. Author manuscript; available in PMC: 2022 Apr 21.

Published in final edited form as: Obesity (Silver Spring). 2021 Apr;29(Suppl 1):S9–S24. doi: 10.1002/oby.23086

TABLE 3.

Comparison of dynamic weight loss and static reduced-weight maintenance

	Active weight loss	Maintenance of a reduced body weight
Prior metabolic state	Usual weight (energy balance)	Weight loss (negative energy balance)
Current metabolic state	Negative energy balance	Energy balance
Changes compared with weight maintenance at usual body weight
Energy expenditure	↓↓ REE (~2× reduced-weight maintenance residual)	↓ REE^a
	↓ NREE	↓ NREE^a
	↑ Muscle contraction efficiency	↑ Muscle contraction efficiency^a
Neuroendocrine axes	↓↓ T3, ↓↓T4, ↓↓TSH, ↑rT3	↓ T3^a, ↓T4^a, ↓TSH, ↑rT3
	↓↓ Leptin/FM by 40%-50%	↓ Leptin/FM by ~10%^a
	↑ Cortisol	Cortisol within normal range
	↑ GH	No change or small ↑ GH
Autonomics	↑↑ PNS tone and ↓↓ SNS tone	↑ PNS tone and ↓SNS tone^a
Energy intake	↓↓ Satiation	↓ Satiation^a
	↑↑ Hunger	↑ Hunger^a

GH, growth hormone; FM, fat mass; nl, XXX; NREE, nonresting energy expenditure; PNS, parasympathetic nervous system; REE, resting energy expenditure; rT3, reverse T3 (bioinactive enantiomer of T3); SNS, sympathetic nervous system; T3, triiodothyronine; T4, thyroxine; TSH, thyroid-stimulating hormone.

Variables are at least partially reversed by leptin repletion, based on Rosenbaum et al. (9,51), Sumithran and Proietto (52) and Sumithran et al. (53).