VIDEO: Experts debate role of metabolic adaptation in weight regain

BOSTON — The phenomenon known as metabolic adaptation and its impact on weight regain remains “one of the biggest controversies in the nutrition field,” according to a presenter at NUTRITION.

“We all know that obesity is a big problem, particularly in the U.S., and the biggest challenge in its management is weight regain,” Catia Martins, PhD, RD, an associate professor at the University of Alabama at Birmingham, said. “It has been proposed that one of the mechanisms responsible for weight regain is a physiological adaptation called metabolic adaptation.”

Martins explained that when an individual loses weight, there is an expected reduction in energy expenditure.

“However, some studies suggest that this reduction is larger than expected for the lower body weight, and that is what we call metabolic adaptation,” she said. “Some studies show that it exists. Other studies show that it doesn’t.”

In their presentation, Martins and Jonathon Krakoff, MD, chief of the obesity and diabetes clinical research section at the National Institute of Diabetes and Digestive and Kidney Diseases, gave differing opinions on the topic.

“My perspective is that metabolic adaptation is an illusion due to methodological constraints of the available studies, and that it does not predict weight regain in the long term,” Martins said.

Although the researchers do not currently know the clinical relevance of metabolic adaptation, Martins said “we hope to put together a golden standard study to try to address these controversies.”

Reference:

• Martins C, et al. Metabolic adaptation and increased drive to eat as drivers or weight regain in individuals with obesity. Myth or reality? An exercise in adversarial collaboration. Presented at: NUTRITION; July 22-25, 2023.