A higher-protein, low-glycemic-index diet for weight maintenance did not attenuate changes in ghrelin or peptide YY compared to a conventional diet over 3 years following weight loss.
No difference between dietsHigher-protein, low-GI diet did not attenuate ghrelin or PYY changes over 3 years of weight maintenance
What the researchers found
Higher-protein, low-GI diet for weight maintenance did not attenuate post-weight-loss changes in ghrelin or PYY compared to moderate-protein diet, and appetite hormone changes did not predict weight regain over 3 years.
Why it matters
The idea that higher-protein diets could counter hormonal drivers of weight regain is popular but largely unproven. This well-designed long-term study provides important evidence that diet composition may not be sufficient to override the body's weight-regain physiology.
The numbers in context
136 participants; 34-month follow-up; ~50% weight regain; ghrelin and PYY returned to baseline by 6-24 months
How the study worked
Sub-study of the PREVIEW RCT. 136 adults with pre-diabetes underwent 2-month weight loss (≥8% body weight), then randomized to two dietary patterns for 34 months. Fasting ghrelin, PYY, and appetite sensations measured at 0, 2, 6, 12, 24, and 36 months.
Who was studied
Adults with pre-diabetes and BMI 25+ who lost 8%+ body weight
What this study cannot tell us
Sub-study of a larger trial with limited statistical power. Measured only total ghrelin and total PYY (not active forms). Self-reported dietary adherence. High attrition common in long-term diet studies.
How to read the evidence
Sub-study of a well-designed RCT with long-term follow-up (3 years). Moderate-quality evidence limited by sub-study design and attrition.
When this study was published
Published in 2021, from the PREVIEW trial (NCT01777893) — one of the largest diet and diabetes prevention studies.
The bigger picture
Weight regain after dieting remains one of the biggest challenges in obesity management. This study suggests that hormonal appetite regulation may be more resilient than previously thought — returning toward normal within months — and that weight regain likely involves other factors beyond ghrelin and PYY changes.
Questions still open
- If appetite hormones normalize after weight loss, what other mechanisms drive weight regain?
- Would measuring active (acylated) ghrelin reveal different patterns between diet groups?
- Could other satiety hormones like GLP-1 respond differently to diet composition?
Common questions
Does eating more protein prevent hunger hormones from increasing after weight loss?
Do appetite hormones stay elevated forever after dieting?
Read the original research
Can a Higher Protein/Low Glycemic Index vs. a Conventional Diet Attenuate Changes in Appetite and Gut Hormones Following Weight Loss? A 3-Year PREVIEW Sub-study.
Frontiers in nutrition, 8, 640538
Citation
Buso, Marion E C; Seimon, Radhika V; McClintock, Sally; Muirhead, Roslyn; Atkinson, Fiona S; Brodie, Shannon; Dodds, Jarron; Zibellini, Jessica; Das, Arpita; Wild-Taylor, Anthony L; Burk, Jessica; Fogelholm, Mikael; Raben, Anne; Brand-Miller, Jennie C; Sainsbury, Amanda. (2021). Can a Higher Protein/Low Glycemic Index vs. a Conventional Diet Attenuate Changes in Appetite and Gut Hormones Following Weight Loss? A 3-Year PREVIEW Sub-study.. Frontiers in nutrition, 8, 640538. https://doi.org/10.3389/fnut.2021.640538