{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:15:02Z","timestamp":1791238502516,"version":"4.1.0"},"reference-count":91,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Obesity is a multifactorial chronic disease characterized by pathological adipose tissue expansion and systemic metabolic dysfunction. This review examines metabolic adaptation\u2014the counter-regulatory physiological response to weight loss\u2014and its contribution to weight recidivism. Although weight reduction confers substantial clinical benefit, long-term maintenance is frequently compromised by reductions in total daily energy expenditure (TDEE) that exceed predictions based on body composition. Bariatric surgery induces profound metabolic remodeling; however, its durability may be constrained by persistent biological defense mechanisms of body weight. Similarly, GLP-1 receptor agonists have transformed pharmacological management, yet in the absence of structured nutritional intervention, lean mass loss and energetic compensation may attenuate long-term stability. We propose an integrated model in which precision nutrition, surgery, and pharmacotherapy operate synergistically. Within this framework, nutrition should assume a central regulatory role in modulating body composition, substrate partitioning, and long-term energetic homeostasis to enhance the sustainability of clinical outcomes.<\/jats:p>","DOI":"10.3390\/nu18111725","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T09:57:43Z","timestamp":1779962263000},"page":"1725","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Metabolic Adaptation and Weight Regain in Obesity Treatment: The Central Role of Nutrition in the Era of Bariatric Surgery and GLP-1-Based Pharmacotherapy"],"prefix":"10.3390","volume":"18","author":[{"given":"Larissa Vicente","family":"Pereira","sequence":"first","affiliation":[{"name":"Centro de Nutri\u00e7\u00e3o Cl\u00ednica da Para\u00edba, Jo\u00e3o Pessoa 58032-090, PB, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rio de Almeida Pereira","family":"Coutinho","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Lauro Wanderley, Federal University of Para\u00edba (UFPB), Jo\u00e3o Pessoa 58059-900, PB, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Hortiz","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Lauro Wanderley, Federal University of Para\u00edba (UFPB), Jo\u00e3o Pessoa 58059-900, PB, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline Lira","family":"Xavier","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Lauro Wanderley, Federal University of Para\u00edba (UFPB), Jo\u00e3o Pessoa 58059-900, PB, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel Patricia Ataide","family":"Lima","sequence":"additional","affiliation":[{"name":"Centro de Nutri\u00e7\u00e3o Cl\u00ednica da Para\u00edba, Jo\u00e3o Pessoa 58032-090, PB, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1111\/obr.12551","article-title":"Obesity: A chronic relapsing progressive disease process. 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