Effects of gradual weight loss v. rapid weight loss on body composition and RMR: a systematic review and meta-analysis

Br J Nutr. 2020 Dec 14;124(11):1121-1132. doi: 10.1017/S000711452000224X. Epub 2020 Jun 24.


This systematic review and meta-analysis compared the effects of different rates of weight loss (WL), but equivalent total WL, on body composition and RMR. Studies examining gradual v. rapid WL on body composition and RMR in participants with overweight/obesity published up to October 2019 were identified through PubMed, the Cochrane Library, Web of Science, Embase, Scopus and Ovid databases. Meta-analysis was carried out using a fixed or random effects model as appropriate. Although the magnitude of WL was similar (mean difference 0·03 kg, 95 % CI –0·65, 0·71), gradual WL promoted greater reductions in fat mass (FM) (–1 kg, 95 % CI –1·70, –0·29) and body fat percentage (BFP) (–0·83 %, 95 % CI –1·49, –0·17). Gradual WL significantly preserved RMR compared with rapid WL (407·48 kJ, 95 % CI 76·76, 118·01). However, there was no significant difference in waist and hip circumferences, waist:hip ratio and fat-free mass (FFM) between gradual and rapid WL. The present systematic review and meta-analysis indicates beneficial effects of gradual WL, as compared with rapid WL, on FM, BFP and RMR in individuals with overweight/obesity. However, FFM changes and anthropometric indices did not significantly differ following different rates of WL.

Keywords: Body composition; Diet; Fat mass; Fat-free mass; Obesity; RMR; Weight loss.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anthropometry
  • Basal Metabolism / physiology*
  • Body Composition / physiology*
  • Body Mass Index
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / physiopathology*
  • Obesity / therapy
  • Randomized Controlled Trials as Topic
  • Time Factors*
  • Treatment Outcome
  • Weight Loss / physiology*
  • Young Adult