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Over time, the body adapts by: Reducing basal metabolic rate (BMR) the body becomes more efficient, burning fewer calories at rest Decreasing levels of leptin a hormone that regulates hunger and energy balance Increasing ghrelin the hunger hormone, which can intensify appetite These adaptations are part of the body's natural defence against prolonged energy restriction and can make sustained weight loss progressively more challenging

doi:10.1017/S1368980019001782