Do Changes in Leptin, Ghrelin or Insulin Predict Weight Regain?



sharma-obesity-blood-sugar-testing2One of the main reasons why keeping weight off, is because of the complex neuroendocrine response to weight loss, which serve to promote weight regain.

While some of the players involved in these responses are known, whether or not measuring them would help predict who may have a harder time losing weight or who is more likely to regain weight is not.

As paper by Stohacker and colleagues from Brown University, Rhode Island, USA, published in the International Journal of Obesity suggests that this may be more complicated than some may think.

In their review of 12 studies reporting changes in leptin, ghrelin or insulin during intentional weight loss with a follow-up period to assess regain, no consistent relationship was found between any of these factors and weight regain.

Indeed, if anything, the data on this issue is more than confusing.

For e.g. as the authors note,

“…two of the nine studies examining leptin suggested that larger decreases were associated with great regain, three studies found the opposite (smaller decreases were associated with regain) while four studies found no significant relationship”.

Similarly,

“One study suggested that improvements in insulin resistance were associated with weight gain, but five subsequent studies reported no association.”

Thus, the notion that simply measuring some of the hormones associated with weight loss is unlikely to predict weight regain in a given individual.

This should come as no surprise.

Not only, are these only three of a whole array of possible biological mediators of weight regain but, as the authors point out, there may also be important behavioural and environmental (and I would add psychological and medical) reasons why some people may find it easier to sustain weight loss than others. And of course, genetic factors as well as past weight-loss history may also play a role in this.

Overall, there does not appear to be any simple test that clinicians can use to predict who is likely to regain weight and who is not.

On the other hand, given that the vast majority of people who lose weight ultimately put it back on (perhaps with the exception of those undergoing bariatric surgery – but even there regain may happen), this question may not be the most pressing – after all, spotting weight regain when it happens is not rocket science.

@DrSharma
Edmonton, AB

ResearchBlogging.orgStrohacker K, McCaffery JM, Maclean PS, & Wing RR (2013). Adaptations of leptin, ghrelin or insulin during weight loss as predictors of weight regain: a review of current literature. International journal of obesity (2005) PMID: 23801147

 

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