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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)
Postprint DOI PMC
Open Access Green
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
Corresponding Author
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
Journal International Journal of Obesity
Quellenangaben Volume: 45, Issue: , Pages: 840–849 Article Number: , Supplement: ,
Publisher Nature Publishing Group
Publishing Place Campus, 4 Crinan St, London, N1 9xw, England
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Helmholtz Institute for Metabolism, Obesity and Vascular Research (HI-MAG)
Grants National Institute of Diabetes and Digestive and Kidney Diseases
National Institutes of Health
Ministero dell’Istruzione, dell’Università e della Ricerca