The role of appetite-related hormones, adaptive thermogenesis, perceived hunger and stress in long-term weight-loss maintenance: a mixed-methods study

Thom, George; Dombrowski, Stephan U; Brosnahan, Naomi; Algindan, Yasmin Y.; Lopez-Gonzalez, M. Rosario; Roditi, Giles; Lean, Michael E. J.; Malkova, Dalia

doi:10.1038/s41430-020-0568-9

Cited by 38 publications

(37 citation statements)

References 63 publications

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“…The present study is a secondary analysis of data collected from healthy adult women across energy balance research studies performed in the Human Nutrition Unit at the University of Glasgow between 2008 and 2017 (24)(25)(26)(27)(28)(29) . Participants (n 125; aged 20-57 years; BMI 17-44 kg/m 2 ) were sedentary, non-smokers, not pregnant, not taking medication which could affect RMR and had maintained stable body weight for at least 2 months prior to study enrolment.…”

Section: Participantsmentioning

confidence: 99%

“…Only the baseline RMR values measured prior to participation in the interventions were considered for the present study. Four studies were approved by the College of Medical, Veterinary and Life Sciences of the University of Glasgow Ethics Committee (24)(25)(26)(27)(28) , and the other by the West of Scotland NHS Ethics Committee (29) . Studies were conducted in accordance with the Declaration of Helsinki, and all participants recruited provided written informed consent.…”

Section: Participantsmentioning

confidence: 99%

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Validity of predictive equations to estimate RMR in females with varying BMI

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Estimation of RMR using prediction equations is the basis for calculating energy requirements. In the present study, RMR was predicted by Harris–Benedict, Schofield, Henry, Mifflin–St Jeor and Owen equations and measured by indirect calorimetry in 125 healthy adult women of varying BMI (17–44 kg/m2). Agreement between methods was assessed by Bland–Altman analyses and each equation was assessed for accuracy by calculating the percentage of individuals predicted within ± 10 % of measured RMR. Slopes and intercepts of bias as a function of average RMR (mean of predicted and measured RMR) were calculated by regression analyses. Predictors of equation bias were investigated using univariate and multivariate linear regression. At group level, bias (the difference between predicted and measured RMR) was not different from zero only for Mifflin–St Jeor (0 (sd 153) kcal/d (0 (sd 640) kJ/d)) and Henry (8 (sd 163) kcal/d (33 (sd 682) kJ/d)) equations. Mifflin–St Jeor and Henry equations were most accurate at the individual level and predicted RMR within 10 % of measured RMR in 71 and 66 % of participants, respectively. For all equations, limits of agreement were wide, slopes of bias were negative, and intercepts of bias were positive and significantly (P < 0⋅05) different from zero. Increasing age, height and BMI were associated with underestimation of RMR, but collectively these variables explained only 15 % of the variance in estimation bias. Overall accuracy of equations for prediction of RMR is low at the individual level, particularly in women with low and high RMR. The Mifflin–St Jeor equation was the most accurate for this dataset, but prediction errors were still observed in about one-third of participants.

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Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Validity of predictive equations to estimate RMR in females with varying BMI

et al. 2020

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“…Weight loss is considered to alter hunger and satiety pathways in a direction favouring positive energy balance ( 41 ) , although, in a separate mixed‐methods analysis of the data generated as part of the present study, stress rather than hunger was perceived as the factor most likely to trigger eating/weight regain during WLM ( 18 ) . Nevertheless, self‐regulation of appetite involves a complex interaction between several biological and psychological factors ( 42 ) .…”

Section: Discussionmentioning

confidence: 89%

“…This research was part of a wider, single‐arm study investigating changes in body composition ( 17 ) and metabolic adaptation to weight loss ( 18 ) , which was approved by the West of Scotland Research Ethics Committee (reference number: 14/WS/1164) and NHS Greater Glasgow & Clyde Research and Development Department. Participants provided their written informed consent to participate in all aspects of the study; however, ethical approval for this qualitative study was obtained after seven of 22 participants had already been recruited into the weight management programme.…”

Section: Methodsmentioning

confidence: 99%

‘I have been all in, I have been all out and I have been everything in‐between’: A 2‐year longitudinal qualitative study of weight loss maintenance

Thom

Lean

Brosnahan

et al. 2020

J Human Nutrition Diet

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Background Qualitative studies investigating weight management experiences are usually cross‐sectional or of short duration, which limits understanding of the long‐term challenges. Methods Eleven women [mean (SD) age 44.9 (9.8) years; body mass index 40.3 (4.0) kg m−2] participated in this longitudinal qualitative study, which included up to 20 weeks of total diet replacement (825–853 kcal day−1) and ongoing support for weight loss maintenance (WLM), to 2 years. Semi‐structured interviews were conducted at baseline and programme end, as well as at key intervals during the intervention. Questions examined five theoretical themes: motivation, self‐regulation, habits, psychological resources and social/environmental influences. Data were coded and analysed in nvivo (https://qsrinternational.com/nvivo) using the framework method. Results In total, 64 interviews were completed (median, n = 6 per participant). Mean (SD) weight loss was 15.7 (9.6) kg (14.6% body weight) at 6 months and 9.6 (9.9) kg (8.8% body weight) at 2 years. The prespecified theoretical model offered a useful framework to capture the variability of experiences. Negative aspects of obesity were strong motivations for weight loss and maintenance. Perceiving new routines as sustainable and developing a ‘maintenance mindset’ was characteristic of ‘Maintainers’, whereas meeting emotional needs at the expense of WLM goals during periods of stress and negative mood states was reported more often by ‘Regainers’. Optimistic beliefs about maintaining weight losses appeared to interfere with barrier identification and coping planning for most participants. Conclusions People tended to be very optimistic about WLM without acknowledging barriers and this may undermine longer‐term outcomes. The potential for regain remained over time, mainly as a result of emotion‐triggered eating to alleviate stress and negative feelings. More active self‐regulation during these circumstances may improve WLM, and these situations represent important targets for intervention.

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“…We thank Professor. Martins for comments on our paper (1). She is entirely correct concerning the description of Figure 4c: an oversight in the original manuscript was missed by all co-authors and reviewers.…”

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The role of appetite-related hormones, adaptive thermogenesis, perceived hunger and stress in long-term weight-loss maintenance: a mixed-methods study

Abstract: The role of appetite-related hormones, adaptive thermogenesis, perceived hunger and stress in long-term weight-loss maintenance: a mixed-methods study.

Cited by 38 publications

References 63 publications

Validity of predictive equations to estimate RMR in females with varying BMI

Validity of predictive equations to estimate RMR in females with varying BMI

‘I have been all in, I have been all out and I have been everything in‐between’: A 2‐year longitudinal qualitative study of weight loss maintenance

Response to comments on “The role of appetite-related hormones, adaptive thermogenesis, perceived hunger and stress in long-term weight-loss maintenance: a mixed methods study”

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