The Metabolic Adaptation Manual: Problems, Solutions, and Life After Weight Loss
The Metabolic Adaptation Manual: Problems, Solutions, and Life After Weight Loss
The Metabolic Adaptation Manual: Problems, Solutions, and Life After Weight Loss
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Much of the research pertaining to weight loss and proton leak is done
in rodents; while this requires a small leap of faith in assuming that
the results are relevant to human beings, it allows for an otherwise
impossible level of experimental control. In rodents, studies
using short-term (two weeks to two months), medium-term (six
months), and long-term (12 to 18 months) calorie restriction have
reported decreased proton leak, which is indicative of an adaptive
increase in mitochondrial efficiency. Conceptually, it appears that
mitochondria sense the relative lack of energy availability and adapt in
a manner that reduces wasteful proton leak. This increases the ability
of mitochondria to meet their ATP-production “quota” while burning
fewer calories in the process. Exactly how they go about doing this is a
bit less straightforward. In these rodent studies, an unexpected but
consistent observation was that UCP-3 protein content increased,
which is counterintuitive; while proton leak decreased, this protein
that facilitates proton leakage actually increased. Human studies,
however, indicate the opposite.
One study evaluated UCP-2 and UCP-3 mRNA levels in lean, obese, and
weight-reduced humans. They found that muscle levels of UCP-3 were
reduced in people who had lost weight and stabilized at their reduced
weight, which is intuitively consistent with reduced proton leakage.
Another study by a different research group reported similar findings,
with lower UCP-3 mRNA expression observed in individuals who had
undergone prolonged energy restriction to induce weight loss. Perhaps
the strongest evidence supporting the importance of proton leak and
UCP-3 comes from a 2002 study in which “diet-responsive” and “diet-
resistant” individuals were classified based on weight loss results, then
compared on a variety of parameters. Results showed that diet-
responsive individuals lost 43% more weight, and this difference was
accompanied by significantly higher rates of proton leak and UCP-3
mRNA levels. Taken together, it seems likely that rodents and humans
share a common strategy in which mitochondrial proton leakage is
reduced in response to energy restriction, as a fairly straightforward
means of conserving scarce energy stores. While differing changes in
UCP-3 expression between rodents and humans are less
straightforward, it is possible that subtle distinctions exist with regard
to the mechanisms by which they restrict proton leakage.
Figure 2.
Leptin is reduced by fat loss and the presence of an energy deficit, and the
activity of leptin is inhibited by high cortisol levels. As a result of reduced leptin
activity, widespread changes include increased hunger and reductions in
thyroid hormone, sex hormones, non-exercise activity thermogenesis (NEAT),
total daily energy expenditure (TDEE), sympathetic nervous system (SNS)
tone, and brown adipose tissue (BAT) activation.
There are also hormonal effects of energy restriction that extend
beyond mitochondrial efficiency or adaptive thermogenesis. Several
case studies have been carried out in physique athletes, and
alterations in anabolic and catabolic hormones are pronounced and
consistent. One such case studydocumented reductions in testosterone
while cortisol increased; our group did a similar case study and found
similar changes in testosterone and cortisol. Recently, there has been a
lot of discussion about whether or not post-exercise changes in
testosterone play an important role in muscle growth, and
the common consensus is that they do not. But it’s critically important
to distinguish normal, resting testosterone levels from short-term,
post-exercise elevations. Resting testosterone levels do appear to have
an impact on the growth and maintenance of lean mass (otherwise,
professional athletes probably wouldn’t have consistently risked their
careers to elevate it for the last several decades). Aside from its impact
on BAT activation, insulin is also known to have anabolic properties.
While there is some debate over how significant this effect is within
normal physiological ranges of insulin, a study in
bodybuilders documented a reduction in fasting insulin levels during
contest preparation, and insulin changes were significantly correlated
with changes in lean mass. This means that people who had larger
insulin reductions tended to lose the most lean mass. However, it’s
important to note that they also tended to lose more fat mass, so this
could potentially just be demonstrating that some individuals
preserved some additional lean mass by failing to get super lean.
To make matters worse, loss of lean mass is not the only thing driving
excessive hunger. Hunger is probably the most undesirable side effect
of dieting for fat loss, and there are multiple hormonal responses that
play a direct role in the urge to eat. Ghrelin is mainly produced in the
stomach and is primarily known as a messenger to keep the brain
informed about short-term energy availability. After a meal, the
stomach produces less ghrelin, and the brain is aware that additional
energy is not acutely necessary. During times of fasting, its production
increases, and levels ultimately get high enough to induce hunger.
However, there is also evidence that ghrelin plays a role in sensing
long-term energy availability, and diet-induced weight loss increases
24-hour ghrelin levels. Unsurprisingly, two separate case studieshave
documented increased ghrelin levels from the beginning to the end of
contest prep in male bodybuilders.
Every day we consume energy and we burn energy; the net balance of
this equation determines whether we gain or lose weight. As indicated
in Figure 4, total daily energy expenditure (TDEE) describes the total
number of calories we burn in a given day, and TDEE is made up of
four components:
Basal Metabolic Rate (~70% of TDEE in general population)
This describes the energy required to simply keep our body
“on,” at rest, assuming we lay in bed all day without moving
or eating.
Thermic effect of feeding (~10% of TDEE in general population)
This describes the energy used in the process of eating,
digesting, metabolizing, and storing food.
Exercise Activity Thermogenesis (~5% of TDEE, depending on how
much you exercise)
This describes the energy used during structured, intentional
exercise.
Non-Exercise Activity Thermogenesis (~15% of TDEE, depending
on your activity level)
This describes the energy used for any movement that isn’t
purposeful exercise. This would include walking around your
school or office, doing yard work, taking out the trash, and
even fidgeting in your chair
Figure
4. The approximate relative contributions of basal metabolic rate (BMR),
thermic effect of feeding (TEF), exercise activity thermogenesis (EAT), and
non-exercise activity thermogenesis (NEAT) to total daily energy expenditure
in the general population.
To tie up some loose ends, let’s consider a few terms we have
mentioned haven’t yet fully contextualized. We know that brown
adipose tissue increases thermogenesis, particularly in response to
cold exposure, thyroid hormone, leptin, and insulin; BAT
thermogenesis would therefore primarily affect basal metabolic rate
and the thermic effect of feeding. We noted that thyroid hormone and
leptin increase mitochondrial uncoupling and muscle thermogenesis;
these broad effects would have the potential to affect essentially all
components of energy expenditure. So, all of the mitochondrial and
thermogenesis-related concepts previously discussed
fit somewhere within our four components of energy expenditure, and
sometimes span multiple components. Unfortunately, when we
embark on a weight loss diet, all four components are influenced to
some extent.
In weight loss diets, the thermic effect of feeding will be reduced for a
very straightforward reason, with no need for any biologically adaptive
explanation: If you eat less food, you won’t burn as many calories in
the process of eating, digesting, metabolizing, and storing it. It
remains unclear whether or not we have an adaptive shift in the
thermic effect of feeding (that is, a disproportionate increase in the
efficiency with which we handle the energy cost of feeding). While
there are some isolated studies suggesting that a small adaptation
favoring a relatively lower thermic effect of feeding does occur, the
collective evidence would suggest that any such adaptation is
negligible in magnitude. For example, Miles et al found that feeding
caused subjects to burn 13% of the calories consumed in an
experimental meal before weight loss. After losing ~7.3 kg over a 12-
14 week period, participants burned 12.5% of the calories consumed in
the very same meal; this amounts to a difference of 3 Calories. Leibel
et al carried out an ambitious study in which some subjects were over-
fed to induce weight gain, and others were under-fed to induce weight
loss. Their results showed that weight gain from intentional
overfeeding did reduce the energy efficiency of feeding, leading to a
relatively greater thermic effect of feeding. In contrast, weight loss
from intentional under-feeding did not increase this efficiency, and the
thermic effect of feeding was not significantly different when
comparing baseline values to the values obtained after weight loss.
Overall, the body of evidence suggests that the thermic effect of
feeding is lower during weight loss dieting, but this is caused by lower
overall food intake and less sympathetic nervous system activation in
response to caloric intake. If there is any adaptation that makes us
more efficient with regard to this thermic effect, it is very small in
magnitude.
There are a couple “non-metabolic” reasons why you could use less
energy for the same amount of cardio as your weight loss diet
progresses forward. For any kind of locomotive cardio, such as
walking, running, or cycling, the task itself involves generating enough
force to transport the mass of your body. As you lose weight, the mass
is reduced, and you naturally require less energy to transport your
body a given distance. Even for some non-locomotive tasks like
stationary cycling, weight of the limbs is reduced, so slightly less
energy is required to perform the same amount of cycling work.
Another factor that is rarely discussed relates to the fact that a lot of
people, myself included, do absolutely no cardio unless required to.
Many forms of cardio are trainable skills that we become substantially
more proficient at as we do them more frequently throughout a weight
loss attempt. Using running as an example, there are about 22
factors (give or take) that relate to running economy. Many of them are
trainable, meaning that a novice runner can probably make substantial
improvements to their running economy over the course of a few
months. While this improvement in running economy is great for your
joints, it also means you’re probably covering the same distance with
greater efficiency, and therefore burning fewer calories in the process.
Aside from these predictable reductions in exercise activity
thermogenesis in response to a weight loss attempt, there are also
metabolic adaptations that increase energy efficiency and reduce
energy expenditure during exercise.
Within the first six months, subjects lost 14% of their body weight,
which was maintained until leaving the dome. A week after leaving the
dome, energy expenditure was assessed via a 23-hour confinement in a
respiratory chamber and compared to control subjects. Total energy
expenditure was suppressed in the Biosphere residents compared to
controls, and this difference persisted after adjusting for relevant
characteristics (age, sex, fat mass, and fat-free mass). When in the
respiratory chamber, control subjects had nearly twice as much
spontaneous physical activity (fairly synonymous with NEAT) than the
Biosphere residents. When total energy expenditure was adjusted
for this factor, the difference between Biosphere subjects and control
subjects was no longer significant, which further highlights the huge
impact that NEAT has on energy expenditure during weight loss.
Lending further support to these findings, Leibel et al found a
significant reduction in energy expenditure that was not attributable
to resting metabolic rate, the thermic effect of feeding, or the loss of
lean mass following 10-20% body weight reduction. A
separate study had participants either gain or lose 10% of their body
weight, then maintain it. Weight loss resulted in an absolute non-
resting energy expenditure reduction of 37.5%, whereas weight gain
increased non-resting energy expenditure by 60.2%. Linear regression
showed that the change in non-resting energy expenditure explained
78% of the observed change in total energy expenditure among both
groups. As summarized in Figure 5, it is very clear that weight loss
causes a disproportionate drop in total energy expenditure, and it is
clear that NEAT is the primary component driving this effect.
Figure
5. The effects of weight loss on various components of energy expenditure,
including total energy expenditure (TDEE), thermic effect of feeding (TEF),
basal metabolic rate (BMR), exercise activity thermogenesis (EAT), and non-
exercise activity thermogenesis (NEAT). Absolute effects pertain to raw,
unadjusted values. Absolute EAT “depends” because one can choose to
complete ever-increasing amounts of exercise, or restrict it altogether.
Relative effects refer to values that are scaled relative to lean body mass
(TDEE, BMR, NEAT), total mechanical work (EAT), or total caloric intake
(TEF). Loosely based on Figure 5 from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174765/
Conclusion
The original question posed was, “Why does dieting suck so much?” It
turns out, the research literature offers us a variety of answers to that
question. Weight loss attempts are met with changes in mitochondrial
function, hormone levels, and energy expenditure. These changes
produce some unpleasant side effects, threaten our ability to gain (or
even keep) muscle mass and strength, manipulate biological cues
pertaining to the regulation of appetite and activity level, and require
us to eat even fewer calories or incorporate even more cardio into our
training program. When metabolic adaptation first became a big
conversation in the fitness scene, it was treated as a controversial
topic. However, the content discussed in Part 1 of this article is
objectively noncontroversial. The scientific literature has rigorously
and repeatedly shown downregulation of energy expenditure, and the
long list of physiological changes that accompany it, in response to
weight loss. The controversy comes from how some of this
information has been discussed, such as implausible anecdotes of fat
gain despite remarkably low caloric intake, or the use of less rigorous
terms like starvation mode. Rest assured, there is not a single member
of our species that can elude the inescapable grasp of starvation; our
caloric needs for weight loss may fluctuate from person to person, but
we all have a number. Furthermore, nobody is failing to lose fat
because they are eating too few calories. Metabolic adaptation places
speed bumps in our path to fat loss, no more and no less. But this
raises the next important question: Can we do anything to circumvent
these speed bumps?
Rather that shifting meal times within a day, some studies have
investigated the effects of shifting the days in which calories are
consumed. These protocols often encourage people to have anywhere
from 1-4 “fasting” days per week in which they either consume a mere
25% of their normal energy intake, or skip out on eating altogether. In
the research world, this is known as intermittent fasting or
intermittent energy restriction (note the terminology discrepancy: the
fitness industry often uses “intermittent fasting” to describe time-
restricted feeding, while the research world uses “intermittent fasting”
to describe the implementation of one or more weekly fasting days). In
comparison to time-restricted feeding, many studies have investigated
the weight loss effects of intermittent energy restriction. As displayed
in Figure 8, there are a few types of protocols for intermittent energy
restriction; the most common include alternate day fasting, fasting for
a two-day period, or including two fasts per week on non-consecutive
days. Multiple meta-analyses have investigated the efficacy of these
interventions in comparison to normal, continuous energy restriction,
all with slightly different inclusion criteria and analytical approaches.
All three of these meta-analyses have indicated that intermittent
energy restriction strategies, using a variety of fasting protocols, do
not lead to greater weight loss. However, they also don’t seem to be
substantially worse (at least in untrained subjects). While I maintain
concerns about lean mass retention when using prolonged fasting
periods during fairly extreme dieting, intermittent fasting strategies
that implement short (16-20 hours) or long (24+ hours) fasting
windows can be effectively used by dieters who prefer the way these
protocols fit their daily schedule or satiety preferences.
Figure 8. Popular intermittent energy restriction protocols include alternate-
day fasting, implementation of two consecutive fasting days per week, and
implementation of two weekly fasts on non-consecutive days. Fasting days
often include restricting energy intake to 0-25% of the individual’s daily energy
requirement.
Implementation of “refeeds” offer yet another option for manipulating
energy intake throughout the week. A refeed involves acutely
increasing caloric intake, usually by specifically increasing
carbohydrate intake, and usually for no more than a day or two at a
time. Research has shown that this approach is commonly used by
competitive physique athletes, either through structured refeeds or
unstructured “cheat meals.” The purported benefits of refeeds are
multifaceted; by acutely increasing carbohydrate (and energy) intake,
one could potentially boost leptin and thyroid hormone levels, acutely
increase energy expenditure, enhance muscle and liver glycogen
content, and provide a welcome reprieve from the low-carb food menu
that often accompanies contest preparation, particularly in the later
stages. There is absolutely evidence supporting acute effects of
refeeding on hormones and energy expenditure; one study found that
a three-day carbohydrate refeed, but not a fat refeed, increased leptin
by 28% and total daily energy expenditure by 7%. However, there is a
big problem regarding the applicability of this protocol: it requires
three days of 40% overfeeding, so that 7% increase in energy
expenditure is entirely overshadowed by a huge caloric surplus.
Viewed purely as a weight loss strategy, this is taking one step forward
and several steps backward. Our study on physique athletes observed
a marked increase in resting energy expenditure when comparing
values measured shortly before competition to values obtained shortly
after, which coincided with an increase in food intake. Again, this
marked increase in energy expenditure was nowhere near enough to
compensate for the increase in calorie intake required to induce it.
When it comes to more practical approaches to refeeding, Bill
Campbell’s lab from the University of South Florida has published a
couple of abstractsfrom a seven-week study that provide some useful
data. The study imposed a 25% calorie deficit for a group of resistance-
trained individuals; one group had the same caloric intake every day,
while the other had two consecutive, high-carbohydrate refeed days. In
order to accommodate this two-day increase in energy intake, the
deficit imposed on the other five days of the week was increased to
ensure that both groups had the same overall energy deficit. Results
from the abstracts should be taken with a grain of salt; abstracts are
not reviewed as rigorously as full manuscripts, and the primary
analysis for each abstract found no group by time interactions.
However, some follow-up pairwise comparisons suggested that
refeeding may have conferred slight benefits when it comes to
maintenance of resting metabolic rate and the retention of fat-free
mass.
Even longer diet breaks have been implemented in the literature. For
example, a 2010 abstract implemented a five-month intervention in
which subjects consumed 1,200 Calories for a week, 1,500 Calories for
three weeks, 2,200 Calories for four weeks, then repeated the cycle. By
the end of month five, participants had lost an average of almost 5kg,
while avoiding significant reductions in resting energy expenditure.
This study did not have a comparator group undergoing continuous
weight loss, but it does offer an extreme example of the dilemma we
face with the concept of refeeds or diet breaks. Refeeds and diet
breaks appear to have the capacity to attenuate metabolic adaptation
to some extent, but they also dramatically extend the timeline of the
diet. As a result, there is a cost-to-benefit ratio that must be
considered when determining the frequency and duration of refeeds or
diet breaks.
If you’re keeping your caloric intake within a reasonable range (i.e., not
dramatically overeating), a once-weekly refeed probably isn’t going to
be enough to make a meaningful effect. If you implement four refeeds
per week, you’re mostly not on a diet, from a mathematical
perspective, and it’s hard to make your weekly caloric deficit large
enough to promote substantial weight loss. To keep fat loss
progressing forward and attenuate metabolic adaptation, two refeeds
per week is probably the number most people should aim for. Refeeds
should absolutely emphasize carbohydrate intake, and caloric intake
should be increased to right around maintenance level. Some argue
that these refeeds should be placed on consecutive days, to allow a
longer duration of time to physiologically “adjust” to being out of a
deficit. Others argue that refeeds should be staggered throughout the
week; they contend that metabolic adaptations are exacerbated by
spending several days in a row in an energy deficit. A large portion of
the leptin drop observed with weight loss occurs in the first week. For
example, a study demonstrated that a huge fall in leptin occurs during
the first four days of energy restriction, followed by a much slower
decline over the following 24 days. By providing a refeed every three
or four days, you could potentially provide a timely pulse of energy
balance to keep metabolic adaptation at bay.
At this point, you can’t really say either approach is definitely wrong. I
lean toward consecutive refeeds rather than splitting them up for a
few reasons. From a theoretical perspective, we have operationalized
metabolic adaptation as a coordinated response to prevent starvation.
It’s hard to imagine that a single meal (or a couple meals) would
convince our hypothalamus that, despite our prolonged confrontation
with starvation, our circumstances have completely changed, such that
we would rapidly override one of our most important survival
responses. If we draw inferences from some tangentially relevant data,
alternate-day fasting can be used to assess the effects of short but
frequent refeeds. In rats, alternating between one day of fasting and
one day of eating increased leptin, which had favorable effects on
weight control and food intake compared to control rats. However,
these results are confounded by the fact that one human day equals
about 34 rat days, from a biological perspective. In humans, one
alternate-day fasting study showed that the intervention did cause
weight loss, but reduced leptin by 40%. Another trial compared
alternate-day fasting to a “normal” weight loss group; over the eight-
week intervention, both groups had similar reductions in weight,
leptin, and resting metabolic rate. It’s also important to note that the
rise in leptin after consuming a meal is not immediate; according to
one study, it’s not until about the fifth hour after a meal that leptin
levels appreciably rise, and they continue to rise thereafter. Studies
generally show that leptin reductions from short-term energy
restriction can be restored within about 12-24 hours of refeeding, but
leptin levels also begin fallingagain within hours of the return to
energy restriction. This is coupled with the facts that leptin clearance
is especially rapid in lean people, and that many of the downstream
benefits we hope to obtain from a leptin spike require multiple-step
processes that take some time to play out. With a one-day refeed, I
question exactly how much of an opportunity we would have to
physiologically capitalize from any observed alteration in leptin.
Finally, and most importantly, I’ve actually seen research with two-day
refeeds done in lean, resistance-trained people, and it produced
modest but favorable results. Once one decides to implement refeeds
on consecutive days, the lines between refeeds and diet breaks become
blurred. How much time is sufficient? Two days? A week? Two weeks?
Dropping Protein
When evaluating the success of a weight loss diet, the two primary
outcomes of interest are: 1) how much weight has been lost, and 2)
how much of the weight lost was actually fat mass. In a short-term
study (one week) back in 1988, Walberg et al compared isocaloric diets
with 0.8 g/kg/day or 1.6 g/kg/day of protein. While the study was
almost certainly too short to detect meaningful body composition
differences using underwater weighing, the nitrogen balance analysis
revealed that the lower protein group was is negative nitrogen balance,
with the higher protein group in positive nitrogen balance. These
changes in nitrogen balance are consistent with reduced breakdown of
lean tissues in the high protein group. More recently, Mettler et
al followed up with a slightly longer study, in which 20 resistance-
trained athletes were randomly assigned to a high-protein weight loss
diet (2.3 g/kg/day of protein) or a control weight loss diet (1.0
g/kg/day of protein) for two weeks. At first glance, the control diet
seemed to be favorable, as they lost more weight during the brief
weight loss diet. However, a closer look would reveal that fat loss was
virtually identical between the two groups, and the difference in
weight loss was due to a significantly greater loss of lean mass in the
control group. Eric Helms published a review on the role of protein
intake during energy restriction in resistance trained (and lean)
athletes; in line with the findings of Walberg et al and Mettler et al, the
collective body of evidence suggests that protein intake must be
prioritized for the retention of lean mass under these circumstances.
As noted in a review by Paddon-Jones et al, protein also carries some
additional fringe benefits with it. Compared to carbohydrate and fat,
protein features a substantially larger thermic effect of feeding and
induces greater feelings of satiety on a calorie-for-calorie basis. As
Helms points out in his protein review, there is a high likelihood that
protein needs are not just important, but actually higher than
normal when lean, resistance-trained individuals are engaged in weight
loss. While typical protein intake recommendations are around 1.4-2.0
g/kg/day, this fails to account for hypocaloric conditions, and
inherently assumes a fairly “typical” body fat level. For these reasons,
Helms scales his recommendations to kilograms of fat-free mass and
recommends daily protein intakes of 2.3-3.1 g/kg of fat-free mass
during energy restriction.
Dropping Fat
Dropping Carbohydrate
Striking a Balance
At this point, we’ve reviewed the evidence suggesting that your weight
loss diet should be high in protein, high in fat, and high in
carbohydrates in order to maintain muscle, attenuate metabolic
adaptation and related side effects, and support performance in the
gym. Good luck trying to make that work while successfully losing
weight.
Supplements
Conclusion
While weight loss doesn’t alter the number of adipocytes, rapid weight
regain might. Ideally, any weight regain would just refill the existing
adipocytes, but the altered metabolic environment following weight
loss may promote the addition of new fat cells, known as
adipocyte hyperplasia (Figure 9). This effect has been observed in
overfed rats; while it still requires additional research to demonstrate
its relevance to humans, it could be but one of many factors
contributing to fat regain after weight loss. As noted in a review
by Peos et al, this would be particularly disadvantageous for athletes
that complete several weight loss cycles across a career. Addition of
new adipocytes increases the overall capacity for fat storage, and
allows fat to be stored while the original adipocytes have yet to be
fully replenished with energy. In the short-term, this could increase the
likelihood that individuals not only regain the fat they lost, but
actually gain more fat than they lost. In the long-term, this could yield
even more adipocytes with the potential to convey their relative
“emptiness” during the next weight loss attempt, potentially
amplifying some of the physiological signals that promote metabolic
adaptation and oppose weight loss.
Figure 9. A depiction of adipocyte hyperplasia during weight regain following
energy restriction (ER), created by Peos et al. (2019).Source:
https://www.mdpi.com/2075-4663/7/1/22/htm© 2019 by the authors (Peos,
Norton, Helms, Galpin, Fournier). Licensee MDPI, Basel, Switzerland.
Mechanistic rodent data are fascinating, but only if they pan out in
humans. While we don’t have much direct evidence of adipocyte
hyperplasia in re-fed humans, we do have some intriguing
observations of loosely related outcomes. An interesting observation
in studies evaluating weight regain is that the early regain phase is
characterized by selective storage of fat, with minimal restoration of
fat-free mass. This effect, known as post-starvation obesity, has been
observed in several previous studies, including the old Biosphere
study from Part 1 of this article. This could be related to adipocyte
hyperplasia to some degree, but the more prominent driver appears to
be the loss of fat-free mass while dieting (Figure 10).
Figure 10. Both short-term energy deficits and fat mass reduction promote
lower-than-predicted energy expenditure, altered hormone levels, and
excessive hunger (hyperphagia). When the dieter returns to maintenance (or
surplus) calories and regains the fat they lost, hormones trend back toward
baseline levels, and energy expenditure trends toward the predicted value.
However, if the amount of lean mass remains substantially below the baseline
level, hyperphagia may persist.
As explained in a paper by Dulloo et al, adaptive suppression of
metabolic rate is most closely linked to the existence of an energy
deficit and the loss of fat mass; in contrast, hyperphagia is linked
most closely to reductions in fat mass and fat-free mass. With weight
regain, the energy deficit is eliminated immediately, and fat mass is
restored fairly promptly. However, the restoration of fat-free mass
takes longer, and it is common for fat mass to be entirely restored to
pre-diet levels before fat-free mass is fully restored (for a visualization
of this effect using arbitrary numbers, see Figure 11). In this scenario,
hyperphagia continues in order to complete the restoration of fat-free
mass, and the dieter actually regains more fat than they initially lost.
This is known as fat overshooting, and may be driving the results
of observational studies reporting that athletes who engaged in
repeated cycles of weight loss and weight regain tend to have higher
BMIs later in life.
Figure 11. Research commonly shows that fat regain occurs more rapidly than
fat-free mass regain after weight loss. As such, fat mass may be fully restored
before fat-free mass is restored, as shown in the figure. In such a case,
hyperphagia may persist until fat-free mass is fully restored, and body fat
overshooting may occur.
Whether or not adipocyte hyperplasia is an important contributing
mechanism in humans, the available human research indicates that the
physiological environment following weight loss favors weight gain, fat
is preferentially regained in the initial phase of weight regain,
restoration of fat-free mass is a comparatively slower process, and it is
not uncommon to regain more fat than was initially lost. For physique
athletes (or strength/power athletes dieting to fairly low body
weights), this has some important implications for managing the post-
diet period. First, it suggests that the old-school idea of being “primed
for muscle growth,” or banking on some rebound effect of rapid
muscle gain after a weight loss diet, is mythical and unsubstantiated.
We ran a study on the topic, and results showed quite clearly that the
initial, immediate post-show weight gain is largely attributable to
increased water weight, and the additional weight gained in the first 4-
6 weeks was almost entirely fat mass.
I don’t see much value in pitting these approaches against each other
to determine which is best. Frankly, I struggle to see “reverse diet
versus recovery diet” as anything but a false dichotomy. Both
approaches seek to address the dilemma of promoting recovery while
mitigating excessive fat storage and weight regain. If we were to
construct a Venn diagram, these terms would have a lot more overlap
than exclusivity. There might be subtle differences with regard to how
quickly calories are added, but there are plenty of factors to consider
when determining how much weight should be regained, and how
quickly. I will certainly acknowledge that a really slowreverse diet
could theoretically leave the dieter in a slight caloric deficit for weeks
after the intended end of the weight loss diet; this would serve only to
delay even the most basic and immediate aspects of recovery, and
make their life unnecessarily difficult. Furthermore, an attempt to
stay too lean during the offseason would likely inhibit an individual’s
ability to fully restore normal hormone levels, reverse the hyperphagia
induced from dieting, and make strength and hypertrophy gains in the
offseason. It’s also relevant to note that a very slow, very strict reverse
diet is unequivocally more challenging and psychologically draining
than the most brutal of contest preps. How do you reasonably
convince yourself to exercise that level of dietary restraint when it
defies all of your physiological cues, and you don’t intend to step on
stage for another 24 months?
If your diet is over, get the hell out of a deficit, immediately. Beyond
that point, any time spent in a deficit is wasted recovery time. If that
puts me in the “anti-reverse-dieting” camp, then so be it. Based on this
reasoning, I don’t really see a lot of utility in using nonlinear
approaches like refeeds or diet breaks; every day should be a surplus,
to some degree. If you want some extra special HUGE surplus days to
accommodate your eating preferences, and that’s why you’re using a
nonlinear approach to calorie distribution, go for it, as long as the “low
calorie” days keep you at or above maintenance calories. If you are
planning to increase calories slowly enough to create a super-charged
metabolic rate, don’t bother. The premise of fabricating a new
metabolic rate from scratch is implausible. We only have the capacity
to restore a transiently suppressed level of energy expenditure, and we
have two primary tools to use: more calories, and more time spent in a
surplus. There are certainly instances in which people slowly raise
calories and manage to reach fairly high caloric intakes while staying
lean, but there are explanations for this that do not require wizardry
as an assumption. In the initial stages of slow overfeeding, they are
simply fixing an impairment. Their metabolic rate is lower than it
should be at the start, and they restore it to its normal level (and, for
some people, “normal” is higher than others). After the impairment of
energy expenditure is restored, there is also the potential for the
opposite effect to occur; in response to overfeeding, some people
dramatically increase their non-exercise activity thermogenesis
to prevent weight gain. There is a great deal of variability between
people for this response; as you might imagine, individuals prone to
weight gain typically have a very minor increase in NEAT when they
are overfed, while individuals resistant to weight gain display large
increases. Furthermore, the individuals who are able to slowly work
toward high caloric intakes while maintaining almost-stage-ready body
composition are still fairly miserable and unrecovered, for the most
part. From a very basic viewpoint, recovery can be viewed in three
stages: elimination of the calorie deficit, restoration of reasonably
sufficient fat mass levels, and restoration of lean mass. Someone who
clings to competition-level body fat is unlikely to achieve fully
comprehensive recovery from the multifaceted barrage of metabolic
adaptation, and unlikely to reach a high enough body fat level (or
energy surplus) to support substantial hypertrophy and strength
improvements in the offseason.
Conversely, if you’re planning to rapidly overfeed to capitalize on a
quick rebound of muscle gain, don’t bother. As previously discussed,
the body is effectively primed for fat accretion, but lean mass gains
are hard to come by in this scenario. To optimize the ratio of weight
that is regained as lean mass (within a realistic range), the best bet is
to get the body into a caloric surplus, nudge the body toward recovery
with incremental caloric increases that promote positive energy
balance and fat mass restoration at a conservative pace, while
engaging in a challenging and progressive resistance training program.
Rapid fat gain would probably expedite the recovery process, but
would come at the cost of an elevated ratio of fat gain to lean tissue
gain and an increased likelihood of fat overshooting.
From the case studies, we see a wide range of timelines for weight
recovery; some physique athletes return to their baseline weight
by nine weeks post-competition, while others are still below baseline
weight a full six monthsafter. On that topic, weight overshooting has
been observed by 5-8 months post-competition, with
both male and female competitors ending up a couple of kilograms
heavier than they started. While the subject described by Rossow et
al did not fully return to his initial bodyweight six months post-
competition, he also had not yet restored his fat-free mass to baseline
levels. Generally speaking, hormones more closely associated with
short-term energy availability (such as ghrelin, thyroid hormone,
insulin, and cortisol) start to show pretty substantial recovery in the
first 3-4 months. Leptin and male testosterone levels seem to take
longer; case studies measuring up to 5-6 months after competition
have failed to document full testosterone and leptin recovery in males.
Generally speaking, these 3-6 month hormone recovery timelines seem
to fit pretty well with the most relevant studyfeaturing a reasonably
large sample. In this study of female physique athletes, 27 dieters were
compared to 23 controls throughout approximately 5 months of
dieting and 4 months of recovery, give or take. By the end of recovery,
body composition had almost fully returned to baseline levels, and
most hormones were still a little below normal, but moving in the
direction of full recovery. Performance recovery seems to vary quite a
bit; for example, Rossow et al described complete recovery of deadlift
and squat performance within four months, but bench press remained
below baseline after six months. Pardue et al reported that absolute
Wingate sprint performance, assessed as both peak and average
power, had increased but not fully recovered five months after
competition. Using squat dynamometry, Tinsley et al showed that peak
force production was modestly suppressed nine weeks after
competition, but the rate of force production remained substantially
below baseline.
The early weight regain phase can be associated with body image
issues, a variety of disordered or problematic eating habits, reduced
motivation, and the general negative affect that physique athletes call
the post-competition blues. Having a plan for the period after weight
loss also involves a psychological component. I’m no psychologist, so
take this with a grain of salt, but it intuitively seems remarkably ill-
advised to leave this component entirely unaddressed. The perspective
for what constitutes a “good” check-in and a “bad” check-in should be
either drastically revised, or thrown out altogether. Positive post-
competition progress for a super-lean physique athlete doesn’t
just allow for some fat regain, it requires it. There is tremendous
benefit to embracing the positive aspects of weight regain: it’s
promoting recovery of your endocrine system, it’s making you feel
better on a day-to-day basis, it’s restoring your energy level, it’s giving
you more dietary flexibility, it’s fueling substantially better training in
the gym, and it is an instance of successfully implementing the post-
competition plan. This shift in perspective has to be intentional and
approached in a proactive manner, primarily to ensure that post-diet
weight gain doesn’t psychologically and emotionally hit you like a ton
of bricks. When psychological recovery is not proactively planned for,
it can sometimes take up to 12-18 months to truly feel “normal” after
a rigorous weight loss diet. When the challenges and stressors that
accompany the period after weight loss are anticipated and planned
for, this timeline can be dramatically shortened.
Conclusion
When you finish a weight loss diet, many of the unfavorable effects of
metabolic adaptation are in full swing, and your body is primed for fat
regain. If you’ve dieted to a reasonably sustainable body fat
percentage, maintenance is certainly achievable. If you’ve dieted to a
physique competition-level body fat percentage, weight regain is an
important part of recovering from the unfavorable metabolic and
hormonal effects of metabolic adaptation. However, if there’s no plan
in place for transitioning from weight loss to either maintenance or a
controlled weight regain process, the likelihood of excessive fat regain
and body fat overshooting is increased. When the weight loss phase
ends, calories should promptly be raised to maintenance levels, at
minimum. Prolonging the energy deficit serves only to inhibit recovery,
but the “ideal” rate at which caloric intake should increase depends on
the goals and circumstances of the individual. For individuals who are
comfortable returning to their initial body weight, metabolic,
hormonal, and performance-related adaptations should be largely
reversed within 4-6 months. Other aspects of recovery, such as
restored menstrual regularity and psychological recovery, are much
more variable between individuals. More conservative approaches to
the post-diet recovery process that seek to delay or minimize fat
regain have the potential to substantially prolong the recovery
timeline.
Summary
Weight loss attempts are met with changes in mitochondrial
function, hormone levels, and energy expenditure.
These changes produce some unpleasant side effects, threaten our
ability to gain (or even keep) muscle mass and strength,
manipulate biological cues pertaining to the regulation of appetite
and activity level, and require us to eat even fewer calories and/or
incorporate even more cardio into our training program.
To mitigate the effects of metabolic adaptation, dieters should
avoid rapid weight loss (>1% of body mass per week), eat
sufficient protein (2.3-3.1 g/kg of fat-free mass), and avoid
excessive cardio volumes and frequencies.
Refeeds (twice weekly) and diet breaks (1-2 weeks at a time) may
also help to attenuate the effects of metabolic adaptation.
To avoid body fat overshooting and promote recovery, it’s
important to have a transition plan in place for when the weight
loss diet ends.
The caloric deficit should not extend beyond the period of
intended weight loss; the rate at which calories should be
increased depends on the goals and circumstances of the
individual.
For competitors that return to (or near) their initial body weight,
most physiological parameters tend to recover within 4-6 months,
while menstrual cycle regularity and psychological factors are far
more variable and often take longer.
Conservative approaches that raise calories more slowly may
minimize fat regain, but may also extend the timeline for full
recovery.