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Introduction
Obesity increases the risk of a range of chronic diseases and negative health outcomes. And trials where a sufficient amount of weight loss is achieved show health improvements. However, despite the “straightforward” nature of causing weight loss through a hypocaloric diet, it is clear that most people who lose weight will regain some or all of the weight.
This is a result of both the physiologic control of intake and expenditure (i.e. homeostatic regulation by the body to avoid staying at a lower body or fat mass), and environmental factors. Diet-induced weight loss is followed by a number of hormonal change that encourage weight regain. So how do we tackle this problem?
In this episode, Dr. Priya Sumithran discusses this physiologic control of body mass, in addition to environmental and behavioural factors that make weight loss maintenance difficult. Dr. Sumithran also discusses what this means for setting weight loss targets, choosing the correct intervention, and looking to non-weight-centric approaches for certain individuals. We also discuss the evidence on GLP-1 receptor agonist drugs, such as Semaglutide, as a treatment for obesity.
Related resources
- Papers:
- Sumithran & Proietto, 2013 – The defence of body weight: a physiological basis for weight regain after weight loss
- Sumithran & Proietto, 2016 – Maintaining Weight Loss: an Ongoing Challenge
- Sumithran et al., 2011 – Long-term persistence of hormonal adaptations to weight loss
- Petre et al., 2022 – A better understanding of the science and reality of obesity is urgently needed
- Tahrani & Morton, 2022 – Benefits of weight loss of 10% or more in patients with overweight or obesity: A review
- Iqbal et al., 2022 – Effect of glucagon-like peptide-1 receptor agonists on body weight in adults with obesity without diabetes mellitus-a systematic review and meta-analysis of randomized control trials
- Brown et al., 2021 – SGLT2 inhibitors and GLP-1 receptor agonists: established and emerging indications
- Related Podcast Episdoes:
- Models of body mass regulation
- Physiologic control of intake/expenditure in obesity
- Weight loss in obesity: observed benefits & potential risks
- Long-term WL maintenance: how much WL is achievable? Is it possible to maintain?
- Strategies moving forward: GLP-1 agonists and other drugs
Guest Information
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Dr. Priya Sumithran is an endocrinologist and clinician researcher. She is Group Leader of the Obesity Research Group at the University of Melbourne, Department of Medicine (St Vincent’s) and Head of Obesity Medicine at Austin Health.
Her research and clinical interests are in the neuroendocrine regulation of appetite and eating behaviours, the intersection between obesity and mental health, and improving access to effective treatment of obesity.
Dr. Sumithran is on the council of the Australian and New Zealand Obesity Society, and a member of the Endocrine Society of Australia, Australian Diabetes Society, and The Obesity Society.
Danny Lennon has a master’s degree (MSc.) in Nutritional Sciences from University College Cork, and he is the founder of Sigma Nutrition.
Danny is currently a member of the Advisory Board of the Sports Nutrition Association, the global regulatory body responsible for the standardisation of best practice in the sports nutrition profession.
Introduction to this Episode
Obesity increases the risk of a range of chronic diseases and negative health outcomes. And trials where a sufficient amount of weight loss is achieved show health improvements. However, despite the “straightforward” nature of causing weight loss through a hypocaloric diet, it is clear that most people who lose weight will regain some or all of the weight.
This is a result of both the physiologic control of intake and expenditure (i.e. homeostatic regulation by the body to avoid staying at a lower body or fat mass), and environmental factors. Diet-induced weight loss is followed by a number of hormonal changes that encourage weight regain. So how do we tackle this problem?
In this episode, Dr. Priya Sumithran discusses this physiologic control of body mass, in addition to environmental and behavioral factors that make weight loss maintenance difficult. Dr. Sumithran also discusses what this means for setting weight loss targets, choosing the correct intervention, and looking to non-weight-centric approaches for certain individuals. We also discuss the evidence on GLP-1 receptor agonist drugs, such as Semaglutide, as a treatment for obesity.
Connection to Previous Episodes
- Danny and Alan went through the literature on weight loss maintenance in episode 352, titled ʻDo Diets Even Work in the Long-term?ʼ. This episode also gets into claims about “all diets fail”.
- In episode 395, Danny interviewed renowned obesity researcher Prof. Carel Le Roux, where they discussed misconceptions people have about obesity, what treatment options are available, and what a more inclusive approach looks like.
- Obesity treatments and the issues of weight bias and weight stigma were the subject of conversation in episode 324, where Dr. Fatima Cody Stanford was the guest. This included the practical realities of obesity treatment, and how we can simultaneously accept that weight loss can have significant benefits while also not promoting positions that lead to weight stigma.
- In the current episode with Dr. Sumithran, reference was made to some of Prof. Roy Taylorʼs research showing weight loss lead to diabetes remission, as well as Taylorʼs concept of a “personal fat threshold”. You can hear Prof. Taylor on the podcast in episode 331.