About Unsuccessful Responders to Diet and Physical Activity Interventions: A Focus on Energy Balance and Body-Weight Loss

TL;DR

Some people gain weight despite following diet and exercise programs, suggesting that individual differences in metabolism and genetics play a role in weight loss outcomes.

Contribution

The paper highlights that unsuccessful weight loss responses are partly due to genetic and metabolic factors, not just lack of adherence.

Findings

Unsuccessful weight loss responses occur in 5% to 20% of individuals despite adherence to interventions.

Behavioral and metabolic changes, including appetite control and thermogenesis, influence weight outcomes.

Experimental evidence shows that responses to negative-energy balance are genetically determined.

Abstract

It is difficult to imagine that an individual living with obesity may gain body weight in response to a diet and physical activity program aiming at a negative energy balance. However, this type of case is a matter of usual occurrence in obesity clinics and has been traditionally explained by a lack of adherence to guidelines. While a link between adherence to a weight loss intervention and its outcome has been demonstrated, there is growing evidence showing that unsuccessful response to weight-reducing programs may happen in some individuals despite adequate adherence, be it imposed experimentally or spontaneously expressed in a free-living context. As described in this paper, the response to a weight loss program may range from a weight gain to a greater than expected weight loss. Based on our research findings and available literature, an unsuccessful body-weight response is seen in 5% to 20% of individuals and is attributable to behavioral and metabolic changes affecting appetite control and thermogenesis. Experimental evidence also shows that the response to a negative-energy balance is genetically determined. Globally, these observations emphasize the importance of future research in precision medicine to develop treatment approaches that progressively become more individualized.

Figures