Fatores comportamentais e metabólicos envolvidos no ganho de peso
DOI:
https://doi.org/10.61565/revista-aquila.i34.360Palavras-chave:
Obesidade, Perda de peso, Reganho de peso, ApetiteResumo
A obesidade é um problema de saúde pública crescente e afeta 1 em cada 8 pessoas no mundo. Embora a dieta seja a forma mais comum de emagrecimento, sua eficácia isolada é limitada, com alta taxa de reganho de peso. Este artigo revisa os principais mecanismos comportamentais e metabólicos envolvidos nesse processo. Foi realizada uma busca bibliográfica nas bases PubMed, Nature e Scopus, com artigos em português e inglês, publicados entre 2014 e 2024. Foram utilizadas as palavras-chave: obesidade, perda de peso, reganho de peso, mecanismos adaptativos, apetite, recompensa e comportamento. Foram incluídos 30 estudos que abordam as adaptações fisiológicas à perda de peso, como redução do gasto energético, alterações hormonais e aumento do apetite, além do impacto do ambiente obesogênico. A revisão conclui que os mecanismos subjacentes ao reganho de peso ainda não estão totalmente esclarecidos, sendo necessários estudos de longo prazo que considerem tais fatores para uma abordagem mais eficaz no tratamento da obesidade.
Downloads
Referências
AFFINATI AH, Myers MG Jr.. Neuroendocrine Control of Body Energy Homeostasis. [Updated 2021 May 15]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570658/ ANDERSONJW,etal. Long-term weight-loss maintenance: a meta-analysis of US studies. Am J Clin Nutr 2001;74(5):579–584.
ABESO. Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica Diretrizes brasileiras de obesidade 2016 / ABESO- Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica.– 4.ed.- São Paulo, SP ABESO. Posicionamento sobre o tratamento nutricional do sobrepeso e da obesidade: departamento de nutrição da Associação Brasileira para o estudo da obesidade e da síndrome metabólica (ABESO- 2022) / coordenação Renata Bressan: Abeso, 2022.
BRASIL. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Estratégias para o cuidado da pessoa com doença crônica: obesidade / Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Atenção Básica.– Brasília : Ministério da Saúde, 2014. 212 p. : il.– (Cadernos de Atenção Básica, n. 38).
BERRIDGE KC,HoCY,Richard JM, Di Felice Antonio AG. The tempted brain eats: pleasure and desire circuits in obesity and eating disorders. Brain Res 2010;1350:43-64 BERTHOUD,Hans‐rudolf ; Seeley, Randy J.; Roberts, Susan B. (2021). "Physiology of Energy Intake in the Weight- Reduced State." Obesity : S25-S30.
BERTHOUDHR. Theneurobiology of food intake in an obesogenic environment. Proc Nutr Soc. 2012 Nov;71(4):478-87. doi: 10.1017/S0029665112000602. Epub 2012.
BOBBIONI-HARSH E, Assimacopoulos-Jeannet F, Lehman T, Munger R, Allaz A, Golay A. Leptin plasma levels as a marker of sparing-energy mechanisms in obese women. Int J Obes Relat Metab Disord, 23: 470-475. 1999
BROWNELL,K.D., Horgen, KB. (2003) Food Fight: The Inside Story of America's Obesity Crisis and What WeCanDoAboutIt. Contemporary Books: Chicago, IL.
BUSETTOL, Bettini S, Makaronidis J, Roberts CA, Halford JCG, Batterham RL. Mechanisms of weight regain. Eur J Intern Med 2021. https://doi.org/10.1016/j.
CRUJEIRAS AB, Goyenechea E, Abete I, Lage M, Carreira MC, Martinez JA et al. Weight regain after a diet-induced loss is predicted by higher baseline leptin and lower ghrelin plasma levels. J Clin Endocrinol Metab, 95: 5037–5044. 2010.
FAROOQI IS, Bullmore E, Keogh J, Gillard J, O’Rahilly S, Fletcher PC. Leptin regulates striatal regions and human eating behavior. Science, 317:1355. 2007.
FLANAGANEW,SpannR,Berry SE, Berthoud HR, Broyles S, Foster GD, Krakoff J, Loos RJF, Lowe MR, Ostendorf DM, Powell-Wiley TM, Redman LM, Rosenbaum M, Schauer PR, Seeley RJ, Swinburn BA, Hall K, Ravussin E. New insights in the mechanisms of weight-loss maintenance: Summary from a Pennington symposium. Obesity (Silver Spring). 2023 Dec;31(12):2895-2908. doi: 10.1002/oby.23905. Epub 2023 Oct 16.
FOTHERGILL, E., Guo, J., Howard, L., Kerns, J.C., Knuth, N.D., Brychta, R., Chen, K.Y., Skarulis, M.C., Walter, M., Walter, P.J. and Hall, K.D. (2016), Persistent metabolic adaptation 6 years after “The Biggest Loser” competition. Obesity, 24: 1612-1619. https://doi.org/10.1002/oby.21538
GREENWAY,F. L. Physiological adaptations to weight loss and factors favouring weight regain. International journal of obesity, v. 39, n. 8, p. 1188-1196, 2015.
HAASECL,Lopes S, Olsen AH, Satylganova A, Schnecke V, McEwan P. Weight loss and risk reduction of obesity-related outcomes in 0.5 million people: evidence from a primary care database. Int J Obes (Lond). 2021 Jun;45(6):1249-1258. doi: 10.1038/s41366-021-00788-4. Epub 2021 Mar 3. PMID: 33658682; PMCID: PMC8159734.
HALLKD,Kahan S. Maintenance of Lost Weight and Long-Term Management of Obesity. Med Clin North Am. 2018 Jan;102(1):183-197. doi: 10.1016/j.mcna.2017.08.012. PMID: 29156185; PMCID: PMC5764193.
HARDMANC,JonesA,Burton S, Duckworth J, McGale L, Mead B, et al. Food-related attentional bias and its associations with appetitive motivation and body weight: A systematic review and meta-analysis. Appetite 2020. In Press.
HERMANNP,GálV,Kóbor I, Kirwan CB, Kovács P, Kitka T, et al. Efficacy of weight loss intervention can be predicted based on early alterations of fMRI food cue reactivity in the striatum. Neuroimage Clin. 2019;23:101803. 20.
HEO, Moonseong, et al. "Obesity and functional impairment: influence of comorbidity, joint pain, and mental health." Obesity 18.10 (2010): 2030-2038.
KENNYPJ2011Reward mechanisms in obesity: new insights and future directions. Neuron 69:664–679 KLEMML,WingRR,LangW,McGuire MT, Hill JO. Does weight loss maintenance become easier over time? Obes Res, 8(6):438-44. 2000.
LE DS, Pannacciulli N, Chen K, Del Parigi A, Salbe A, Reiman E, Krakoff J. Less activation of the left dorsolateral prefrontal cortex in response to a meal: a feature of obesity. The American journal of clinical nutrition, 84:725–31. 2008.
LEIBEL RL, Rosenbaum M, Hirsch J. Changes in energy expenditure resulting from altered body weight. N Engl Med 1995; 332: 621–628.
MACLEANPS,Higgins JA, Giles ED, Sherk VD, Jackman MR. The role for adipose tissue in weight regain after weight loss. Obes Rev. 2015;16 Suppl 1(Suppl 1):45-54. doi: 10.1111/obr.12255.
MACLEANPS,Bergouignan A, Cornier MA, Jackman MR. Biology's response to dieting: the impetus for weight regain. Am J Physiol Regul Integr Comp Physiol 2011; 301: R581–R600.
MARTINSC, Gower BA, Hunter GR. Metabolic adaptation delays time to reach weight loss goals. Obesity (Silver Spring). 2022 Feb;30(2):400-406. doi: 10.1002/oby.23333. PMID: 35088553; PMCID: PMC8852805.
MOGENSONGJ,YangCR.Thecontribution of basal forebrain to limbic—motor integration and the mediation of motivation to action. In: Napier TC, Kalivas PW, Hanin I, eds. The Basal Forebrain. Boston, MA: Springer; 267-290. 54. 1991.
MORALESI, Berridge KC. ‘Liking’and ‘wanting’in eating and food reward: Brain mechanisms and clinical implications. PhysiolBehav. 2020;227:113152. POLIDORI D, Sanghvi A, Seeley RJ, Hall KD. How strongly does appetite counter weight loss? Quantification of the feedback control of human energy intake. Obesity (Silver Spring), 24(11):2289-2295. 2016.
REICHELT AC, Westbrook RF, Morris MJ. Integration of reward signalling and appetite regulating peptide systems in the control of food-cue responses. Br J Pharmacol. 2015 Nov;172(22):5225-38. doi: 10.1111/bph.13321. Epub 2015 Nov 1. PMID: 26403657; PMCID: PMC5341214
ROBERTSCA, Christiansen P, Halford JCG. Tailoring pharmacotherapy to specific eating behaviours in obesity: Can recommendations for personalised therapy be made from the current data? Acta Diabetol, 54:715-25. 34. 2017
ROSENBAUMM,Leibel RL. 20 years of leptin: role of leptin in energy homeostasis in humans. J Endocrinol 2014; 223: T83–T96
ROSENBAUM,M.,Murphy, E. M., Heymsfield, S. B., Matthews, D. E., Leibel, RL. (2002) Low dose leptin administration reverses effects of sustained weight-reduction ROSENBAUMM,Hirsch J, Gallagher DA, Leibel RL. Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight. Am J Clin Nutr. 2008;88(4):906-12.on energy expenditure and circulating concentrations of thyroid hormones. J Clin Endocrinol Metab. 87: 2391–2394.
SARWANG,RehmanA.Management of Weight Loss Plateau. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576400/
SCHWARTZ, M.W., Woods, S. C., Porte, D., Jr, Seeley, R. J., Baskin, D. G. (2000) Central nervous system control of food intake. Nature. 404: 661–671. SHAI I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, et al. Dietary Intervention Randomized Controlled Trial (DIRECT) Group. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med, 359(3):229-41. 2008
STEWARTTM,Bhapkar M, Das S, Galan K, Martin CK, McAdams L, Pieper C, Redman L, Roberts S, Stein RI, Rochon J, Williamson DA; CALERIE Study Group. Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy Phase 2 (CALERIE Phase 2) screening and recruitment: methods and results. Contemp Clin Trials. 2013 Jan;34(1):10-20. doi: 10.1016/j.cct.2012.08.011. Epub 2012 Sep 5. PMID: 22981898; PMCID: PMC3525758.
SUMITHRANP,Proietto J. The defence of body weight: a physiological basis for weight regain after weight loss. Clin Sci (Lond). 2013 Feb;124(4):231-41. doi: 10.1042/CS20120223. PMID: 23126426.
SUMITHRAN, P. et al. Long-term persistence of hormonal adaptations to weight loss. New England Journal of Medicine, v. 365, n. 17, p. 1597-1604, 2011.
SUZUKI K, Jayasena CN, Bloom SR. The gut hormones in appetite regulation. J Obes. 2011;2011:528401. doi: 10.1155/2011/528401. Epub 2011 Sep 22. PMID: 21949903; PMCID: PMC3178198.
TAYLORVH, Forhan M, Vigod SN, McIntyre RS, Morrison KM . The impact of obesity on quality of life. Best Pract Res Clin Endocrinol Metab 2013; 27: 139–146.
THOMASJ,BondD,Phelan S, Hill J, Wing R. Weight-loss maintenance for 10 years in the National Weight Control Registry. Am J Prev Med 2014; 46: 17-23. TREMBLAYA,Chaput JP. Adaptive reduction in thermogenesis and resistance to lose fat in obese men. Br J Nutr. 2009;102(4):488-92.
VANBAAK, M.A., Mariman, E.C.M. Obesity-induced and weight-loss-induced physiological factors affecting weight regain. Nat Rev Endocrinol 19, 655–670 (2023). https://doi.org/10.1038/s41574-023-00887-4
VIKTORIA L. Gloy, Thomas A. Lutz, Wolfgang Langhans, Nori Geary, Jacquelien J. Hillebrand, Basal Plasma Levels of Insulin, Leptin, Ghrelin, and Amylin Do Not Signal Adiposity in Rats Recovering from Forced Overweight, Endocrinology, Volume 151, Issue 9, 1 September 2010, Pages 4280–4288, https://doi.org/10.1210/en.2010-0439
YEUNGAY, Tadi P. Physiology, Obesity Neurohormonal Appetite And Satiety Control. [Updated 2023 Jan 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555906.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2026 Aquila

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.







