Dietary adherence during weight loss predicts weight regain

Area of Science:

• Nutrition Science
• Obesity Research
• Behavioral Medicine

Background:

• Weight regain is a common challenge after successful weight loss.
• Identifying predictors of long-term weight maintenance is crucial for public health.
• Dietary adherence during initial weight loss may influence future weight stability.

Purpose of the Study:

• To investigate the association between dietary adherence during a low-calorie diet (LCD) intervention and weight change over a 2-year follow-up period.
• To determine if adherence levels predict subsequent weight regain in recently weight-reduced women.
• To explore potential mechanisms, such as energy intake and activity-related energy expenditure, linking adherence to weight maintenance.

Main Methods:

• Study population: 116 healthy, premenopausal women with recent weight loss (BMI 22-25 kg/m2).
• Dietary adherence assessment: Doubly labeled water (DLW) and body composition changes during the weight loss intervention.
• Follow-up: Weight change and related factors assessed at 1- and 2-year intervals, comparing upper and lower tertiles of adherence.

Main Results:

• Women in the upper tertile of previous dietary adherence regained significantly less weight (30.9% vs. 66.7%) at 2-year follow-up compared to the lower tertile.
• Higher adherence was associated with increased activity-related energy expenditure (AEE) (+95 kcal/day vs. -44 kcal/day).
• Higher adherence was also linked to lower daily energy intake (2,066 kcal/day vs. 2,289 kcal/day).

Conclusions:

• Higher adherence to a low-calorie diet during weight loss is a significant predictor of reduced weight regain over 2 years.
• Lower energy intake and higher physical activity levels partially mediate the relationship between adherence and weight maintenance.
• Dietary adherence during weight loss interventions may serve as a valuable biomarker for identifying individuals at risk of weight regain.