Submitted by: Amy Sercel MS RD CD
Edited by: Marcia Bristow MS RDN CSSD CD
It’s an unfortunate fact that, when it comes to losing weight, many people end up re-gaining the weight they lost and sometimes more. This trend is common with crash diets where people temporarily restrict certain food groups and/or carefully control calorie intake. This dietary trend often leads to resuming old eating habits once the diet is “done”. However, even people who make gradual dietary changes and incorporate more activity into their lifestyles may be unable to maintain weight loss. One study found that only about 1 in 6 people who were overweight or obese were able to maintain a 10% weight loss for over a year.1 This difficulty maintaining weight loss could be related to a hormone called ghrelin.
Ghrelin is a hormone produced by the stomach when food has not been eaten for a period of time. Ghrelin is then sent to your brain to stimulate your appetite. High ghrelin levels also promote the storage of energy as fat tissue. After eating, ghrelin levels decrease the hunger signal and a sense of fullness or satiety results. When someone purposefully eats less to promote weight loss, ghrelin levels go up throughout the day and aren’t as impacted by eating.2 One particular study found that ghrelin levels increased by 24% after people dieted for six months, and other studies suggest that ghrelin continues to increase as diets go on.3 This phenomenon was once critical for the survival of our hunter/gatherer ancestors, since it signaled the need to find food when it wasn’t readily available, and helped humans store calories to draw upon in a time of famine. Now that food is plentiful, ghrelin may be more problematic than helpful.
Researchers have been looking for eating patterns that might help prevent this increase in ghrelin to make long-term weight loss sustainable for more people. One study measured ghrelin levels and food cravings in people following meal patterns designed to facilitate weight loss. One group ate three low carbohydrate, high protein meals each day, and the other group ate a high carbohydrate breakfast and low carbohydrate, high protein lunch and dinner. The two groups ate the same number of calories each day. Researchers found that people experienced fewer food cravings and had lower ghrelin levels when they ate a high carbohydrate breakfast. The low carbohydrate breakfast group lost slightly more weight during the course of the study, but regained more than half of the weight they lost within four months after the study ended. On the other hand, the high carbohydrate breakfast group continued to lose weight after the study ended, losing an average of 45 pounds over 8 months.2
Getting enough sleep, choosing a balanced meal pattern, and engaging in regular physical activity can all help keep ghrelin levels low. Studies suggest that lack of sleep promotes ghrelin production, leading to hunger and cravings throughout the day. Increased muscle mass and regular protein intake have also been associated with lower ghrelin levels.3
People working to lose weight should meet with a Registered Dietitian, who will provide support and recommendations tailored to their unique lifestyle. A dietitian will calculate the number of calories someone needs to eat in a day and collaboratively develop a meal plan that will facilitate weight loss while the person to meets their calorie and nutrient needs. Through this collaboration, the dietitian will discover times of the day when their client might feel more hungry or crave certain foods and develop strategies to help them prevent hunger, distract themselves from the craving, and achieve their weight loss goals.
- Montesi L, El Ghoch M, Brodosi L, Calugi S, Marchesini G, Dalle Grave R. Long-term weight loss maintenance for obesity: a multidisciplinary approach. Diabetes Metab Syndr Obes Targets Ther. 2016;9:37-46. doi:10.2147/DMSO.S89836
- Jakubowicz D, Froy O, Wainstein J, Boaz M. Meal timing and composition influence ghrelin levels, appetite scores and weight loss maintenance in overweight and obese adults. Steroids. 2012;77(4):323-331. doi:10.1016/j.steroids.2011.12.006
- Ghrelin: The “Hunger Hormone” Explained. https://www.healthline.com/nutrition/ghrelin. Accessed January 29, 2018.