Hormonal
Massive weight loss induces significant metabolic adaptation (reduced resting metabolic rate beyond what is predicted by body composition changes) that is strongly correlated with the degree of energy imbalance, rate of weight loss, and changes in circulating leptin levels.
After losing a large amount of weight, your body will biologically resist keeping it off by slowing your metabolism and altering hunger hormones (leptin). This is not a failure of willpower but a strong physiological adaptation. Expecting to maintain massive weight loss requires acknowledging this metabolic defense and likely ongoing, structured energy management.
Metabolic adaptation was significantly correlated with energy imbalance (r=0.72, P<0.0001), rate of weight loss (r=0.67, P=0.0002), and percent change in leptin (r=0.52, P=0.006)... metabolic adaptation was significantly correlated with energy imbalance (r=0.62, P=0.0001), rate of weight loss (r=0.61, P=0.0001), and percent change in leptin (r=0.38, P=0.02).
Why this rating
The data comes from a corrected analysis of a well-known clinical study (Biggest Loser and RYGB patients) with strong statistical significance (P<0.0001) for the correlations reported.
Source
Erratum: 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 · 2016
DOI 10.1002/oby.21634
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