The proposed goal of periodic refeeding is to temporarily increase circulating leptin and stimulate the metabolic rate. There is evidence indicating that leptin is acutely responsive to short-term overfeeding [72], is highly correlated with carbohydrate intake [71, 73], and that pharmacological administration of leptin reverses many unfavorable adaptations to energy restriction [33]. While interventions have shown acute increases in leptin from short-term carbohydrate overfeeding, the reported effect on metabolic rate has been modest [71]. Dirlewanger et al. reported a 7% increase in TDEE; this increase amounts to approximately 138 kilocalories

SBI-0206965 of additional energy expenditure, of which 36 kilocalories can be attributed to the thermic effect of carbohydrate intake [71]. More research is needed to determine if acute

bouts of refeeding are an efficacious strategy for improving weight loss success during prolonged hypocaloric states. A theoretical model of metabolic adaptation and potential strategies to attenuate adaptations is presented Ferrostatin-1 cost in Figure 2. Figure 2 A theoretical model of metabolic adaptation and potential strategies to attenuate adaptations. A/A/T hormones = Anabolic, Anorexigenic, and Thermogenic hormones; O/C hormones = Orexigenic and Catabolic hormones. Dotted lines represent inhibition. In the period shortly after cessation of a restrictive diet, body mass often reverts toward pre-diet PF-01367338 concentration values [29, 74, 75]. This body mass is preferentially gained as fat mass, in a phenomenon known as post-starvation obesity

[29]. While many of the metabolic adaptations to weight loss persist, a dramatic increase in energy intake results in rapid accumulation of fat mass. It is common for individuals to “overshoot” their baseline level of body fat, and leaner individuals (including many athletes) may be more susceptible to overshooting than obese individuals [74, 75]. In such a situation, the individual may increase body fat over beyond baseline levels, yet retain a metabolic rate that has yet to fully recover. There is evidence to suggest that adipocyte hyperplasia may occur early in the weight-regain process [76], and that repeated cycles of weight loss and regain by athletes in sports with weight classes are associated with long-term weight gain [77]. Therefore, athletes who aggressively diet for a competitive season and rapidly regain weight may find it more challenging to achieve optimal body composition in subsequent seasons. To avoid rapid fat gain following the cessation of a diet, “reverse dieting” has also become popular among physique athletes. Such a process involves slowly increasing caloric intake in a stepwise fashion.