Persistent metabolic adaptation 6 years after "The Biggest Loser" competition.

Bibliographic Collection: 
Publication Type: Journal Article
Authors: Fothergill, Erin; Guo, Juen; Howard, Lilian; Kerns, Jennifer C; Knuth, Nicolas D; Brychta, Robert; Chen, Kong Y; Skarulis, Monica C; Walter, Mary; Walter, Peter J; Hall, Kevin D
Year of Publication: 2016
Journal: Obesity (Silver Spring)
Volume: 24
Issue: 8
Pagination: 1612-9
Date Published: 2016 Aug
Publication Language: eng
ISSN: 1930-739X
Keywords: Absorptiometry, Photon, Adult, Basal Metabolism, Body composition, Body Mass Index, Body Weight, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Morbid, Weight Loss

OBJECTIVE: To measure long-term changes in resting metabolic rate (RMR) and body composition in participants of "The Biggest Loser" competition.

METHODS: Body composition was measured by dual energy X-ray absorptiometry, and RMR was determined by indirect calorimetry at baseline, at the end of the 30-week competition and 6 years later. Metabolic adaptation was defined as the residual RMR after adjusting for changes in body composition and age.

RESULTS: Of the 16 "Biggest Loser" competitors originally investigated, 14 participated in this follow-up study. Weight loss at the end of the competition was (mean ± SD) 58.3 ± 24.9 kg (P < 0.0001), and RMR decreased by 610 ± 483 kcal/day (P = 0.0004). After 6 years, 41.0 ± 31.3 kg of the lost weight was regained (P = 0.0002), while RMR was 704 ± 427 kcal/day below baseline (P < 0.0001) and metabolic adaptation was -499 ± 207 kcal/day (P < 0.0001). Weight regain was not significantly correlated with metabolic adaptation at the competition's end (r = -0.1, P = 0.75), but those subjects maintaining greater weight loss at 6 years also experienced greater concurrent metabolic slowing (r = 0.59, P = 0.025).

CONCLUSIONS: Metabolic adaptation persists over time and is likely a proportional, but incomplete, response to contemporaneous efforts to reduce body weight.

DOI: 10.1002/oby.21538
Alternate Journal: Obesity (Silver Spring)