All obesity interventions eventually lead to a plateau in weight, where further loss ceases despite ongoing efforts. But the duration of continuous weight loss before hitting a plateau is longer with both glucagon-like peptide 1 receptor agonist drugs and gastric bypass surgery than with dietary restriction, primarily because they alter how weight loss affects appetite, not energy expenditure.
"The plateau is not primarily due to reduction in calorie expenditure, which I think many physicians still believe. It's mostly about how quickly your appetite is going up as weight is lost as you persist in this constant intervention," Hall said. However, Yeo noted that the study is not empirical."What he's done is taken open access data that has been published in the clinical trials and fit it into his model to ask the question about the rate at which we finally get to a plateau, and to work out the role of appetite vs the role of energy expenditure.
And RYGB surgery resulted in a 3600 kcal/d cut, weight loss through 24 months, and approximately a 58 kcal/d increase in energy intake per kilogram of weight loss after that.