to Dieting: the Impetus for Weight Regain. Am J Physiol Regul Integr Comp Physiol. 2011;301(3):R581-600. PubMed PMID: 21677272.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biology's response to dieting: the impetus for weight regain. AU - Maclean,Paul S, AU - Bergouignan,Audrey, AU - Cornier,Marc-Andre, AU - Jackman,Matthew R, Y1 - 2011/06/15/ PY - 2011/6/17/entrez PY - 2011/6/17/pubmed PY - 2011/10/25/medline SP - R581 EP - 600 JF - American journal of physiology. Regulatory, integrative and comparative physiology JO - Am J Physiol Regul Integr Comp Physiol VL - 301 IS - 3 N2 - Dieting is the most common approach to losing weight for the majority of obese and overweight individuals. Restricting intake leads to weight loss in the short term, but, by itself, dieting has a relatively poor success rate for long-term weight reduction. Most obese people eventually regain the weight they have worked so hard to lose. Weight regain has emerged as one of the most significant obstacles for obesity therapeutics, undoubtedly perpetuating the epidemic of excess weight that now affects more than 60% of U.S. adults. In this review, we summarize the evidence of biology's role in the problem of weight regain. Biology's impact is first placed in context with other pressures known to affect body weight. Then, the biological adaptations to an energy-restricted, low-fat diet that are known to occur in the overweight and obese are reviewed, and an integrative picture of energy homeostasis after long-term weight reduction and during weight regain is presented. Finally, a novel model is proposed to explain the persistence of the "energy depletion" signal during the dynamic metabolic state of weight regain, when traditional adiposity signals no longer reflect stored energy in the periphery. The preponderance of evidence would suggest that the biological response to weight loss involves comprehensive, persistent, and redundant adaptations in energy homeostasis and that these adaptations underlie the high recidivism rate in obesity therapeutics. To be successful in the long term, our strategies for preventing weight regain may need to be just as comprehensive, persistent, and redundant, as the biological adaptations they are attempting to counter. SN - 1522-1490 UR - https://www.unboundmedicine.com/medline/citation/21677272/Biology's_response_to_dieting:_the_impetus_for_weight_regain_ L2 - https://journals.physiology.org/doi/10.1152/ajpregu.00755.2010?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -