Biologic Responses to Weight Loss and Weight Regain: Report From an American Diabetes Association Research Symposium

On 26–28 April 2013, the American Diabetes Association convened an international group of experts in Washington, DC, for a research symposium titled “Biologic Responses to Weight Loss and Weight Regain.” The speakers addressed the following topics: 1 ) developmental processes and the prevention of weight gain, 2 ) behavioral management approaches to weight loss, 3 ) distinctions between the physiological mechanisms of weight loss and weight maintenance and the implications for treatment, 4 ) the role of exercise in weight loss and maintenance, 5 ) the physiological mechanisms and effectiveness of bariatric surgery, and 6 ) pharmacological approaches to weight loss and maintenance. Both scientific and clinical perspectives were provided. The meeting concluded with an open session in which all the participants discussed emerging areas of investigation as well as unmet research needs. This discussion resulted in a series of recommendations for future research directions (Table 1). This Perspective article consists of summaries of the symposium sessions, by topic. View this table: Table 1 Recommendations for research questions regarding biologic responses to weight loss and weight regain The rapid increase in the prevalence of childhood obesity has drawn attention to early life influences that may, in part, explain the increased susceptibility to weight gain for individuals and populations. This session featured investigators examining gestational factors and events early in intra- and extrauterine development that may predispose individuals to obesity later in life, such as the programming of the body weight “set point.” These investigations may uncover developmental stages where behavioral or clinical interventions could be implemented to prevent or minimize excessive weight gain. A propensity toward obesity may begin in utero. Over 40 studies have found a U-shaped relationship between birth weight and the risk for a variety of illnesses, including obesity, type 2 diabetes, and cardiovascular disease, with both high and low birth weights associated with greater risk. Susan Ozanne …