Modeling weight-loss maintenance to help prevent body weight regain

Based on several randomized clinical trials, it has been suggested that baseline glucose homeostasis interacts with the influence of diet composition on weight loss and weight loss maintenance. In this secondary analysis of the YoYo study, a study investigating predictors of weight loss maintenance, we tested the hypothesis that (self-selected) dietary carbohydrate and/or fibre intake interact with the glucose homeostasis parameters for weight loss maintenance. Sixty-one overweight or obese individuals lost around 10 kg of body weight on an energy-restricted diet and were then followed for 9 months. During this period, participants were advised to maintain their body weight and eat a healthy diet without further recommendations on calorie intake or diet composition. Contrary to our hypothesis, carbohydrate intake showed no positive association with weight regain after weight loss, and no interaction with baseline fasting glucose concentration was found. There was a non-significant negative association between fibre intake and weight regain (B = −0.274, standard error (SE) 0.158, p = 0.090), but again, no interaction with fasting plasma glucose was found. In conclusion, the data from the YoYo study do not support a role for baseline glucose homeostasis in determining the association between self-reported carbohydrate and/or fibre intake and weight regain after weight loss.

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A personal-contact weight-loss maintenance intervention reduced weight regain in overweight and obese adults

Annals of Internal Medicine ◽

10.7326/0003-4819-149-2-200807150-02004 ◽

2008 ◽

Vol 149 (2) ◽

pp. JC1

Author(s):

Lawrence J. Cheskin

Keyword(s):

Weight Loss ◽

Weight Regain ◽

Weight Loss Maintenance ◽

Personal Contact ◽

Obese Adults ◽

Maintenance Intervention

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Breakfast consumption and weight-loss maintenance: results from the MedWeight study

British Journal Of Nutrition ◽

10.1017/s0007114516001550 ◽

2016 ◽

Vol 115 (12) ◽

pp. 2246-2251 ◽

Cited By ~ 12

Author(s):

Dora Brikou ◽

Dimitra Zannidi ◽

Eleni Karfopoulou ◽

Costas A. Anastasiou ◽

Mary Yannakoulia

Keyword(s):

Weight Loss ◽

Body Weight ◽

Dietary Intake ◽

Eating Behaviour ◽

Weight Loss Maintenance ◽

Precise Definition ◽

Confounding Factors ◽

Initial Body Weight ◽

Breakfast Consumption ◽

At Home

AbstractDaily breakfast consumption is a common eating behaviour among people who have maintained their weight loss after weight-loss management. However, there is not a precise definition for breakfast in the literature. The purpose of this study was to investigate potential associations between breakfast consumption (based on several definitions) and weight-loss maintenance, as well as to explore differences in breakfast quality between individuals who managed to maintain part of the weight loss and in those who regained weight loss. The study sample consisted of 354 participants of the MedWeight study (age: 32 (sd 10) years, 61 % women) who had lost ≥10 % of their initial body weight and either maintained the loss for ≥1 year (maintainers, n 257) or regained weight loss (regainers, n 97). Participants completed online questionnaires and reported their dietary intake through two telephone 24-h recalls. Breakfast consumption was evaluated using twelve different definitions. The analysis indicated that breakfast consumption was associated with weight-loss maintenance only in men, when using self-reported breakfast consumption or the following breakfast definitions: (1) the first eating episode consumed at home and (2) the first eating episode consumed at home excluding caffeinated drinks. This association remained statistically significant even after adjustment for potential confounding factors. Thus, breakfast, the first eating episode of the day, when consumed at home, may be protective against weight regaining.

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Long-Lasting Improvements in Liver Fat and Metabolism Despite Body Weight Regain After Dietary Weight Loss

Diabetes Care ◽

10.2337/dc13-0102 ◽

2013 ◽

Vol 36 (11) ◽

pp. 3786-3792 ◽

Cited By ~ 33

Author(s):

S. Haufe ◽

V. Haas ◽

W. Utz ◽

A. L. Birkenfeld ◽

S. Jeran ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Weight Regain ◽

Liver Fat ◽

Dietary Weight Loss

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MON-LB101 5-Year Data of an Aggressive Pharmacological Approach to Moderate and Morbid Obesity: Is Prevention of Bariatric Surgery Feasible in the Long Run?

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.2340 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Flavio Cadegiani

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Weight Loss ◽

Body Weight ◽

Weight Regain ◽

Morbidly Obese ◽

Biochemical Profile ◽

Initial Weight ◽

Initial Weight Loss

Abstract Background: Maintenance of weight loss in patients that undergo weight loss interventions is highly challenging, irrespective of the type of approach to obesity (whether surgical, pharmacological, or non-pharmacological). We proposed a protocol of an aggressive clinical treatment for obesity aiming to prevent the need of bariatric surgery, in patients unwilling to undergo this procedure, by proposing a protocol that included the combination of different anti-obesity medications and non-pharmacological modalities, for longer duration, and with an active approach to prevent weight regain. Our initial 2-year data showed that 93% (40 of 43 patients) with moderate and morbid obesity were able to avoid the need of bariatric surgery, with concomitant improvements of the biochemical profile. However, whether these patients would maintain their successful rates after five years was uncertain. Our objective is to describe the efficacy and safety of a long term (5-year data) pharmacological and multi-modal treatment for moderate and severe obesity. Methods: The 40 patients that were successful in the two-year approach in our obesity center (Corpometria Institute, Brasilia, DF, Brazil) were enrolled. A long-term anti-obesity protocol was employed, with continuous or intermittent use of anti-obesity drugs, trimestral body composition analysis, psychotherapy, visit to a nutritionist every four months, and both resistance and endurance exercises at least four times a week. Body weight (BW), total weight excess (TWE), body fat, markers of lipid and glucose metabolism, liver function, and inflammation were analyzed. Subjects that dropped out were considered as weight regain. Therapeutic success for the 5-year follow-up included as the maintenance of >20% loss of the initial BW loss, and no weight regain (or < 20% of the initial weight loss). Results: A total of 27 patients (67.5%) were able to maintain the body weight, seven dropped out, and six regained more than 20% of the initial weight loss. Of these, 21 (77.8%) had significant further increase of muscle mass and decrease of fat loss, while 17 (63.0%) had further weight loss (p < 0.05), compared to the 2-year data. Improvements on the biochemical profile persisted in all 27 patients, and had significant further improvements in 24 (88.9%) of these patients. Conclusion: The risk of weight regain five years after a weight loss treatment for obesity was significantly lower compared to previous literature, and comparable to the long-term outcomes of bariatric procedures. An aggressive, structured, and long-term clinical weight loss approach has been shown to be feasible, even for morbidly obese patients.

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Associations between the proportion of fat-free mass loss during weight loss, changes in appetite, and subsequent weight change: results from a randomized 2-stage dietary intervention trial

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz331 ◽

2020 ◽

Vol 111 (3) ◽

pp. 536-544 ◽

Cited By ~ 3

Author(s):

Jake Turicchi ◽

Ruairi O'Driscoll ◽

Graham Finlayson ◽

Cristiana Duarte ◽

Mark Hopkins ◽

...

Keyword(s):

Weight Loss ◽

Body Composition ◽

Energy Balance ◽

Weight Regain ◽

Dietary Intervention ◽

Body Weight Loss ◽

Weight Loss Maintenance ◽

Fat Free Mass ◽

Weight Outcomes ◽

Dietary Intervention Trial

ABSTRACT Background Dynamic changes in body composition which occur during weight loss may have an influential role on subsequent energy balance behaviors and weight. Objectives The aim of this article is to consider the effect of proportionate changes in body composition during weight loss on subsequent changes in appetite and weight outcomes at 26 wk in individuals engaged in a weight loss maintenance intervention. Methods A subgroup of the Diet, Obesity, and Genes (DiOGenes) study (n = 209) was recruited from 3 European countries. Participants underwent an 8-wk low-calorie diet (LCD) resulting in ≥8% body weight loss, during which changes in body composition (by DXA) and appetite (by visual analog scale appetite perceptions in response to a fixed test meal) were measured. Participants were randomly assigned into 5 weight loss maintenance diets based on protein and glycemic index content and followed up for 26 wk. We investigated associations between proportionate fat-free mass (FFM) loss (%FFML) during weight loss and 1) weight outcomes at 26 wk and 2) changes in appetite perceptions. Results During the LCD, participants lost a mean ± SD of 11.2 ± 3.5 kg, of which 30.4% was FFM. After adjustment, there was a tendency for %FFML to predict weight regain in the whole group (β: 0.041; 95% CI: −0.001, 0.08; P = 0.055), which was significant in men (β: 0.09; 95% CI: 0.02, 0.15; P = 0.009) but not women (β: 0.01; 95% CI: −0.04, 0.07; P = 0.69). Associations between %FFML and change in appetite perceptions during weight loss were inconsistent. The strongest observations were in men for hunger (r = 0.69, P = 0.002) and desire to eat (r = 0.61, P = 0.009), with some tendencies in the whole group and no associations in women. Conclusions Our results suggest that composition of weight loss may have functional importance for energy balance regulation, with greater losses of FFM potentially being associated with increased weight regain and appetite. This trial was registered at clinicaltrials.gov as NCT00390637.

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Lipolysis defect in white adipose tissue and rapid weight regain

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00542.2018 ◽

2019 ◽

Vol 317 (2) ◽

pp. E185-E193 ◽

Cited By ~ 1

Author(s):

Michal Kasher-Meron ◽

Dou Y. Youn ◽

Haihong Zong ◽

Jeffery E. Pessin

Keyword(s):

Weight Loss ◽

Body Weight ◽

Adipose Tissue ◽

Caloric Restriction ◽

White Adipose Tissue ◽

Weight Regain ◽

Serine Phosphorylation ◽

Lean Body Weight ◽

Control Group ◽

Short Period

Weight regain after weight loss is a well-described phenomenon in both humans and animal models of obesity. Reduced energy expenditure and increased caloric intake are considered the main drivers of weight regain. We hypothesized that adipose tissue with obesity memory (OM) has a tissue-autonomous lipolytic defect, allowing for increased efficiency of lipid storage. We utilized a mouse model of diet-induced obesity, which was subjected to 60% caloric restriction to achieve lean body weight, followed by a short period of high-fat diet (HFD) rechallenge. Age-matched lean mice fed HFD for the first time were used as the control group. Upon rechallenge with HFD, mice with OM had higher respiratory exchange ratios than lean mice with no OM despite comparable body weight, suggesting higher utilization of glucose over fatty acid oxidation. White adipose tissue explants with OM had comparable lipolytic response after caloric restriction; however, reduced functional lipolytic response to norepinephrine was noted as early as 5 days after rechallenge with HFD and was accompanied by reduction in hormone-sensitive lipase serine phosphorylation. The relative lipolytic defect was associated with increased expression of inflammatory genes and a decrease in adrenergic receptor genes, most notably Adrb3. Taken together, white adipose tissue of lean mice with OM shows increased sensitization to HFD compared with white adipose tissue with no OM, rendering it resistant to catecholamine-induced lipolysis. This relative lipolytic defect is tissue-autonomous and could play a role in the rapid weight regain observed after weight loss.

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Effects of green tea on weight maintenance after body-weight loss

British Journal Of Nutrition ◽

10.1079/bjn20041061 ◽

2004 ◽

Vol 91 (3) ◽

pp. 431-437 ◽

Cited By ~ 144

Author(s):

Eva M. R. Kovacs ◽

Manuela P. G. M. Lejeune ◽

Ilse Nijs ◽

Margriet S. Westerterp-Plantenga

Keyword(s):

Weight Loss ◽

Body Weight ◽

Green Tea ◽

Weight Regain ◽

Weight Maintenance ◽

Epigallocatechin Gallate ◽

Body Weight Loss ◽

Caffeine Consumption ◽

Very Low Energy Diet ◽

Obese Subjects

The present study was conducted to investigate whether green tea may improve weight maintenance by preventing or limiting weight regain after weight loss of 5 to 10% in overweight and moderately obese subjects. The study had a randomised, parallel, placebo-controlled design. A total of 104 overweight and moderately obese male and female subjects (age 18–60 years; BMI 25–35kg/m2) participated. The study consisted of a very-low-energy diet intervention (VLED; 2·1MJ/d) of 4 weeks followed by a weight-maintenance period of 13 weeks in which the subjects received green tea or placebo. The green tea contained caffeine (104mg/d) and catechins (573mg/d, of which 323mg was epigallocatechin gallate). Subjects lost 6·4 (sd 1·9) kg or 7·5 (sd 2·2) % of their original body weight during the VLED (P<0·001). Body-weight regain was not significantly different between the green tea and the placebo group (30·5 (sd 61·8) % and 19·7 (sd 56·9)%, respectively). In the green tea treatment, habitual high caffeine consumption was associated with a higher weight regain compared with habitual low caffeine consumption (39 (sd 17) and 16 (sd 11)%, respectively; P<0·05). We conclude that weight maintenance after 7·5% body-weight loss was not affected by green tea treatment and that habitual caffeine consumption affected weight maintenance in the green tea treatment.

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Weight Loss Medications in Young Adults after Bariatric Surgery for Weight Regain or Inadequate Weight Loss: A Multi-Center Study

Children ◽

10.3390/children5090116 ◽

2018 ◽

Vol 5 (9) ◽

pp. 116 ◽

Cited By ~ 10

Author(s):

Alexander Toth ◽

Gricelda Gomez ◽

Alpana Shukla ◽

Janey Pratt ◽

Hellas Cena ◽

...

Keyword(s):

Weight Loss ◽

Young Adults ◽

Body Weight ◽

Weight Change ◽

Weight Regain ◽

Body Weight Loss ◽

Total Body Weight ◽

Percent Weight Loss ◽

Total Body ◽

Weight Loss Medications

This paper presents a retrospective cohort study of weight loss medications in young adults aged 21 to 30 following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) between November 2000 and June 2014. Data were collected from patients who used topiramate, phentermine, and/or metformin postoperatively. Percentage of patients achieving ≥5%, ≥10%, or ≥15% weight loss on medications was determined and percent weight change on each medication was compared to percent weight change of the rest of the cohort. Our results showed that 54.1% of study patients lost ≥5% of their postsurgical weight; 34.3% and 22.9% lost ≥10% and ≥15%, respectively. RYGB had higher median percent weight loss (−8.1%) than SG (−3.3%) (p = 0.0515). No difference was found in median percent weight loss with medications started at weight plateau (−6.0%) versus after weight regain (−5.4%) (p = 0.5304). Patients taking medications at weight loss plateau lost 41.2% of total body weight from before surgery versus 27.1% after weight regain (p = 0.076). Median percent weight change on metformin was −2.9% compared to the rest of the cohort at −7.7% (p = 0.0241). No difference from the rest of the cohort was found for phentermine (p = 0.2018) or topiramate (p = 0.3187). Topiramate, phentermine, and metformin are promising weight loss medications for 21 to 30 year olds. RYGB patients achieve more weight loss on medications but both RYGB and SG benefit. Median total body weight loss from pre-surgical weight may be higher in patients that start medication at postsurgical nadir weight. Participants on metformin lost significantly smaller percentages of weight on medications, which could be the result of underlying medical conditions.

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