Using Metabolic Testing to Personalize Behavioral Obesity Treatment.

IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Obesity Science & Practice Pub Date : 2025-03-11 eCollection Date: 2025-04-01 DOI:10.1002/osp4.70065

Leonard H Epstein, John W Apolzan, Molly Moore, Nicholas V Neuwald, Myles S Faith

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Abstract

Background: There are large individual differences in weight loss and maintenance. Metabolic testing can provide phenotypical information that can be used to personalize treatment so that people remain in negative energy balance during weight loss and remain in energy balance during maintenance. Behavioral testing can assess the reinforcing value and change in the temporal window related to the personalized diet and exercise program to motivate people to maintain engagement in healthier eating and activity programs.

Objective: Provide an expository overview of how metabolic testing can be used to personalize weight control. Ideas about incorporating behavioral economic concepts are also included.

Methods: A broad overview of how resting metabolic rate, thermic effect of food and respiratory quotient can be used to improve weight control. Also discussed are behavioral economic principles that can maximize adherence to diet and activity protocols.

Results: Research suggests that measuring metabolic rate can be used to set calorie goals for weight loss and maintenance, thermic effect of food to increase energy expenditure, and respiratory quotient to guide macronutrient composition of the diet and maximize fat loss. Developing programs that foster a strong motivation to eat healthier and be active can maximize treatment success.

Conclusion: Incorporating metabolic measures can personalize behavioral weight loss programs, and the use of behavioral economic principles can increase the probability of adherence and long-term success in weight control.

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