Research Study Abstract

Predictors of successful weight loss with relative maintenance of fat-free mass in individuals with overweight and obesity on an 8-week low-energy diet

  • Published on June 27, 2019

A low-energy diet (LED) is an effective approach to induce a rapid weight loss in individuals with overweight. However, reported disproportionally large losses of fat-free mass (FFM) after an LED trigger the question of adequate protein content. Additionally, not all individuals have the same degree of weight loss success. After an 8-week LED providing 5020 kJ/d for men and 4184 kJ/d for women (84/70 g protein/d) among overweight and obese adults, we aimed to investigate the relationship between protein intake relative to initial FFM and proportion of weight lost as FFM as well as the individual characteristics associated with weight loss success. We assessed all outcomes baseline and after the LED. A total of 286 participants (sixty-four men and 222 women) initiated the LED of which 82 % completed and 70 % achieved a substantial weight loss (defined as ≥8 %). Protein intake in the range 1·0–1·6 g protein/d per kg FFM at baseline for men and 1·1–2·2 g protein/d per kg FFM at baseline for women was not associated with loss of FFM (P = 0·632). Higher Three-Factor Eating Questionnaire (TFEQ) hunger at baseline and reductions in TFEQ disinhibition and hunger during the LED were associated with larger weight loss (all P ≤ 0·020); whereas lower sleep quality at baseline predicted less successful weight loss using intention to treat analysis (P = 0·021), possibly driven by those dropping out (n 81, P = 0·067 v. completers: n 198, P = 0·659). Thus, the protein intakes relative to initial FFM were sufficient for maintenance of FFM and specific eating behaviour characteristics were associated with weight loss success.


  • Thea Toft Hansen 1
  • Mads Fiil Hjorth 1
  • Karoline Sandby 1
  • Sarah Vold Andersen 1
  • Arne Astrup 1
  • Christian Ritz 1
  • Mònica Bulló 2,3
  • Maria Lucia Camacho-Barcía 2,3
  • Jesús Francisco García-Gavilán 2,3
  • Jordi Salas-Salvadó 2,3
  • Joanne A. Harrold 4
  • Jason C.G. Halford 4
  • Anders Sjödin 1


  • 1

    Department of Nutrition, Exercise and Sports, Section for Obesity Research, Faculty of Science, University of Copenhagen, 1958 Copenhagen, Denmark

  • 2

    Human Nutrition Unit, Faculty of Medicine and Health Sciences, Institut d’Investigació Sanitària Pere Virgili, Rovira i Virgili University, 43201 Reus, Spain

  • 3

    CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain

  • 4

    Department of Psychological Sciences, University of Liverpool, Liverpool L69 7ZA, UK


British Journal of Nutrition