Endocrine Society Offers Statement on Long-Term Weight Maintenance

A new scientific statement from the Endocrine Society calls for more research to understand what too many of us already know: as hard as it is to lose weight, it’s even harder to keep it off.

In the United States, 1 in 3 American adults is affected by obesity, which costs an estimated $147 billion to treat, according to the CDC. Yet the underlying causes of this epidemic are not well understood, although evidence suggests that obesity is a disorder of the body’s system for maintaining energy balance.

Thus, once a person loses weight, the body compensates by reducing the amount of energy it spends during various states—at rest, during exercise, and during work activities. This increases the feeling of hunger. Over time, the combination of less energy expenditure and increased hunger causes a person to eat more without burning the extra energy—perfect conditions for weight gain.

And, as recent research has shown, even if a person loses weight, the body adjusts the level of energy needed to maintain that weight, making it even harder sustain the weight loss.

“To effectively treat obesity, we need to better understand the mechanisms that cause this phenomenon, and to devise interventions that specifically address them,” said Michael W. Schwartz, MD, of the University of Washington and chair of the task force that created the statement.

The statement calls for research into the following areas:

• Interactions between genetics, development influences, and environment.
• The effect of endocrine-disrupting chemicals on obesity.
• The microbiome, or gut bacteria, and its interactions with the digestive system.
• The reasons behind the therapeutic success of bariatric surgery.
• Biomarkers that predict diabetes, heart disease, and other comorbidities that appear with obesity.
• The effects of socioeconomic status on obesity.
• Brain imaging to understand eating behavior and appetite.

The scientific statement is published in Endocrine Reviews.

Reference

Schwartz MW, Seeley RJ, Zeltser LM, et al. Obesity pathogenesis: an Endocrine Society Scientific Statement [published June 26, 2017]. Endocr Rev. 2017; https://academic.oup.com/edrv/article-lookup/doi/10.1210/er.2017-00111.