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Hollstein, T.* ; Heinitz, S. ; Basolo, A.* ; Krakoff, J.* ; Votruba, S.B.* ; Piaggi, P.*

Reduced metabolic efficiency in sedentary eucaloric conditions predicts greater weight regain in adults with obesity following sustained weight loss.

Int. J. Obes. 45, 840–849 (2021)
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Free by publisher: Publ. Version/Full Text online available 03/2026
BACKGROUND: Successful long-term weight loss maintenance after caloric restriction (CR) is rarely achieved. Besides known metabolic, behavioural, and cognitive factors, 24-hour energy expenditure (24hEE) relative to body size (i.e., metabolic efficiency) might influence subsequent weight loss maintenance. METHODS: Eleven participants with obesity (BMI = 39.0 ± 8.7 kg/m2, body fat = 36.1 ± 6.4%) had 24hEE measured in a whole-room indirect calorimeter during eucaloric conditions and weight stability prior to starting a 6-week inpatient CR study (50% of daily energy needs). Twenty-four-hour energy expenditure was adjusted via regression analysis for fat free mass (FFM) and fat mass (FM) by DXA. Body composition was reassessed at the end of CR and after 1-year follow-up. Free-living weight was assessed by monthly weight measurements during 12 months. RESULTS: After 6-week CR, participants lost 8.5 ± 2.7% weight (FFM: -6.3 ± 3.6 kg, FM: -3.4 ± 1.2 kg) but regained 5.1 ± 8.0% 1 year following CR, which was mostly due to FFM regain (+5.7 ± 5.5 kg) and unchanged FM. A relatively higher 24hEE by 100 kcal/day prior to CR was associated with an average greater rate of weight regain by +0.3 kg/month during follow-up and a greater final weight regain by +5.1 kg after 1 year of follow-up. CONCLUSION: These results suggest that reduced metabolic efficiency in 24hEE during eucaloric, sedentary conditions may predict greater weight regain after CR-induced weight loss.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Fat-free Mass; Daily Energy-expenditure; Muscle Work Efficiency; Ad-libitum Food; Respiratory Quotient; Physical-activity; Body-composition; Appetite Control; Adaptive Thermogenesis; Caloric Restriction
ISSN (print) / ISBN 0307-0565
e-ISSN 1476-5497
Quellenangaben Volume: 45, Issue: , Pages: 840–849 Article Number: , Supplement: ,
Publisher Nature Publishing Group
Publishing Place Campus, 4 Crinan St, London, N1 9xw, England
Reviewing status Peer reviewed
Institute(s) Helmholtz Institute for Metabolism, Obesity and Vascular Research (HI-MAG)
Grants Ministero dell’Istruzione, dell’Università e della Ricerca
National Institutes of Health
National Institute of Diabetes and Digestive and Kidney Diseases