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Metabolic Adaptation and Increased Drive to Eat as Drivers of Weight Regain in Individuals with Obesity. Myth or Reality? An Exercise in Adversarial Collaboration
Weight regain remains the main challenge in obesity management, with 30-50% of the initial weight lost being regained within the first year and most individuals returning to, or above, their baseline weight within 5 years. Weight loss is followed by an increased drive to eat and reduced energy expenditure (EE), both suggested to drive weight regain. Metabolic adaptation, a reduction in EE below predicted values, is a physiological phenomenon that might contribute to resistance to weight loss and increase the risk of weight regain. However, the existence and clinical relevance of metabolic adaptation remain one of the most controversial issues in nutrition science.
Meet our collaborators who each have differing views and have agreed to work together to untangle the controversy: Catia Martins, PhD, RD, Associate Professor, The University of Alabama at Birmingham and Jonathan Krakoff, MD, NIDDK-Phoenix, Arizona.
Originally presented at NUTRITION 2023, ASN's flagship meeting which was held July 22-25, 2023 in Boston, MA.
Speakers
James Hill, PhD
Professor and Director, Nutrition Obesity Research Center, Department of Nutrition Sciences, University of Alabama at Birmingham
Jonathan Krakoff, MD
Chief, Obesity and Diabetes Clinical Research Section, Obesity and Diabetes Clinical Research Section, NIDDK-Phoenix
Catia Martins, PhD, RD
Associate Professor, Nutrition Sciences Research, The University of Alabama at Birmingham
Drew Sayer, PhD
Assistant Professor, Department of Family and Community Medicine, The University of Alabama at Birmingham
Learning Objectives
- Describe the concept of Adversarial Collaboration
- Define the proposed concept of metabolic adaptation
- Explain the areas of controversies surrounding metabolic adaptation
This activity includes the following presentations:
Introduction to the ASN – UAB NORC Adversarial Collaboration Project
Drew Sayer, PhD
Assistant Professor, Department of Family and Community Medicine, The University of Alabama at Birmingham
What Do We Know and Not Know About Metabolic Adaptation?
Catia Martins, PhD, RD
Associate Professor, Nutrition Sciences Research, The University of Alabama at Birmingham
Two Views: Part 1
Catia Martins, PhD, RD
Associate Professor, Nutrition Sciences Research, The University of Alabama at Birmingham
Two Views: Part 2
Jonathan Krakoff, MD
Chief, Obesity and Diabetes Clinical Research Section, Obesity and Diabetes Clinical Research Section, NIDDK-Phoenix
The Plan to Unravel the Controversy
Catia Martins, PhD, RD
Associate Professor, Nutrition Sciences Research, The University of Alabama at Birmingham
Jonathan Krakoff, MD
Chief, Obesity and Diabetes Clinical Research Section, Obesity and Diabetes Clinical Research Section, NIDDK-Phoenix
Crowdsourced Perspectives
James Hill, PhD
Professor and Director, Nutrition Obesity Research Center, Department of Nutrition Sciences, University of Alabama at Birmingham
Jonathan Krakoff, MD
Chief, Obesity and Diabetes Clinical Research Section, Obesity and Diabetes Clinical Research Section, NIDDK-Phoenix
Catia Martins, PhD, RD
Associate Professor, Nutrition Sciences Research, The University of Alabama at Birmingham
Drew Sayer, PhD
Assistant Professor, Department of Family and Community Medicine, The University of Alabama at Birmingham
Disclosure Policy
It is the policy of the American Society of Nutrition, in compliance with the Standards for Integrity and Independence in Accredited Continuing Education to ensure that education presents learners with only accurate, balanced, and scientifically justified recommendations and protects learners from promotion, marketing, and commercial bias. ASN requires disclosure of all financial interest that the planning committee (including ASN staff) or faculty members have with ineligible companies. All faculty and contributors to this continuing education activity have disclosed any relevant financial relationship that may have direct bearing on the subject matter of this program. Specific disclosure information is in the course materials.
The American Society for Nutrition supports fair and unbiased participation of individuals in its education activities. Any real or potential conflicts of interest must be identified and managed. All relevant financial relationships with commercial interests that directly impact and/or might conflict with ASN activities must be disclosed, or disclosure that no relevant financial relationships exist must be documented. Other relationships that could cause private interests to conflict with professional interests must also be disclosed. This policy is intended to openly identify any potential conflict so that participants in an education activity are able to form their own judgments about the presentation. In addition, disclosure must be made of presentations on drugs or devices or uses of drugs or devices that have not been approved by the Food and Drug Administration.
Speakers
James Hill, PhD, Professor and Director, Nutrition Obesity Research Center, Department of Nutrition Sciences, University of Alabama at Birmingham
Disclosures: General Mills: Advisory Committee/Board Member (Ongoing); McCormick Science Institute: Advisory Committee/Board Member (Ongoing); Shakabuku, LLC: Ownership Interest (Ongoing)
All of the relevant financial relationships listed for this individual have been mitigated.
Jonathan Krakoff, MD, Chief, Obesity and Diabetes Clinical Research Section, Obesity and Diabetes Clinical Research Section, NIDDK-Phoenix
No relevant financial relationship(s) with ineligible companies to disclose.
Catia Martins, PhD, RD, Associate Professor, Nutrition Sciences Research, The University of Alabama at Birmingham
No relevant financial relationship(s) with ineligible companies to disclose.
Drew Sayer, PhD, Assistant Professor, Department of Family and Community Medicine, The University of Alabama at Birmingham
No relevant financial relationship(s) with ineligible companies to disclose.
Planners
The following individuals served on the NUTRITION 2023 Scientific Program Committee. The session titled 'Metabolic Adaptation and Increased Drive to Eat as Drivers of Weight Regain in Individuals with Obesity. Myth or Reality? An Exercise in Adversarial Collaboration' was included in the scientific program of NUTRITION 2023, ASN's flagship meeting which was held from July 22-25, 2023.
Paola Baratto, MS, Rutgers University
No relevant financial relationship(s) with ineligible companies to disclose.
Nicolaas Deutz, MD, PhD, Texas A&M University
Disclsoures: Abbott: Speaker Fees
All of the relevant financial relationships listed for this individual have been mitigated.
Bradley Ferguson, PhD, University of Nevada, Reno
No relevant financial relationship(s) with ineligible companies to disclose.
Martha Field, PhD, Cornell University
No relevant financial relationship(s) with ineligible companies to disclose.
Daniel Hoffman, PhD, Rutgers University
No relevant financial relationship(s) with ineligible companies to disclose.
Hannah Holscher, PhD, RD, University of Illinois at Urbana-Champaign
Disclosures: Almond Board of California; Grant/Research Support; Beneo: Speaker/Speaker's Bureau; Bio-Cat: Grant/Research Support; General Mills Inc.: Grant/Research Support; Hass Avocado Board: Grant/Research Support; ISAPP: Speaker/Speaker's Bureau; National Dairy Council: Speaker/Speaker's Bureau; National Honey Board:Grant/Research Support; Tate & Lyle: Grant/Research Support
All of the relevant financial relationships listed for this individual have been mitigated.
Frank Hu, MD, MPH, PhD, Harvard T.H. Chan School of Public Health
No relevant financial relationship(s) with ineligible companies to disclose.
Zhaoping Li, MD, PhD, UCLA
Nutrient Institute (Scientific Advisory Board Member)
All of the relevant financial relationships listed for this individual have been mitigated.
Laura Murray-Kolb, PhD, Purdue University
No relevant financial relationship(s) with ineligible companies to disclose.
Kathryn Porter Starr, PhD, RD, Duke University School of Medicine and Durham VA Medical Center
No relevant financial relationship(s) with ineligible companies to disclose.
Lewis Rubin, MD, Georgetown University Medical Center
Disclosures: Abbott Nutrition: Grant/Research Support
All of the relevant financial relationships listed for this individual have been mitigated.
Anna Thalacker-Mercer, PhD, The University of Alabama at Birmingham
No relevant financial relationship(s) with ineligible companies to disclose.
Staff
Michelle Crispino, CAE, DES, American Society for Nutrition
No relevant financial relationship(s) with ineligible companies to disclose.
Gwen Twillman, American Society for Nutrition
No relevant financial relationship(s) with ineligible companies to disclose.
Continuing education credit is not available for this activity. A Certificate of Attendance can be downloaded by learners who complete the course.
Available Credit
- 1.50 Attendance
Learners are eligible to download a Certificate of Attendance upon activity completion. A Certificate of Attendance confirms the learner has completed the activity and does not confer any continuing education credit to the learner from ASN.