NEW YORK — Any dieter knows that it's hard to keep off weight you've lost. Now a study finds that even a year after dieters shed a good chunk of weight quickly, their hormones were still insisting, "Eat! Eat! Eat!"
The findings suggest that dieters who have regained weight are not just slipping back into old habits, but are struggling against a persistent biological urge.
"People who regain weight should not be harsh on themselves, as eating is our most basic instinct," Joseph Proietto of the University of Melbourne in Australia, an author of the study, said in an e-mail. The research appears in today's New England Journal of Medicine.
Proietto and his colleagues enrolled 50 overweight or obese patients in a 10-week diet program in Australia. They wanted to see what would happen in people who lost at least 10 percent of their body weight. Ultimately, only 34 people lost that much and stuck with the study long enough for analysis.
The program was intense. On average, participants lost almost 30 pounds in 10 weeks, taking in 500 to 550 calories a day using a meal replacement called Optifast plus vegetables for eight weeks. Then for two weeks they were reintroduced to ordinary food.
Despite counseling and written advice about how to maintain their new weights, they gained an average of 12 pounds back over the next year.
The scientists checked the blood levels of nine hormones that influence appetite. The key finding came from comparing the hormone levels from before the weight-loss program to one year after it was over. Six hormones were still out of whack in a direction that would boost hunger.
A key message of the study is that "it's better not to gain weight than to try to lose it," said Dr. George Bray of the Pennington Biomedical Research Center in Baton Rouge, La.
People who lose significant weight not only gain bigger appetite but also burn fewer calories than normal, creating "a perfect storm for weight regain," says Dr. Rudolph Leibel, an obesity expert at Columbia University.