The health improvements that come with weight loss, including better blood sugar, blood pressure and cholesterol, reverse when the weight is regained, according to a review in The Lancet Diabetes & Endocrinology by Faidon Magkos of the University of Copenhagen and Norbert Stefan of the German Center for Diabetes Research. The authors point to high-protein eating and exercise as effective ways to limit lean mass loss while weight comes off, citing a meta-analysis in which lean mass made up 19% of the weight lost on high-protein diets, compared with 29% on normal-protein diets.
The paper is a Personal View, a review of evidence from human and animal studies. On Oct. 2, the same authors published a comment in Nature Reviews Endocrinology arguing that the implications of weight cycling may depend on a person’s starting weight.
The body burns fewer calories at rest during weight loss, largely because it loses lean mass, the metabolically active part of the body, the authors write. In people with obesity, lean mass makes up about 20% to 30% of the weight lost, compared with 35% to 50% in people of normal weight.
The authors describe weight regain as a complex process shaped by physiological, psychological and environmental factors, including genetics, body composition and hormonal changes. Nine in 10 people who eventually kept weight off, including participants in the U.S. National Weight Control Registry, had made multiple earlier attempts to lose weight, the review notes.
Regain still carries a cost. In Framingham Heart Study and Diabetes Prevention Program data cited in the review, the link between weight cycling and diabetes disappeared once average body weight or BMI during the study was taken into account. The authors conclude that higher adiposity likely drives both weight cycling and cardiometabolic disease risk.
Trilivy™, the metabolic health system from Medifast, emphasizes body composition during active weight loss, treating it as the more meaningful measure of metabolic progress by tracking what happens to visceral fat and lean mass.
In a 16-week randomized trial (Arterburn LM et al., Obes Sci Pract. 2019;5(1):3-14), the company reports, participants on what is now the Reset 5 & 1 Plan retained 98% of their lean mass.
The company describes a metabolic reset as work on how the body uses energy, burns fat and holds onto lean mass, rather than deeper calorie cuts. “Weight is the most visible signal, but it is rarely the whole story,” said Satya Jonnalagadda, PhD, MBA, RD, vice president of scientific and clinical affairs at Trilivy. “When you organize a program around metabolic function, you are measuring what is happening to visceral fat and lean mass, not just the number on a scale. Two people can lose the same weight and have very different things happening inside their bodies, and the goal of this system is to make the difference work in the person’s favor.”
For people who have lost and regained weight before, the review brings the focus back to keeping it off. The improvements in blood sugar and cholesterol that come with weight loss fade as the weight returns, and the lean mass protected while weight comes off helps determine how many calories the body burns at rest, placing long-term weight maintenance at the center of lasting metabolic health.
* Trilivy™ recommends that you contact your healthcare provider before starting and throughout your weight loss journey.
* Arterburn LM, et al. Randomized controlled trial assessing two commercial weight loss programs in adults with overweight or obesity. Obesity Science & Practice. 2019. https://onlinelibrary.wiley.com/doi/10.1002/osp4.312. In a clinical study, individuals on the Reset 5 & 1 Plan experienced a reduction of 14% visceral fat and 98% of lean mass was retained at 16 weeks.
M&F and editorial staff were not involved in the creation of this content.
