{"doi":"10.1093/ajcn/nqaa086","title":"Metabolic adaptation is not a major barrier to weight-loss maintenance","abstract":"BACKGROUND: The existence of metabolic adaptation, at the level of resting metabolic rate (RMR), remains highly controversial, likely due to lack of standardization of participants' energy balance. Moreover, its role as a driver of relapse remains unproven. OBJECTIVE: The main aim was to determine if metabolic adaptation at the level of RMR was present after weight loss and at 1- and 2-y follow-up, with measurements taken under condition of weight stability. A secondary aim was to investigate race differences in metabolic adaptation after weight loss and if this phenomenon was associated with weight regain. METHODS: A total of 171 overweight women [BMI (kg/m2): 28.3 ± 1.3; age: 35.2 ± 6.3 y; 88 whites and 83 blacks] enrolled in a weight-loss program to achieve a BMI <25, and were followed for 2 y. Body weight and composition (4-compartment model) and RMR (indirect calorimetry) were measured after 4 wk of weight stability at baseline, after weight loss and at 1 and 2 y. Metabolic adaptation was defined as a significantly lower measured compared with predicted RMR (from own regression model). RESULTS: Participants lost, on average, 12 ± 2.6 kg and regained 52% ± 38% and 89% ± 54% of their initial weight lost at 1 and 2 y follow-up, respectively. Metabolic adaptation was found after weight loss (-54 ± 105 kcal/d; P < 0.001), with no difference between races and was positively correlated with fat-mass loss, but not with weight regain, overall. In a subset of women (n = 46) with data at all time points, metabolic adaptation was present after weight loss, but not at 1- or 2-y follow-up (-43 ± 119, P = 0.019; -18 ± 134, P = 0.380; and - 19 ± 166, P = 0.438 kcal/day respectively). CONCLUSIONS: In overweight women, metabolic adaptation at the level of RMR is minimal when measurements are taken under conditions of weight stability and does not predict weight regain up to 2 years follow-up.The JULIET study is registered at https://clinicaltrials.gov/ct2/show/NCT00067873 as NCT00067873.","journal":"American Journal of Clinical Nutrition","year":2020,"id":60929,"datarank":1.980846874310351,"base_score":4.0943445622221,"endowment":4.0943445622221,"self_citation_contribution":0.6141516843333151,"citation_network_contribution":1.3666951899770359,"self_endowment_contribution":0.6141516843333151,"citer_contribution":1.3666951899770359,"corpus_percentile":null,"corpus_rank":null,"citation_count":59,"citer_count":45,"citers_with_citation_signal":36,"citers_with_endowment":36,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9626,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT00067873"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":321518,"name":"Barbara A. Gower","orcid":"0000-0001-8461-4613","position":1,"is_corresponding":false},{"id":307269,"name":"James O. Hill","orcid":"0000-0003-4690-2264","position":2,"is_corresponding":false},{"id":321519,"name":"Gary R. Hunter","orcid":"0000-0002-5015-242X","position":3,"is_corresponding":false},{"id":321517,"name":"Cátia Martins","orcid":"0000-0002-4560-0013","position":0,"is_corresponding":true}],"reference_count":57,"raw_metadata":null,"created_at":"2026-07-18T21:09:05.493770Z","pmid":"32386226","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}