Mechanisms of weight regain

•Weight regain is not a simplistic matter of lack of compliance of patients.•Gut hormone secretion profiles impact upon predisposition to weight regain.•Metabolic adaptation explains the reduction of energy expenditure after weight loss.•Appetite regulation consists in an interplay between hunger/sa...

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Bibliographic Details
Published in:European journal of internal medicine 2021-11, Vol.93, p.3-7
Main Authors: Busetto, Luca, Bettini, Silvia, Makaronidis, Janine, Roberts, Carl A., Halford, Jason C.G., Batterham, Rachel L.
Format: Article
Language:English
Subjects:
Body Weight
Energy Intake
Energy Metabolism
Gut hormones
Humans
Metabolic adaptation
Obesity
Reward
Weight Gain
Weight Loss
Weight regain
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Summary:•Weight regain is not a simplistic matter of lack of compliance of patients.•Gut hormone secretion profiles impact upon predisposition to weight regain.•Metabolic adaptation explains the reduction of energy expenditure after weight loss.•Appetite regulation consists in an interplay between hunger/satiety and reward. Weight regain following weight loss is frequent problem that people with obesity face. This weight recidivism is often attributed to the lack of compliance with appropriate food habits and exercise. On the contrary, it is known that body weight and fat mass are regulated by numerous physiological mechanisms, far beyond voluntary food intake and physical exercise. Thus, the aim of this paper is to review the main peripheral and central mechanisms involved in weight regain. Gut hormone secretion profiles impact upon predisposition to weight regain according to an individual variability, although it is recognised a usual pattern of compensatory changes: a reduction in anorectic hormones secretion and an increase in orexigenic hormone. These changes lead to both increased appetite and reward value of food leading to increased energye intake. In addition, resting energy expenditure after weight loss is lower than expected according to body composition changes. This gap between observed and predicted energy expenditure following weight loss is named metabolic adaptation, which has been suggested to explain partly weight regain. This complicated scenario, beyond patient motivation, makes weight regain a challenge in long-term management interventions in patients with obesity.
ISSN:0953-6205
1879-0828
DOI:10.1016/j.ejim.2021.01.002