Hormonal
Massive weight loss induces metabolic adaptation (resting metabolic rate suppression beyond body composition changes) that is directly correlated with the magnitude of energy imbalance and the degree of circulating leptin reduction.
When you lose a large amount of weight, your body defends its previous weight by lowering your resting metabolic rate beyond what is explained by simply losing tissue. This 'metabolic adaptation' is driven by the size of your calorie deficit and the drop in leptin (a hormone from fat cells). To manage this, focus on maintaining energy balance rather than chronic severe deficits, as adaptation lessens when you stop losing weight.
In both groups, RMR decreased significantly more than expected based on measured body composition changes. The magnitude of this metabolic adaptation was correlated with the degree of energy imbalance (r = 0.55, P = 0.004) and the decrease in circulating leptin (r = 0.47, P = 0.02).
Why this rating
Retrospective matched cohort study with rigorous biochemical assays and indirect calorimetry, though not a randomized controlled trial of the mechanism itself.
Source
Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin
Nicolas D. Knuth et al. · Obesity · 2014
DOI 10.1002/oby.20900
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