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Relapse in obesity management: does increased appetite and reduced energy expenditure play a role?
Published on January 31, 2022 33 min
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Hi, my name is Cátia Martins and I'm a professor of obesity and metabolism at the Norwegian University of Science and Technology. Today, I'm going to talk about relapse in obesity management and discuss with you if increased appetite and reduced energy expenditure play a role in this process.
The biggest challenge in obesity management is not weight-loss. The majority of the individuals with obesity are able to lose clinically significant amounts of weight with different interventions. The challenge is that the majority regain at least some of the weight that they have worked so hard to lose in the long-term. Some even relapse above baseline weight. This happens regardless of the intervention that is used to induce weight loss- different types of exercise, different diets, combined behavioral interventions, and even bariatric surgery.
There are two main theories that try to explain relapse and obesity treatment. One is related to motivation and behavioral issues. The lack of willpower and poor compliance to diet and exercise regime. This idea is that patients will sooner or later revert back to their old lifestyle of overeating and sedentary lifestyle. This is related to a self-regulatory theory that restraint is always followed by disinhibition or loss of inhibition. The other view is related to physiology, which is called the compensatory theory. This theory claims that the body fights against weight loss and tries to bring it back to its original state. This theory claims that weight loss is followed by a significant increase in the drive to eat, despite a significant reduction in total energy expenditure. Of course, both of these mechanisms, both behavioral and physiology could then lead to weight regain in the long term.