Persistence of weight loss and acquired behaviors 2 y after stopping a 2-y calorie restriction intervention

Abstract

Background: Calorie restriction (CR) influences aging processes and extends average and maximal life spans. The CALERIE 2 (Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy Phase 2) study was the first randomized clinical trial to examine the metabolic and psychological effects of CR in nonobese humans. Objective: We conducted a 2-y follow-up study of adults who underwent 2 y of CR or ad libitum (control) consumption and determined whether weight loss and acquired behaviors persisted after the study ended when participants determined their own lifestyle behaviors. Design: In this prospective, longitudinal study, we assessed differences in weight, body composition, psychological function, and energy expenditure in 39 nonobese [body mass index (in kg/m 2 ): 22-28] men and women (25% CR: n = 24; control: n = 15) 12 and 24 mo after they completed the CALERIE 2 study at Pennington Biomedical. Results: Of 39 participants who were in the follow-up study, 29 subjects (CR: n = 18; control: n = 11) completed all visits at followup months 12 and 24. After the CR intervention, a mean 6 SEM weight loss of 9.0 6 0.6 kg was observed in the CR group, in which only 54% of the weight was regained 2 y later. Despite such a regain, weight, the percentage of body fat, and fat mass remained significantly reduced from baseline throughout follow-up and remained significantly less than in the control group (P , 0.05). At follow-up, the CR group retained higher degrees of dietary restraint and avoidance of certain foods. Conclusion: After a 2-y intensive CR intervention, w50% of CR-induced weight loss was maintained 2 y later, which was probably the result of lasting effects on acquired behaviors and dietary restraint. This trial was registered at clinicaltrials.gov as NCT00943215.Am J Clin Nutr 2017;105:928-35.

From famine to therapeutic weight loss: Hunger, psychological responses, and energy balance‐related behaviors

“…State hunger at 12 months and disinhibited eating increased compared with the control group, with small-moderate effect sizes. 136 In a subgroup of the caloric restriction intervention, followed-up for a further 2 years, 54% of the weight lost (9.0 kg) was regained despite persistence of higher cognitive restraint, 92 consistent with the modeling work mentioned above. 130,132 As weight is progressively lost, evidence suggests that physiological signaling systems actively oppose further WL through compensatory decreases EE and increases in appetite and EI.…”

“…142 The evidence from the CALERIE studies shows similarly weak evidence of small alterations in appetitive states. 86,91,92,124 These studies provide limited evidence under conservative conditions (10% WL in people with a high body weight and FM) that the relationship between changes in BC and appetitive outcomes so clearly elucidated in the Minnesota study 141,143 are (barely) detectable, but small, at lower levels of WL in people with a higher FM than the Minnesota or CNL subjects. We hypothesize that the subtlety of this effect is likely to be a real phenomenon (see below), which would escalate at higher degrees of WL and lower levels of body fatness.…”

“…In more severe famines, the average WLs fall in the region of 20%-25% 1 (pp. [90][91][92][93][94][95][96][97][98] but can reach 40%-50%. Accounts of the effects of semistarvation on body weight are available from WW2 for the population of Leige 27 ; inmates in a Belgian prison, 28 have been estimated.…”

“…82 Presumably, movement-based physical activity is less, which is apparently balanced out by the higher energy cost of movement in heavier people. 91 The adaptations can in some, 67,87 but not other circumstances, persist for 12 months or longer after WL, 92 possibly influenced by the FM at the onset of the ED. produced some evidence of postoverfeeding compensatory reductions in hunger or responsivity to food cues.…”

Obesity and Eating Disturbance: the Role of TFEQ Restraint and Disinhibition

“…In comparison, those studies which utilized, for example, the Mediterranean diet [83] and high-protein and high0carbohydrate diets [79], calorie restricting diets [88], and lifestyle intervention including dietary advice [80] saw increases in TFEQ Restraint and decreases in Disinhibition. Weight loss with these diets was associated with increases in Restraint [80, 88], decreases in Disinhibition [79], or both [83]. It is plausible that changes in eating behavior traits are associated with changes in appetite peptides, where TFEQ Hunger positively predicted ghrelin levels during weight loss [85].…”