Hormonal
GLP-1 receptor agonists (semaglutide, tirzepatide) and Roux-en-Y gastric bypass (RYGB) surgery extend the duration of weight loss before reaching a plateau by weakening the physiological appetite feedback control circuit, whereas calorie restriction fails to weaken this circuit, leading to an earlier plateau.
If you are using GLP-1 medications or had bariatric surgery, your body's 'starvation signal' (appetite feedback) is chemically or surgically dampened, which is why you can lose weight for longer than diet-only approaches allow. Do not mistake the eventual plateau for failure; it is a sign that the feedback loop has stabilized. Calorie restriction alone fights this feedback loop directly, causing an earlier plateau.
These preliminary mathematical modeling results suggest that both GLP-1 receptor agonism and RYGB surgery interventions act to weaken the appetite feedback control circuit regulating body weight and induce greater persistent effects to shift the body weight equilibrium as compared to intensive calorie restriction.
Why this rating
The evidence is based on mathematical modeling fitted to published trial data, not a new primary clinical trial.
Source
Physiology of the Weight Loss Plateau after Calorie Restriction, GLP-1 Receptor Agonism, and Bariatric Surgery
Kevin D. Hall · bioRxiv (Cold Spring Harbor Laboratory) · 2023
DOI 10.1101/2023.11.05.565699
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