Ghrelin changes predict weight regain after DiRECT diet
medwireNews: Ghrelin is the only appetite-related hormone that predicted weight regain among the participants of the DiRECT trial, say the researchers.
For this analysis, Mike Lean (University of Glasgow, UK) and study co-authors assessed 253 participants with data on hormone changes. The 147 in the intervention group lost an average of 14.4 kg after 5 months, following the total diet replacement and food reintroduction phases of the trial, but then regained an average of 3.4 kg (24% of weight lost) by month 12 and 6.4 kg (44%) by month 24.
Increases in ghrelin in the postintervention period were significantly associated with weight regain, as were changes in leptin, but weight change was not associated with changes in glucagon like-peptide 1 or peptide YY. Only ghrelin levels had predictive ability, with each 1 ng/mL increase in ghrelin at month 12 associated with a 1.1% greater weight regain at month 24.
These findings support “the widely held view that hormonal adaptations oppose long-term [weight loss maintenance],” say the researchers, by changing “in a direction that seems to favour increased hunger and reduced satiety.”
They add: “Although effect sizes were modest and explain only a small proportion of weight regain, attenuating the sustained rise in ghrelin in response to weight loss may have therapeutic benefit.”
The study is published in Diabetes, Obesity and Metabolism.
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