Mechanisms of weight regain

Area of Science:

• Physiology
• Metabolism
• Endocrinology

Background:

• Weight regain is a significant challenge for individuals with obesity, often incorrectly attributed solely to lifestyle non-compliance.
• Body weight and fat mass are regulated by complex physiological mechanisms extending beyond voluntary control of diet and exercise.

Purpose of the Study:

• To review the primary peripheral and central physiological mechanisms contributing to weight regain after weight loss.
• To elucidate the hormonal and metabolic factors influencing weight recidivism in obesity.

Main Methods:

• Literature review of peripheral and central regulatory mechanisms of body weight.
• Analysis of gut hormone secretion profiles and their role in appetite regulation.
• Examination of resting energy expenditure changes post-weight loss and the phenomenon of metabolic adaptation.

Main Results:

• Individual variability in gut hormone secretion influences predisposition to weight regain.
• A common pattern involves reduced anorectic hormone secretion and increased orexigenic hormone secretion, elevating appetite and food reward.
• Resting energy expenditure is often lower than predicted based on body composition changes, a state termed metabolic adaptation.

Conclusions:

• Weight regain is a multifactorial physiological process involving hormonal imbalances and metabolic adaptations.
• These mechanisms contribute to increased energy intake and reduced energy expenditure, challenging long-term obesity management.
• Understanding these complex factors is crucial for developing effective interventions beyond patient motivation.