Low-calorie diet induced weight loss may alter regulatory hormones and contribute to rebound visceral adiposity in obese persons with a family history of type-2 diabetes

J Am Assoc Nurse Pract. 2013 Aug;25(8):440-448. doi: 10.1111/j.1745-7599.2012.00808.x. Epub 2012 Nov 20.


Purpose: To examine potential detrimental long-term effects of acute diet-induced weight loss on visceral adiposity, insulin resistance, cortisol, and adipokines in obese individuals at risk for type-2 diabetes.

Data sources: Anthropometric measures (height, weight, waist circumference), self-report instruments, abdominal computed tomography (CT) scan, and blood samples (glucose, insulin, interleukin-6, leptin, adiponectin) were obtained from a convenience sample of 20 participants at baseline, after a 28-day low-calorie diet (800 kcal/day) intervention, and again 6 months later.

Conclusions: Fifteen of 20 participants completed the 28-day diet intervention and had a mean weight loss of 15 pounds. Comparison between baseline, postdiet, and 6-month data, demonstrated that although participants had significant improvements after the diet, they regained fat mass, particularly in the visceral area.

Implications for practice: Clinicians may need to revise recommendations for using low-calorie diets to achieve weight loss. Diet-induced weight cycling may contribute to dysregulation of metabolism and have long-term detrimental consequences for accumulation of visceral adipose tissue. The likelihood of success is low, with high dropout rates, and those patients who achieve weight loss are very likely to regain it. Thus, the perceived short-term benefits of calorie-restricted diets in this population likely do not outweigh the potential long-term detrimental effects.

Keywords: Diet; diabetes type 2; insulin resistance; obesity; weight regulation.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipokines / blood
  • Adult
  • Caloric Restriction / adverse effects*
  • Diabetes Mellitus, Type 2 / etiology*
  • Diabetes Mellitus, Type 2 / metabolism
  • Diet, Reducing / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocortisone / blood
  • Insulin Resistance / physiology
  • Male
  • Middle Aged
  • Obesity, Abdominal / etiology*
  • Obesity, Abdominal / metabolism
  • Obesity, Abdominal / therapy*
  • Time Factors
  • Treatment Outcome
  • Weight Loss*
  • Young Adult


  • Adipokines
  • Hydrocortisone