One of the major challenges faced by obese people in terms of weight loss and management is the prevention of weight regain after successful weight loss. Some studies suggest that 80% to 95% of people who lose weight regain it shortly after.
While many people face success with weight loss, long-term maintenance of weight loss has often been an elusive goal.
The Common Causes of Weight Regain after Weight Loss
Energy Expenditure and Nutrient Metabolism
Energy expenditure varies according to changes in body weight. Higher body weight is associated with higher energy expenditure. Weight loss is accompanied by a decrease in resting energy expenditure (REE) (energy needed to fuel minimal daily functions of cells and organs). The reduction in REE can lead to weight gain. Yes, it is a pretty vicious cycle!
The composition of the diet used for weight loss also influences REE and weight gain. According to a study, low-carb, high-protein diets are effective for short-term weight loss, while its effects on long-term weight loss are still hazy.
According to The Prevention of Obesity Using Novel Dietary Strategies (POUNDS LOST) study, REE decreased the least in the very low carbohydrate group, suggesting that a low-carbohydrate diet may discourage weight regain.
Another study found that the high-protein, low-glycemic index diet was best for maintaining weight loss.
How Did Weight Regain After Weight Loss Come About?
Meal Replacement Diets
A meal replacement is a drink, bar, soup, etc., intended as a substitute for a solid food meal, usually with controlled quantities of calories and nutrients. With most branded meal replacements, two of your usual meals are substituted with a meal replacement.
In the early days, the meal replacement diet was very low in calories – around 200-400 kcal a day – compared to the average calorie consumption by an American (2400 kcal). Such low-calorie diets lead to muscle breakdown, slowing down your metabolism. Further, most of these diets are nutritionally deficient. All of these contribute to easy and quick weight regain.
However, these days, the meal replacement diets have become more nutritionally sound, including the appropriate amounts of macronutrients and micronutrients. They are also not as low in calories – nowadays, meal replacement diets have a calorie content of 800–1000 kcal per day. This is sufficient enough to prevent/slow down muscle breakdown. Meal replacements are also used along with the usual diet getting the calorie count up to 1200 per day.
The Role Of Genetics in Weight Regain
ADIPOQ Gene and Weight Regain
This gene is involved in controlling fat metabolism (break down) and insulin sensitivity (how well your body responds to insulin) in the body.
ADIPOQ gene codes for a protein called the adiponectin, which is involved in aids fatty acid breakdown. Higher the adiponectin levels, the more efficient the fatty acid breakdown.
Decreased adiponectin levels are thought to play a central role in obesity, and type 2 diabetes.
rs17300539 of ADIPOQ Gene and Weight Gain Tendency
The SNP rs17300539 is also annotated as -11391 G/A. In a study, 180 Spanish volunteers were put on a low-calorie diet. An 8-week follow-up revealed that people who have the A allele had a protective effect against weight regain. On the other hand, people with the GG type experience weight regain.
A allele carriers also had higher adiponectin levels.
PPARG Gene and Weight Regain
The PPARG gene encodes the peroxisome proliferator-activated receptor, a nuclear receptor found mainly in the adipose tissue, macrophages, and colon. PPARG is associated with fatty acid storage and glucose metabolism. PPARG also increases insulin sensitivity by enhancing the storage of fatty acids in fat cells. Certain mutations in this gene influence the weight regain tendency in individuals.
rs1801282 of PPARG Gene and Weight Gain Tendency
The minor G allele is associated with lower PPAR gamma activity. This decreases insulin sensitivity. People with the G variant were shown to be associated with a higher weight regain tendency.
Other genes influencing weight regain tendency include BDNF and TFAP2B.
Other common factors that influence weight regain are:
The Calorie-Gap
The more weight you lose, the fewer calories your body needs to maintain itself. Say you go on a 1500-calorie diet. You may see some significant weight loss initially. But as your calorie demands reduce, continuing the same calorie consumption may lead to weight regain. So it’s important to recalculate your calorie requirements as and when you experience weight loss.
Slower Metabolism
With some diets, like crash diets or other calorie-deficit diets, your body is forced to break down muscle to use for energy – lower the muscle mass, slower the metabolism. When your metabolism slows down, it becomes a lot easier to regain those lost pounds.
Impact of Weight Cycling
Yo-yo dieting, the colloquial term for weight cycling, describes the cyclic pattern of losing weight, regaining the lost weight, and dieting to lose that weight again. Since the weight goes up and down like a ‘yo-yo,’ the term yo-yo dieting came up. This kind of fluctuation of weight has been linked to conditions like obesity and type 2 diabetes.
A review of 19 studies that examined the effects of the weight cycle revealed that in more than half the studies, there was an association between weight cycling and increased body weight and risk of obesity.
Muscle loss
Weight loss leads to both fat and muscle loss. While fats are regained easily, the same doesn’t happen with muscles. Thus with weight cycling, muscle mass decreases over time.
Increased hunger hormone
Leptin is a hormone released by fat cells. It is a satiety hormone that signals your mind that you are full – controls your appetite. When you lose weight, you lose fat cells – this results in a decrease in your leptin hormone levels. That makes you hungry. Once you come off the diet, you’ll be left with an oversized appetite.
Increased diabetes risk
According to a study in The New England Journal of Medicine, people with the greatest swings in weight also had a 78% increased risk of diabetes, even after correcting all traditional risk factors. This is because weight fluctuations also result in changes in insulin levels.
Increased risk of heart diseases
A study states that weight gain is more dangerous than being overweight for heart diseases. Weight cycling has been studied to narrow down the blood vessels in the heart, leading to coronary heart disease.
Increased risk of gallstones
Weight cycling, or losing and regaining weight repeatedly, may also lead to gallstones. The more weight you lose and regain during a cycle, the greater your chances of developing gallstones. According to a study published in the Archives of Internal Medicine, men whose weight fluctuated more than five pounds were more likely to develop gallstones.
Imbalance in the gut bacteria
Gut bacteria are the good bacteria that help you digest food and are crucial to prevent digestive disorders. Yo-yo dieting can mess up this bacterial population in your gut. This can affect your digestive health, and in some cases, mental health too!
Overcoming The Tendency to Regain Weight
Building Your Muscles
Increasing muscle mass gives a boost to your metabolism. Exercising your muscles can also prevent muscle loss while dieting.
Increasing Your Protein Intake
Protein brings about the feeling of fullness and reduces appetite. It also regulates hunger and satiety hormones. Protein metabolism requires a great deal of energy. Therefore, increasing the protein content in your diet may result in burning more calories.
Maintaining A Healthy Thyroid Gland
The thyroid gland regulates your metabolism. Many studies have shown that treatments with excess thyroid hormones can result in weight loss – however, when the hormone levels drop to the original levels, the weight is regained.
Low thyroid levels (hypothyroidism) can result in weight gain. So, it is important to keep your thyroid hormone levels in check.
Staying Hydrated
Drinking a glass of water before meals can promote fullness and thus, reduce your calorie intake. Further, drinking adequate amounts of water also helps burn calories throughout the day.
Getting Adequate Sleep
Sleep disturbances, especially deprivation, can result in weight gain in adults. It can also interfere with weight maintenance in people who have lost weight. Poor sleeping habits have been linked to lower levels of leptin – an appetite-controlling hormone.
Summary
- Successful weight losses are only one side of the story. Maintaining your weight after successful weight loss is the more challenging part. According to some studies, 80-95% of the people who lose weight tend to regain it (at least some of it) gradually or even shortly after.
- The common causes of weight regain include slowed-down metabolism, calorie gap after experiencing some weight loss, and the change in energy expenditure.
- Your genes also may put you at risk for regaining weight. ADIPOQ is one such gene – it is involved in the formation of adipocytes or fat cells. People with the A allele in rs17300539 have a protective effect against weight regain.
- Weight cycling is the process of repeated weight loss weight gain cycles. It can lead to muscle loss and imbalance in the gut bacteria. It also increases the risk of conditions like diabetes, heart diseases, and gallstones.
- The tendency to regain weight can be avoided by increasing your protein intake, building your muscles, staying hydrated, maintaining healthy thyroid hormone levels, and getting adequate sleep.
Reference
https://pubmed.ncbi.nlm.nih.gov/16469983/
https://www.nejm.org/doi/full/10.1056/NEJMoa1007137
https://www.medicalnewstoday.com/articles/323027
https://www.medicinenet.com/script/main/art.asp?articlekey=17982
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486142/
https://pubmed.ncbi.nlm.nih.gov/18949681/
https://en.wikipedia.org/wiki/Peroxisome_proliferator-activated_receptor_gamma
https://care.diabetesjournals.org/content/diacare/35/2/363.full.pdf
https://www.medscape.com/viewarticle/878295
https://pubmed.ncbi.nlm.nih.gov/17283263/
https://www.eurekalert.org/pub_releases/2006-11/jaaj-wca112206.php
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2777281/
https://pubmed.ncbi.nlm.nih.gov/19661958/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632337/
