Sleep Habits Predict Likelihood of Weight Regain After Diet-Induced Weight Loss

Short sleep duration and worse sleep quality were associated with weight regain in individuals with obesity.

Following diet-induced weight loss in individuals with obesity, those with objectively measured short sleep duration and poorer sleep quality experience less success during weight loss maintenance compared with those with longer sleep duration. These are the findings of a study published in the journal Sleep.

Recognizing that weight regain following weight loss remains a key obstacle in the treatment of obesity, researchers conducted a randomized, controlled, 2-by-2 factorial study (S-LiTE; Identifier: NCT04122716) to explore whether insufficient sleep is predictive of weight regain throughout the maintenance of weight loss.

A total of 185 adults with obesity completed an 8-week, low-calorie diet and were randomly assigned to 1-year weight loss maintenance with or without exercise and liraglutide 3.0 mg/day — which can be used in the treatment of patients with type 2 diabetes — or placebo.

Wrist-worn accelerometers (GENEActive) and the Pittsburgh Sleep Quality Index (PSQI) were utilized to measure sleep duration and sleep quality before and after the low-calorie diet, as well as during the weight maintenance phase. In order to examine the link between insufficient sleep and weight regain, all participants were stratified at randomization into subgroups based on their sleep duration (ie, <6 hours per night or ≥6 hours per night) or sleep quality (PSQI score of ≤5 or PSQI score of >5).

[C]haracterization of sleep habits may be important for people initiating a weight loss program with lifestyle interventions and/or pharmaceutical treatment.

The researchers found that after following a diet-induced 13.1-kg weight loss, those individuals with short sleep duration at randomization regained 5.3 kg of their body weight and experienced less reduction in their percentage of body fat, compared with participants with normal sleep duration (P =.0008 and P =.007, respectively), during the 1-year weight maintenance phase.

Further, individuals with poor sleep quality prior to their weight loss regained
3.5 kg of their body weight, compared with those with good quality sleep (P =.010). Additionally, during the weight maintenance period, participants who received liraglutide therapy demonstrated increased sleep duration, compared with placebo, after 26 weeks (5 minutes per night vs –15 minutes per night, respectively); however, this effect did not persist after 1 year.

Individuals who underwent exercise therapy were shown to preserve the sleep quality improvements that they had achieved from their initial weight loss.

Several limitations of the current study warrant mention. In the study, sleep was a predefined exploratory endpoint in the analysis, but obstructive sleep apnea — which is known to be an important confounder in sleep research — was not part of the inclusion or exclusion study criteria. Further, the researchers could not prove causal inferences that the observed differences in weight change between short and normal sleepers were attributable directly to sleep duration.

“These findings indicate that insufficient sleep predicts weight regain during interventional efforts to maintain weight loss. Exercise maintained low-calorie diet-induced improvements in sleep quality during one year of weight loss maintenance, and liraglutide transiently increased sleep duration,” the researchers noted.

“[C]haracterization of sleep habits may be important for people initiating a weight loss program with lifestyle interventions and/or pharmaceutical treatment.”

Disclosure: Some of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Neurology Advisor


Bogh AF, Jensen SBK, Juhl CR, et al. Insufficient sleep predicts poor weight loss maintenance after one year. Sleep. Published online December 6, 2022. doi:10.1093/sleep/zsac295