Does Physical Activity and Self-Weighing Prevent Weight Regain?

It’s basic physiology and it’s the bane of obesity care – weight regain. When a person loses weight, homeostasis kicks in. The body protects itself by working really hard to restore its reserves of energy in fat tissue. But the lore of weight loss holds that a person can fight that off with physical activity and vigilant self-weighing.

Is it true? Sadly, not 100 percent.

The NULevel Study

Last week, researchers published a randomized, controlled trial of weight maintenance in PLOS Medicine. The whole idea of the NULevel was to deliver an efficient program though telemedicine that would help people maintain a new, lower weight for themselves. The strategy was simple. Encourage people to keep up a higher level of physical activity. Plus, encourage them to keep tabs on their weight more frequently.

The strategy worked. People in the telemedicine program were more active a year later. They also weighed themselves more often. The control group received standard advice in a newsletter. But unfortunately, that extra physical activity and self-weighing didn’t change the weight outcomes. Both groups regained an identical amount of weight – 1.8 kg.

The Power of Physiology

Now the point here is not that weight maintenance is impossible. Not at all. The real point is that conventional wisdom and behavioral strategies have their limits. It may be, as the authors of this study have speculated, that the support program was not intense enough. Or maybe it’s just the wrong approach. “Further work is required,” as the saying goes.

However, it’s also important to recognize the power of physiology. Another recent study offers insight into some ways that adipose tissue metabolism might affect weight maintenance. In Diabetes, Knut Mai and colleagues document changes in lipid metabolism that follow weight loss. And they show those changes can predict who will maintain more weight loss and who will have more weight regain. For the first time, they pinpoint how genes involved with lipid metabolism might guide these differences.

Focus and motivation might play a role, but people who deny the importance of physiology are simply ignorant.

Knowledge is a beautiful thing. And the knowledge we’re building about weight regulation is power. It’s power for developing more effective strategies for obesity care and better health.

Click here for the study from PLOS Medicine and here for the study from Diabetes. For a systematic review of determinants of weight maintenance, click here.

Self-Weighing, photograph © Allan Foster / flickr

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May 12, 2019