Uploaded July 2026 | Updated September 2026, 3 weeks ago
Why is it so hard to keep weight off? When you lose weight, appetite climbs and the calories you burn fall, and both can persist for years. This segment covers Priya Sumithran's 2011 NEJM study showing hunger hormones stay elevated a year after dieting, metabolic adaptation and resting metabolic rate, and the six-year Biggest Loser data showing metabolism running 600 to 700 calories a day below expected.
Timestamps
0:00 Losing weight vs. keeping it off: two different problems
0:47 Appetite vs. hunger: why you can't decide to be less hungry
1:07 The Sumithran 2011 NEJM study on appetite after dieting
2:30 One year later: hunger hormones still elevated
2:56 Ghrelin, leptin, and the hormones of hunger and fullness
5:20 Obesity-sensitive vs. obesity-resistant phenotypes
6:31 Resting metabolic rate and metabolic adaptation
8:46 The Biggest Loser 6-year study: metabolism 600-700 calories lower
9:46 Weight regain is biology, not weak willpower
11:49 Why competitive bodybuilders use GLP-1s
Resources
Barbell Medicine coaching and templates: barbellmedicine.com
Plus podcast subscription: barbellmedicine.com/shop/subscriptions/plus-podcast-subscription
Barbell Medicine Premium: barbellmedicine.com/shop/subscriptions/barbell-medicine-premium
Signal (book pre-order): barbellmedicine.com/shop/learning/signal
Studies referenced in this segment
1. Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597-1604. doi.org/10.1056/NEJMoa1105816
2. Fothergill E, Guo J, Howard L, et al. Persistent metabolic adaptation 6 years after 'The Biggest Loser' competition. Obesity (Silver Spring). 2016;24(8):1612-1619. doi.org/10.1002/oby.21538
3. Hall KD. Energy compensation and metabolic adaptation: 'The Biggest Loser' study reinterpreted. Obesity (Silver Spring). 2022;30(1):11-13. doi.org/10.1002/oby.23308
4. Pontzer H, Raichlen DA, Wood BM, et al. Hunter-gatherer energetics and human obesity. PLoS One. 2012;7(7):e40503. doi.org/10.1371/journal.pone.0040503
5. Careau V, Halsey LG, Pontzer H, et al. Energy compensation and adiposity in humans. Curr Biol. 2021;31(20):4659-4666.e2. doi.org/10.1016/j.cub.2021.08.016
6. Miller WC, Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord. 1997;21(10):941-947. doi.org/10.1038/sj.ijo.0800499
7. Helms ER, Aragon AA, Fitschen PJ. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. J Int Soc Sports Nutr. 2014;11:20. doi.org/10.1186/1550-2783-11-20
8. Garthe I, Raastad T, Refsnes PE, Koivisto A, Sundgot-Borgen J. Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes. Int J Sport Nutr Exerc Metab. 2011;21(2):97-104. doi.org/10.1123/ijsnem.21.2.97
Why is it so hard to keep weight off? When you lose weight, appetite climbs and the calories you burn fall, and both can persist for years. This segment covers Priya Sumithran's 2011 NEJM study showing hunger hormones stay elevated a year after dieting, metabolic adaptation and resting metabolic rate, and the six-year Biggest Loser data showing metabolism running 600 to 700 calories a day below expected.
Timestamps
0:00 Losing weight vs. keeping it off: two different problems
0:47 Appetite vs. hunger: why you can't decide to be less hungry
1:07 The Sumithran 2011 NEJM study on appetite after dieting
2:30 One year later: hunger hormones still elevated
2:56 Ghrelin, leptin, and the hormones of hunger and fullness
5:20 Obesity-sensitive vs. obesity-resistant phenotypes
6:31 Resting metabolic rate and metabolic adaptation
8:46 The Biggest Loser 6-year study: metabolism 600-700 calories lower
9:46 Weight regain is biology, not weak willpower
11:49 Why competitive bodybuilders use GLP-1s
Resources
Barbell Medicine coaching and templates: barbellmedicine.com
Plus podcast subscription: barbellmedicine.com/shop/subscriptions/plus-podcast-subscription
Barbell Medicine Premium: barbellmedicine.com/shop/subscriptions/barbell-medicine-premium
Signal (book pre-order): barbellmedicine.com/shop/learning/signal
Studies referenced in this segment
1. Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597-1604. doi.org/10.1056/NEJMoa1105816
2. Fothergill E, Guo J, Howard L, et al. Persistent metabolic adaptation 6 years after 'The Biggest Loser' competition. Obesity (Silver Spring). 2016;24(8):1612-1619. doi.org/10.1002/oby.21538
3. Hall KD. Energy compensation and metabolic adaptation: 'The Biggest Loser' study reinterpreted. Obesity (Silver Spring). 2022;30(1):11-13. doi.org/10.1002/oby.23308
4. Pontzer H, Raichlen DA, Wood BM, et al. Hunter-gatherer energetics and human obesity. PLoS One. 2012;7(7):e40503. doi.org/10.1371/journal.pone.0040503
5. Careau V, Halsey LG, Pontzer H, et al. Energy compensation and adiposity in humans. Curr Biol. 2021;31(20):4659-4666.e2. doi.org/10.1016/j.cub.2021.08.016
6. Miller WC, Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord. 1997;21(10):941-947. doi.org/10.1038/sj.ijo.0800499
7. Helms ER, Aragon AA, Fitschen PJ. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. J Int Soc Sports Nutr. 2014;11:20. doi.org/10.1186/1550-2783-11-20
8. Garthe I, Raastad T, Refsnes PE, Koivisto A, Sundgot-Borgen J. Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes. Int J Sport Nutr Exerc Metab. 2011;21(2):97-104. doi.org/10.1123/ijsnem.21.2.97
