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Dakin C, Beaulieu K, Hopkins M, Gibbons C, Finlayson G, Stubbs RJ. Do eating behavior traits predict energy intake and body mass index? A systematic review and meta-analysis. Obes Rev 2023; 24:e13515. [PMID: 36305739 PMCID: PMC10078190 DOI: 10.1111/obr.13515] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/05/2022] [Accepted: 10/06/2022] [Indexed: 12/27/2022]
Abstract
At present, it is unclear whether eating behavior traits (EBT) predict objectively measured short-term energy intake (EI) and longer-term energy balance as estimated by body mass index (BMI). This systematic review examined the impact of EBT on BMI and laboratory-based measures of EI in adults ( ≥ 18 years) in any BMI category, excluding self-report measures of EI. Articles were searched up until 28th October 2021 using MEDLINE, PsycINFO, EMBASE and Web of Science. Sixteen EBT were identified and the association between 10 EBT, EI and BMI were assessed using a random-effects meta-analysis. Other EBT outcomes were synthesized qualitatively. Risk of bias was assessed with the mixed methods appraisal tool. A total of 83 studies were included (mean BMI = 25.20 kg/m2 , mean age = 27 years and mean sample size = 70). Study quality was rated moderately high overall, with some concerns in sampling strategy and statistical analyses. Susceptibility to hunger (n = 6) and binge eating (n = 7) were the strongest predictors of EI. Disinhibition (n = 8) was the strongest predictor of BMI. Overall, EBT may be useful as phenotypic markers of susceptibility to overconsume or develop obesity (PROSPERO: CRD42021288694).
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Affiliation(s)
- Clarissa Dakin
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Mark Hopkins
- School of Food Science & Nutrition, University of Leeds, Leeds, UK
| | - Catherine Gibbons
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Graham Finlayson
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - R James Stubbs
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
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Chew HSJ, Koh WL, Ng JSHY, Tan KK. Sustainability of Weight Loss Through Smartphone Apps: Systematic Review and Meta-analysis on Anthropometric, Metabolic, and Dietary Outcomes. J Med Internet Res 2022; 24:e40141. [PMID: 36129739 PMCID: PMC9536524 DOI: 10.2196/40141] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Evidence on the long-term effects of weight management smartphone apps on various weight-related outcomes remains scarce. Objective In this review, we aimed to examine the effects of smartphone apps on anthropometric, metabolic, and dietary outcomes at various time points. Methods Articles published from database inception to March 10, 2022 were searched, from 7 databases (Embase, CINAHL, PubMed, PsycINFO, Cochrane Library, Scopus, and Web of Science) using forward and backward citation tracking. All randomized controlled trials that reported weight change as an outcome in adults with overweight and obesity were included. We performed separate meta-analyses using random effects models for weight, waist circumference, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, blood glucose level, blood pressure, and total energy intake per day. Methodological quality was assessed using the Cochrane Risk of Bias tool. Results Based on our meta-analyses, weight loss was sustained between 3 and 12 months, with a peak of 2.18 kg at 3 months that tapered down to 1.63 kg at 12 months. We did not find significant benefits of weight loss on the secondary outcomes examined, except for a slight improvement in systolic blood pressure at 3 months. Most of the included studies covered app-based interventions that comprised of components beyond food logging, such as real-time diet and exercise self-monitoring, personalized and remote progress tracking, timely feedback provision, smart devices that synchronized activity and weight data to smartphones, and libraries of diet and physical activity ideas. Conclusions Smartphone weight loss apps are effective in initiating and sustaining weight loss between 3 and 12 months, but their effects are minimal in their current states. Future studies could consider the various aspects of the socioecological model. Conversational and dialectic components that simulate health coaches could be useful to enhance user engagement and outcome effectiveness. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42022329197; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=329197
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Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wee Ling Koh
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Janelle Shaina Hui Yi Ng
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ker Kan Tan
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Surgery, National University Hospital, Singapore, Singapore
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Casanova N, Beaulieu K, Oustric P, O'Connor D, Gibbons C, Blundell J, Finlayson G, Hopkins M. Increases in physical activity are associated with a faster rate of weight loss during dietary energy restriction in women with overweight and obesity. Br J Nutr 2022; 129:1-28. [PMID: 35249565 DOI: 10.1017/s000711452200023x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This secondary analysis examined the influence of changes in physical activity (PA), sedentary time and energy expenditure (EE) during dietary energy restriction on the rate of weight loss (WL) and 1-year follow-up weight change in women with overweight/obesity.Measurements of body weight and composition (air-displacement plethysmography), resting metabolic rate (indirect calorimetry), total daily (TDEE) and activity EE (AEE), minutes of PA and sedentary time (PA monitor) were taken at baseline, after 2 weeks, after ≥5% WL or 12 weeks of continuous (25% daily energy deficit) or intermittent (75% daily energy deficit alternated with ad libitum day) energy restriction, and at 1-year post-WL. The rate of WL was calculated as total %WL/number of dieting weeks. Data from both groups were combined for analyses.Thirty-seven participants (age=35±10y; BMI=29.1±2.3kg/m2) completed the intervention (WL=-5.9±1.6%) and 18 returned at 1-year post-WL (weight change=+4.5±5.2%). Changes in sedentary time at 2 weeks were associated with the rate of WL during energy restriction (r=-0.38; p=0.03). Changes in total (r=0.54; p<0.01), light (r=0.43; p=0.01) and moderate-to-vigorous PA (r=0.55; p<0.01), sedentary time (r=-0.52; p<0.01), steps per day (r=0.39; p=0.02), TDEE (r=0.46; p<0.01) and AEE (r=0.51; p<0.01) during energy restriction were associated with the rate of WL. Changes in total (r=-0.50; p=0.04) and moderate-to-vigorous PA (r=-0.61; p=0.01) between post-WL and follow-up were associated with 1-year weight change (r=-0.51; p=0.04).These findings highlight that PA and sedentary time could act as modifiable behavioural targets to promote better weight outcomes during dietary energy restriction and/or weight maintenance.
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Affiliation(s)
- Nuno Casanova
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
- KinesioLab, Research Unit in Human Movement Analysis, Piaget Institute, Av. Jorge Peixinho 30 Quinta da Arreinela, 2805-059 Almada, Portugal
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Pauline Oustric
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Dominic O'Connor
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Catherine Gibbons
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - John Blundell
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Graham Finlayson
- Appetite Control and Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, UK
| | - Mark Hopkins
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
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"I didn't want to do it on my own": A qualitative study of women's perceptions of facilitating and risk factors for weight control on a UK commercial community program. Appetite 2021; 165:105308. [PMID: 34010725 DOI: 10.1016/j.appet.2021.105308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 11/24/2022]
Abstract
Overweight and obesity remain serious public health concerns. Outcomes from community based commercial weight management programmes vary, relapse is common and drop out is high. Outcomes could be improved by better understanding experiences on these programmes. The aim of our study was to generate accounts of people's experience on a commercial weight-management program to identify what experiences were perceived as facilitating, and what posed risks, to programme effectiveness and compliance. We conducted individual, semi-structured interviews with eighteen Caucasian women (mean age 45.4y) who were members of nation-wide UK commercial, fee-paying, community weight management programme. Interview data was analysed via framework analysis. Participants' experiences indicated that the programme helped by triggering several intra- and interpersonal processes that catalysed change across psychological, physiological, dietary and behavioural areas of their life. Risks to program adherence and effectiveness spanned well-known risks such as self-regulation fatigue and the difficulty of recovering from negative self-criticism, as well as new factors such as the confusing nature of weight change, the relatively powerful impact of everyday events, and the difficulty in getting the balance right between personalised support vs. intrusion. The complexity of reported experiences challenges the linear, predictive pathways of change proposed by many health behaviour models of weight management. To improve effectiveness, programmes need to go well beyond behavioural and dietary support. It is recommended that community, commercial programmes educate people about the physiological and psychological tensions they will encounter, why people lose weight at different rates, the likelihood of weight relapse and strategies to manage these, including evidence-based support for managing self-criticism.
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Stubbs RJ, Duarte C, Palmeira AL, Sniehotta FF, Horgan G, Larsen SC, Marques MM, Evans EH, Ermes M, Harjumaa M, Turicchi J, O'Driscoll R, Scott SE, Pearson B, Ramsey L, Mattila E, Matos M, Sacher P, Woodward E, Mikkelsen ML, Sainsbury K, Santos I, Encantado J, Stalker C, Teixeira PJ, Heitmann BL. Evidence-Based Digital Tools for Weight Loss Maintenance: The NoHoW Project. Obes Facts 2021; 14:320-333. [PMID: 33915534 PMCID: PMC8255638 DOI: 10.1159/000515663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 03/04/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.g., provide choice). Stress management and emotion regulation techniques show potential for prevention of relapse and weight regain. Digital technologies (including networked-wireless tracking technologies, online tools and smartphone apps, multimedia resources, and internet-based support) offer attractive tools for teaching and supporting long-term behaviour change techniques. However, many digital offerings for weight management tend not to include evidence-based content and the evidence base is still limited. The Project: First, the project examined why, when, and how many European citizens make WL and WLM attempts and how successful they are. Second, the project employed the most up-to-date behavioural science research to develop a digital toolkit for WLM based on 2 key conditions, i.e., self-management (self-regulation and motivation) of behaviour and self-management of emotional responses for WLM. Then, the NoHoW trial tested the efficacy of this digital toolkit in adults who achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25). The primary outcome was change in weight (kg) at 12 months from baseline. Secondary outcomes included biological, psychological, and behavioural moderators and mediators of long-term energy balance (EB) behaviours, and user experience, acceptability, and cost-effectiveness. IMPACT The project will directly feed results from studies on European consumer behaviour, design and evaluation of digital toolkits self-management of EB behaviours into development of new products and services for WLM and digital health. The project has developed a framework and digital architecture for interventions in the context of EB tracking and will generate results that will help inform the next generation of personalised interventions for effective self-management of weight and health.
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Affiliation(s)
- R. James Stubbs
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Cristiana Duarte
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, University of Coimbra, Coimbra, Portugal
| | - António L. Palmeira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Falko F. Sniehotta
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Graham Horgan
- Biomathematics and Statistics Scotland (James Hutton Institute), Aberdeen, United Kingdom
| | - Sofus C. Larsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Marta M. Marques
- Trinity Centre for Practice and Healthcare Innovation and ADAPT Centre, Trinity College Dublin, Dublin, Ireland
| | - Elizabeth H. Evans
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Miikka Ermes
- VTT Technical Research Centre of Finland, Espoo, Finland
| | - Marja Harjumaa
- VTT Technical Research Centre of Finland, Espoo, Finland
| | - Jake Turicchi
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Ruari O'Driscoll
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Sarah E. Scott
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Beth Pearson
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Lauren Ramsey
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Elina Mattila
- VTT Technical Research Centre of Finland, Espoo, Finland
| | - Marcela Matos
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, University of Coimbra, Coimbra, Portugal
| | - Paul Sacher
- Childhood Nutrition Research Centre, University College London, London, United Kingdom
| | - Euan Woodward
- European Association for the Study of Obesity, Teddington, United Kingdom
| | - Marie-Louise Mikkelsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Kirby Sainsbury
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Inês Santos
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Jorge Encantado
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Carol Stalker
- College of Life and Natural Sciences, University of Derby, Derby, United Kingdom
| | - Pedro J. Teixeira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Berit Lilienthal Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, New South Wales, Australia
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Stubbs RJ, Turicchi J. From famine to therapeutic weight loss: Hunger, psychological responses, and energy balance-related behaviors. Obes Rev 2021; 22 Suppl 2:e13191. [PMID: 33527688 DOI: 10.1111/obr.13191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/18/2022]
Abstract
Understanding physiological and behavioral responses to energy imbalances is important for the management of overweight/obesity and undernutrition. Changes in body composition and physiological functions associated with energy imbalances provide the structural and functional context in which to consider psychological and behavioral responses. Compensatory changes in physiology and behavior are more pronounced in response to negative than positive energy balances. The physiological and psychological impact of weight loss (WL) occur on a continuum determined by (i) the degree of energy deficit (ED), (ii) its duration, (iii) body composition at the onset of the energy deficit, and (iv) the psychosocial environment in which it occurs. Therapeutic WL and famine/semistarvation both involve prolonged EDs, which are sometimes similar in magnitude. The key differences are that (i) the body mass index (BMI) of most famine victims is lower at the onset of the ED, (ii) therapeutic WL is intentional and (iii) famines are typically longer in duration (partly due to the voluntary nature of therapeutic WL and disengagement with WL interventions). The changes in psychological outcomes, motivation to eat, and energy intake in therapeutic WL are often modest (bearing in mind the nature of the measures used) and can be difficult to detect but are quantitatively significant over time. As WL progresses, these changes become more marked. It appears that extensive WL beyond 10%-20% in lean individuals has profound effects on body composition and physiological function. At this level of WL, there is a marked erosion of psychological functioning, which appears to run in parallel to WL. Psychological resources dwindle and become increasingly focused on alleviating escalating hunger and food seeking behavior. Functional changes in fat-free mass, characterized by catabolism of skeletal muscle and organs may be involved in the drive to eat associated with semistarvation. Higher levels of body fat mass may act as a buffer to protect fat-free mass, functional integrity and limit compensatory changes in energy balance behaviors. The increase in appetite that accompanies therapeutic WL appears to be very different to the intense and all-consuming drive to eat that occurs during prolonged semistarvation. The mechanisms may also differ but are not well understood, and longitudinal comparisons of the relationship between body structure, function, and behavior in response to differing EDs in those with higher and lower BMIs are currently lacking.
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Affiliation(s)
- R James Stubbs
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Jake Turicchi
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
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Stubbs RJ, Duarte C, O'Driscoll R, Turicchi J, Kwasnicka D, Sniehotta FF, Marques MM, Horgan G, Larsen S, Palmeira A, Santos I, Teixeira PJ, Halford J, Heitmann BL. The H2020 "NoHoW Project": A Position Statement on Behavioural Approaches to Longer-Term Weight Management. Obes Facts 2021; 14:246-258. [PMID: 33662958 PMCID: PMC8138206 DOI: 10.1159/000513042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 11/13/2020] [Indexed: 12/26/2022] Open
Abstract
There is substantial evidence documenting the effects of behavioural interventions on weight loss (WL). However, behavioural approaches to initial WL are followed by some degree of longer-term weight regain, and large trials focusing on evidence-based approaches to weight loss maintenance (WLM) have generally only demonstrated small beneficial effects. The current state-of-the-art in behavioural interventions for WL and WLM raises questions of (i) how we define the relationship between WL and WLM, (ii) how energy balance (EB) systems respond to WL and influence behaviours that primarily drive weight regain, (iii) how intervention content, mode of delivery and intensity should be targeted to keep weight off, (iv) which mechanisms of action in complex interventions may prevent weight regain and (v) how to design studies and interventions to maximise effective longer-term weight management. In considering these issues a writing team within the NoHoW Consortium was convened to elaborate a position statement, and behaviour change and obesity experts were invited to discuss these positions and to refine them. At present the evidence suggests that developing the skills to self-manage EB behaviours leads to more effective WLM. However, the effects of behaviour change interventions for WL and WLM are still relatively modest and our understanding of the factors that disrupt and undermine self-management of eating and physical activity is limited. These factors include physiological resistance to weight loss, gradual compensatory changes in eating and physical activity and reactive processes related to stress, emotions, rewards and desires that meet psychological needs. Better matching of evidence-based intervention content to quantitatively tracked EB behaviours and the specific needs of individuals may improve outcomes. Improving objective longitudinal tracking of energy intake and energy expenditure over time would provide a quantitative framework in which to understand the dynamics of behaviour change, mechanisms of action of behaviour change interventions and user engagement with intervention components to potentially improve weight management intervention design and evaluation.
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Affiliation(s)
- R James Stubbs
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom,
| | - Cristiana Duarte
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Ruairi O'Driscoll
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Jake Turicchi
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Dominika Kwasnicka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
- Digital Health, NHMRC Centre for Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, University of Melbourne, Melbourne, Virgin Islands, Australia
| | - Falko F Sniehotta
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Marta M Marques
- Trinity Centre for Practice and Healthcare Innovation and ADAPT Centre, Trinity College Dublin, Dublin, Ireland
| | - Graham Horgan
- Biomathematics and Statistics Scotland (James Hutton Institute), Aberdeen, United Kingdom
| | - Sofus Larsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - António Palmeira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Inês Santos
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Pedro J Teixeira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Jason Halford
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Berit Lilienthal Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
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How dieting might make some fatter: modeling weight cycling toward obesity from a perspective of body composition autoregulation. Int J Obes (Lond) 2020; 44:1243-1253. [PMID: 32099104 PMCID: PMC7260129 DOI: 10.1038/s41366-020-0547-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/09/2020] [Accepted: 02/06/2020] [Indexed: 01/28/2023]
Abstract
The notion that dieting makes some people fatter has in the past decade gained considerable interest from both epidemiological predictions and biological plausibility. Several large-scale prospective studies have suggested that dieting to lose weight is associated with future weight gain and obesity, with such predictions being stronger and more consistent among dieters who are in the normal range of body weight rather than in those with obesity. Furthermore, the biological plausibility that dieting predisposes people who are lean (rather than those with overweight or obesity) to regain more body fat than what had been lost (referred to as fat overshooting) has recently gained support from a re-analysis of data on body composition during weight loss and subsequent weight recovery from the classic longitudinal Minnesota Starvation Experiment. These have revealed an inverse exponential relationship between the amount of fat overshot and initial adiposity, and have suggested that a temporal desynchronization in the recoveries of fat and lean tissues, in turn residing in differences in lean-fat partitioning during weight loss vs. during weight recovery (with fat recovery faster than lean tissue recovery) is a cardinal feature of fat overshooting. Within a conceptual framework that integrates the relationship between post-dieting fat overshooting with initial adiposity, the extent of weight loss and the differential lean-fat partitioning during weight loss vs. weight recovery, we describe here a mathematical model of weight cycling to predict the excess fat that could be gained through repeated dieting and multiple weight cycles from a standpoint of body composition autoregulation.
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