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11/21/2019

Weight Loss Without Rebounding Requires Two Steps

Summary

(1)Just as weight gain does, weight loss likely involves two distinct physiological processes. Under conventional calorie restriction, the body tends to perceive an energy deficit and triggers adaptive responses aimed at maintaining the previous body weight level. As a result, weight loss is difficult to sustain, and body weight often returns to its original range.

To achieve long-term weight loss without rebounding, it is necessary to lower the body’s weight “set-point” itself.

　　
(2)Lowering this set-point likely requires at least two physiological steps.
First, before reducing body weight, it is essential to establish a physiological environment in which the body does not perceive energy deprivation. Second, within that environment, undergo a process where body fat naturally decreases over time.

Step One:
The diet is structured around foods that are nutrient-dense and slow-digesting, such as vegetables, dairy products, nuts, and certain protein-rich foods.

When intestinal contents containing less digestible components remain in the gut for extended periods, this may be perceived by the body as a signal that food is sufficiently available. As a result, even if overall energy balance becomes slightly negative, strong adaptive responses are less likely to be triggered.

Step Two :
Sustained satiety not only helps prevent overeating, but may also gradually reduce absorption efficiency. Over the long term, coordinated interactions between the brain—particularly the hypothalamus—and peripheral organs and tissues may allow body fat to decline in a stepwise manner.

　　
(3)Although the two-step approach may result in a dietary pattern that resembles a low-carb diet, the underlying goal is fundamentally different.

Low-carb diets primarily aim to reduce insulin secretion by restricting carbohydrate intake. In contrast, the two-step approach focuses on creating a physiological environment opposite to intestinal starvation. To achieve this, it reduces carbohydrate intake while increasing the intake of nutrient-dense foods that take longer to digest, in sufficient amounts.

【Full text】

Contents

Two distinct physiological processes underlying weight loss
What is required to lower the set-point for body weight?
Step one
Step two
How the two-step approach differs from low-carb diets

Although this blog is not intended as a diet guide, examining the mechanisms of weight gain inevitably requires me to also organize, in theoretical terms, the opposite process—how people lose weight.

In this article, I will outline a theory of sustainable weight loss based on my own hypothesis. This discussion is theoretical rather than practice-based, and its purpose is to share a new way of thinking free from conventional constraints.

1. Two distinct physiological processes underlying weight loss

I propose that just as weight gain involves two physiologically distinct processes, weight loss can also occur through two physiologically distinct processes.

【Related article】The Two Distinct Processes Behind Weight Gain

(1) Weight decreases, but rebounds

Conventional calorie restriction and low-fat diets are designed to reduce body weight by decreasing energy intake and increasing energy expenditure. This approach often involves constant hunger.

In this blog, I use the body weight set-point hypothesis[1,2] as a framework to explain weight homeostasis.

When energy intake is severely restricted and body weight decreases, the body perceives an energy deficit and triggers adaptive responses aimed at preserving stored energy[3,4].

These responses are best understood as adaptive processes that consist of interacting changes in metabolism, neuroendocrine function, autonomic regulation, and behavior[5].

In addition, in my opinion, prolonged hunger leads the body to extract as much nutrition as possible from food, thereby increasing absorption efficiency.

In most cases, however, the body’s weight set-point itself does not change. As a result, weight loss is not sustained, and body weight is likely to return to its original range over time.

(2) Lowering the body weight “set-point” itself

I believe that the fundamental problem in obesity lies in an elevated body weight set-point.

Even though obese individuals have ample energy stores, they still exhibit metabolic resistance to caloric restriction, suggesting that obesity represents a physiologically stable state for some people[1]. Animal studies similarly describe obesity as a condition of energy homeostasis regulated around a higher set-point[1].

Therefore, achieving long-term weight loss requires not merely focusing on short-term energy balance, but lowering the body weight set-point itself. Relevant literature supporting this perspective is cited below.

"There appears to be a “set point” for body weight and fatness, and the problem in obesity is that the set point is too high.(*snip*)

There are two prominent findings from all the dietary studies done over the years.

First: all diets work. Second: all diets fail.

What do I mean?
Weight loss follows the same basic curve so familiar to dieters. Whether it is the Mediterranean, the Atkins or even the old fashioned low-fat, low-calorie, all diets in the short term seem to produce weight loss. Sure, they differ by amount lost–some a little more, some a little less. But they all seem to work.

However, by six to twelve months, weight loss plateaus, followed by a relentless regain, despite continued dietary compliance.(*snip*)

So all diets fail. The question is why.

Permanent weight loss is actually a two-step process. There is a short-term and a long-term (or time-dependent) problem. "
( Fung J. 2016. The obesity code. pages 62,215 )

2. What is required to lower the set-point for body weight?

In my understanding, the “two-step process” described by Doctor Fung is a conceptual framework that views obesity treatment (weight loss) as consisting of a short-term and a long-term challenge, organized primarily from a clinical and practical perspective.

On the other hand, this article focuses on the long-term problem—specifically, why the body resists weight loss and why body weight,once reduced, often returns over time[6]—and explores this issue more deeply from a physiological perspective.

Based on this analysis, I suggest that successful long-term weight loss requires at least the following two physiological steps:　

(1) Before trying to lose weight, creating a physiological state in which the body does not perceive energy deprivation.

(2) Within that state, allowing body fat to decrease naturally over time.

My theory posits that weight gain accompanied by an upward shift in the body’s set-point weight is closely related to adaptive responses that arise when the body perceives a state of starvation. Therefore, I believe that reducing body weight in a sustained manner require creating the opposite physiological environment.

Many diets aim for losing weight from the very beginning. However, when the first step is skipped, the body tends to activate adaptive responses to restore homeostasis[6], which can increase the likelihood of long-term weight rebound.

Specifically, the process can be described as follows.

Step one
Rather than reducing overall food intake and enduring hunger, this approach centers the diet around nutrient-dense foods that either take longer to digest or are partially indigestible.

More specifically, this involves reducing the intake of refined carbohydrates and instead increasing consumption of foods such as whole grains, fiber-rich vegetables, nuts, dairy products, fat, and minimally processed protein foods.

Author: brgfx. Source: Freepik

As a result, intestinal contents that include less easily digestible components remain in the gut for a longer period of time. This may not only reduce the sensation of hunger but also may be perceived by the body as a signal that food is sufficiently available. Consequently, even if overall energy balance becomes slightly negative, the body is less likely to perceive this state as energy deprivation.

Step two
As hunger diminishes, appetite tends to decrease, and absorption efficiency may also gradually decline. Eventually, I suggest that coordinated interactions between the brain—centered on the hypothalamus—and peripheral organs and tissues[7] may contribute to a gradual reduction in body fat.

Changes in absorption efficiency may not be intuitive at first glance, but consider this: consuming carbohydrates in a state of intense hunger tends to cause a rapid rise in blood glucose levels, whereas eating them several hours after a meal moderates the rise. Similarly, alcohol intoxication occurs faster on an empty stomach, but more gradually after eating.

Thus, by avoiding prolonged hunger and consuming foods that require longer digestion at appropriate intervals, absorption efficiency may gradually decrease in relative terms.

3. How the two-step approach differs from low-carb diets

The “two-step approach” proposed here may, in practice, result in a dietary pattern that resembles a low-carbohydrate diet. However, the two differ fundamentally in their starting points and underlying goals. In this section, I will clarify these differences.

▽Low-carb diets primarily aim to limit carbohydrate intake in order to suppress rapid spikes in blood glucose and reduce insulin secretion, which plays a key role in fat storage.

When energy derived from carbohydrates becomes insufficient, the body shifts to using fat as its main energy source, entering what is known as a state of ketosis. As a result, body fat tends to be utilized more readily, and body weight may decrease relatively quickly.

Another commonly cited feature of low-carb diets is that they do not require strict calorie counting, and often promote satiety through higher protein and fat intake.

On the other hand, dietary approaches that involve extreme carbohydrate restriction have raised concerns regarding long-term safety and sustainability. In particular, under certain conditions, potential risks associated with excessive ketone production have also been discussed.

▽In contrast, my own theory likewise considers diets heavily skewed toward refined carbohydrates and highly processed foods to be likely contributors to the modern obesity epidemic. However, this is not because carbohydrates themselves are inherently harmful in a direct sense.

What I emphasize instead are certain properties of carbohydrates: their rapid digestibility; the “dilution effect” that occurs when carbohydrates are consumed together with large amounts of water; and the “push-out effect,” whereby gastric contents are rapidly propelled into the intestine.

Author: brgfx. Source: Freepik

When these factors act together, all ingested food may be digested and expelled relatively quickly, potentially increasing the likelihood of intestinal starvation under specific conditions.

　　　
For this reason, the two-step approach aims to create a physiological environment opposite to intestinal starvation—namely, a state in which intestinal contents containing less digestible components remain in the gut for an extended period. To achieve this, carbohydrate intake is reduced in order to weaken the dilution and push-out effects, while the relative intake of other foods—such as fiber-rich vegetables, dairy products, fats, and minimally processed protein sources—is increased.

In low-carb diets, by contrast, the central strategy is to reduce carbohydrate intake itself, while proteins and fats are consumed relatively freely as alternative energy sources. This distinction represents a fundamental difference between low-carb diets and the two-step approach described here.

References

[1]Richard E. Keesey, Matt D. Hirvonen, Body Weight Set-Points: Determination and Adjustment, The Journal of Nutrition, Volume 127, Issue 9, 1997, Pages 1875S-1883S, ISSN 0022-3166.

[2]Ganipisetti VM, Bollimunta P. Obesity and Set-Point Theory. 2023 Apr 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–.

[3]Hall KD, Guo J. Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition. Gastroenterology. 2017 May;152(7):1718-1727.e3.

[4]Egan AM, Collins AL. Dynamic changes in energy expenditure in response to underfeeding: a review. Proc Nutr Soc. 2022 May;81(2):199-212.

[5] Rosenbaum M, Leibel RL. Adaptive thermogenesis in humans. Int J Obes (Lond). 2010 Oct;34 Suppl 1(0 1):S47-55.

[6] Ochner CN et al. Biological mechanisms that promote weight regain following weight loss in obese humans. Physiol Behav. 2013 Aug 15;120:106-13.

[7] Wilson JL, Enriori PJ. A talk between fat tissue, gut, pancreas and brain to control body weight. Mol Cell Endocrinol. 2015 Dec 15;418 Pt 2:108-19.

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