van Baak Marleen A, Mariman Edwin C M
NUTRIM School for Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, Netherlands.
Nat Rev Endocrinol. 2023 Nov;19(11):655-670. doi: 10.1038/s41574-023-00887-4. Epub 2023 Sep 11.
Weight regain after successful weight loss resulting from lifestyle interventions is a major challenge in the management of overweight and obesity. Knowledge of the causal mechanisms for weight regain can help researchers and clinicians to find effective strategies to tackle weight regain and reduce obesity-associated metabolic and cardiovascular complications. This Review summarizes the current understanding of a number of potential physiological mechanisms underlying weight regain after weight loss, including: the role of adipose tissue immune cells; hormonal and neuronal factors affecting hunger, satiety and reward; resting energy expenditure and adaptive thermogenesis; and lipid metabolism (lipolysis and lipid oxidation). We describe and discuss obesity-associated changes in these mechanisms, their persistence during weight loss and weight regain and their association with weight regain. Interventions to prevent or limit weight regain based on these factors, such as diet, exercise, pharmacotherapy and biomedical strategies, and current knowledge on the effectiveness of these interventions are also reviewed.
生活方式干预成功减重后体重反弹是超重和肥胖管理中的一项重大挑战。了解体重反弹的因果机制有助于研究人员和临床医生找到有效的策略来应对体重反弹，并减少肥胖相关的代谢和心血管并发症。本综述总结了目前对减重后体重反弹潜在生理机制的一些理解，包括：脂肪组织免疫细胞的作用；影响饥饿、饱腹感和奖赏的激素和神经因素；静息能量消耗和适应性产热；以及脂质代谢（脂肪分解和脂质氧化）。我们描述并讨论了这些机制中与肥胖相关的变化、它们在减重和体重反弹过程中的持续性，以及它们与体重反弹的关联。基于这些因素预防或限制体重反弹的干预措施，如饮食、运动、药物治疗和生物医学策略，以及目前关于这些干预措施有效性的知识也在综述范围内。
