Weight Loss Guide · Metabolism

Boosting your metabolism: what counts and what just makes promises

Energy expenditure depends above all on fat-free mass and everyday movement. Between the ages of 20 and 60, relative to body composition, it remains remarkably stable on average. Capsules, tea and cold water move it only a little, if at all.

SJ
Shukri Jarmoukli · Physician, Integrative Medicine · ViveCura Berlin
Basal metabolic rate, muscle, everyday movement Thyroid, iron, medication Fact check: fat burners and tea 63 verified sources, 59 of them with DOI
My starting point

Anyone who diagnoses themselves with a slow metabolism has usually tried a lot already. What you need then is not a new trick, but an honest look at the items that make up your energy expenditure.

You eat less than you used to. You have joined a gym. You drink warm lemon water in the morning, because you read somewhere that it gets your metabolism going.

And the scales barely move. At some point comes the sentence that feels like an explanation and a verdict at the same time: my metabolism is just slow.

Many people know this pattern. And I understand why that sentence feels so natural. It takes the pressure off. At the same time, it opens the door to promises: capsules, teas, cold tricks, metabolism regimens.

Here we look at something more sober. What does your energy expenditure consist of? What changes it measurably? When is there an underlying cause? And what is there to the home remedies?

A note on language first. This is not about calorie targets, kilograms or training plans. All figures in this text are study data with their reference values. They describe what was measured and are not targets for you.

Before you read on

Red flags that should not wait for an article

Seek medical assessment immediately, and in case of chest pain, impaired consciousness or severe shortness of breath call the emergency number 112:

  • Racing heart, chest pain, trembling, heavy sweating or overheating after fat burners, metabolism capsules or weight loss products bought online.
  • Yellowing of the skin or eyes, dark urine or pain in the right upper abdomen, especially after green tea extracts or other dietary supplements. In that case, stop taking the product and have it assessed by a doctor.
  • Thoughts of harming yourself, or the feeling of being in an acute emotional crisis: in Germany, the Telefonseelsorge crisis line is available around the clock and free of charge at 0800 111 0 111 and 0800 111 0 222 (these are German numbers). In acute danger: 112, the nearest psychiatric hospital or an emergency department. Outside Germany, please use your local emergency number.

Seek medical assessment soon:

  • Unintended, unexplained weight gain or weight loss.
  • Tiredness, sensitivity to cold, constipation, dry skin, swelling or a slowed pulse that persist for weeks. This can point to an underactive thyroid.
  • Missed periods, frequent injuries or constantly feeling cold with a lot of training and little food.
  • If thoughts about food, calories and weight dominate your everyday life, if you have binge eating episodes, vomit or take laxatives to lose weight. More on this in Understanding eating disorders.

And one sentence that stands above everything else: Prescribed medications, especially thyroid hormones, are not stopped, reduced or changed in dose on your own. If you suspect that a medication is affecting your weight or your energy, talk to the prescribing doctor.

The essentials in five points

  1. Fat-free mass explains most of the differences in basal metabolic rate. But one kilogram of skeletal muscle uses considerably less energy at rest than guidebooks often claim. Measurement studies
  2. Daily energy expenditure relative to body composition remains stable on average between 20 and 60. With age, it is muscle mass and movement that tend to shift. large database
  3. After diets, the body saves energy. How much and for how long is disputed: extreme cases show a lot, less extreme diets considerably less. small studies, contradictory
  4. A metabolism that feels persistently slow can be a symptom: thyroid, iron deficiency anaemia, energy deficiency, lack of sleep, medication. This belongs in a medical assessment. Guidelines
  5. Green tea, chilli, coffee and cold water show small effects at most. Fat burner products have weak evidence and real risks. Cochrane, meta-analyses
RCT / Meta / Guideline randomised, pooled or guideline consensus Human cohort, cross-sectional, small laboratory study in humans Animal finding in animals, mentioned here only when marked Lab, cell finding without a living organism, not used as evidence here

What metabolism means for weight loss: the four items of your energy expenditure

When someone says their metabolism is slow, they almost never mean the biochemistry inside the cell. They mean energy expenditure over the day. And that is not a single number, but a sum.

Imagine your expenditure as the costs of running a household. There is the basic rent, which is always due. There are delivery charges when food comes into the house. There are the many small trips around the home. And there is the weekend outing.

Item 1
Basal metabolic rate

The basic rent. Energy for the heart, brain, liver, kidneys, breathing and body heat at rest. For most adults, the largest single item.

Item 2
Diet-induced thermogenesis

The delivery charges. Digesting, absorbing and processing food costs energy itself, more for protein than for fat.

Item 3
Everyday movement, NEAT

The trips around the home. Standing, walking, carrying, stairs, fidgeting. In technical terms, non-exercise activity thermogenesis, NEAT for short.

Item 4
Training

The outing. Planned exercise. Valuable for a great many things, but often smaller in terms of daily expenditure than the display on the treadmill suggests.

How large the individual items are varies considerably from person to person. That is why I do not give percentages here that would apply to you. What can be well documented, however, is which factors make basal metabolic rate differ between people.

Cross-sectional, n=150 What explains basal metabolic rate between people

A team led by Johnstone and Speakman repeatedly measured basal metabolic rate in 150 adults in north-east Scotland and statistically broke the differences down into their components.

Of the differences between individuals, fat-free mass explained 63 percent, fat mass 6 percent and age 2 percent. 26 percent remained unexplained. After accounting for these factors, sex was not significant.

What this means for you: how much fat-free mass you have shapes your basal metabolic rate most strongly. And there is a real remainder that these factors do not explain. People are different, and that is not a character flaw.

Johnstone AM, Murison SD, Duncan JS et al. Am J Clin Nutr. 2005;82(5):941-948. PMID: 16280423 · DOI: 10.1093/ajcn/82.5.941 [Cross-sectional, n=150]

The large analysis by Pontzer, which we will come to in the chapter on age, also found deviations of more than plus or minus 20 percent even after adjusting for fat-free mass, fat mass, sex and age, according to the full text. Two people of the same build can therefore use noticeably different amounts of energy.

Just two sentences on the second item, because it is covered in detail elsewhere. Diet-induced thermogenesis is real and higher with a protein-rich diet, but it remains a comparatively small item. How differently the body handles different nutrients is explained in A calorie is not just a calorie.

The quiet item: everyday movement

The flexible part of your expenditure is often not training, but what happens between appointments. In a classic overfeeding study by Levine, a large part of the additional expenditure came from exactly this inconspicuous movement. What that looked like in detail is described in Calorie deficit: why it is not enough.

Here, a follow-up question matters. Is everyday movement just a matter of willpower?

Observation with sensors, n=20 Two more hours sitting

Levine and colleagues fitted 10 lean and 10 mildly obese people, all of whom had a sedentary lifestyle, with sensors for ten days that recorded posture and movement every half second.

The people with obesity sat for an average of 2 hours longer per day. The pattern did not change when they lost weight or when the lean participants gained weight. The authors therefore interpreted the distribution of posture as partly biologically determined.

What this means for you: how much you move in passing is not just a matter of discipline. It appears to be partly built into you. That is precisely why it can be worthwhile to deliberately build movement into your everyday life instead of hoping for a metabolism trick.

Levine JA, Lanningham-Foster LM, McCrady SK et al. Science. 2005;307(5709):584-586. PMID: 15681386 · DOI: 10.1126/science.1106561 [Observational study, n=20]

Now comes the point where many people are disappointed. More movement does not raise daily expenditure one to one. The body compensates.

Pooled database, n=1,754 The body saves elsewhere

Careau and colleagues analysed the largest dataset to date on total expenditure and basal metabolic rate in adults in everyday life, measured with doubly labelled water.

Energy compensation averaged 28 percent, and it came via a lower basal metabolic rate. Of the energy that additional activity costs, on average only 72 percent was therefore reflected in daily expenditure. Compensation differed according to body composition and was associated with obesity, although the direction of cause and effect remained open.

What this means for you: movement counts, but it is not a linear calorie calculator. If training does less for your weight than expected, that need not be due to lack of effort. Part of it is this counter-regulation.

Careau V, Halsey LG, Pontzer H et al.; IAEA DLW database group. Curr Biol. 2021;31(20):4659-4666.e2. PMID: 34453886 · DOI: 10.1016/j.cub.2021.08.016 [Cross-sectional, pooled database, n=1,754]
Cross-sectional, 5 populations, n=332 The plateau with a lot of movement

Pontzer and colleagues compared total expenditure with measured physical activity in 332 adults from five populations.

After adjusting for body size and composition, expenditure rose with activity, but considerably more steeply in the lower activity range. In the upper range, total expenditure reached a plateau.

What this means for you: the step from little to somewhat more movement appears to count most for expenditure. According to these data, people who are already very active do not burn linearly more with even more training.

Pontzer H, Durazo-Arvizu R, Dugas LR et al. Curr Biol. 2016;26(3):410-417. PMID: 26832439 · DOI: 10.1016/j.cub.2015.12.046 [Cross-sectional, n=332]

The German S3 guideline on obesity puts it this way for people with overweight and obesity in its therapy chapter: they shall be motivated to increase their physical activity in everyday life and leisure time. This is an expert consensus. This article deliberately says nothing about minutes or step counts, because the right amount depends on your starting point.

That also answers a common search question: can basal metabolic rate be raised without exercise? Honestly, hardly. Daily expenditure, on the other hand, can, through the trips around the home. Why sitting for long periods is about more than calories is explained in Sitting and lack of movement. How fat metabolism changes with gentle endurance training is covered in Understanding Zone 2 training, and what movement sets in motion at the cellular level in Movement as medicine.

Reframe

Perhaps your metabolism is not slow at all. Perhaps the items have shifted: a little less fat-free mass, considerably more sitting, a body that saves elsewhere after training.

That sounds less dramatic than a broken engine. But it is the better news, because items can be changed.

And now you know why the question is not how to fire up your metabolism, but which item has changed for you.

Muscle as an engine? What muscle mass, strength training, protein and sleep measurably change

Perhaps you have read this sentence many times: muscles burn calories even while you sleep, one extra kilo of muscle means 100 extra kilocalories a day. That sounds like a simple calculation. Build muscle, and your metabolism takes care of itself.

The calculation has a catch. And yet muscle is one of the most important items in this whole topic. Both belong together.

Study data, resting expenditure per kilogram of tissue

Who uses how much at rest

Heart, kidneys440
Brain240
Liver200
Skeletal muscle13
Adipose tissue4.5

Values in kcal per kg of tissue per day according to Elia, tested by Wang and colleagues in 2010. Measured values from a study, not targets.

Validation study, n=131 Muscle is not a blast furnace

Wang and colleagues used MRI to determine the mass of organs and tissues in 131 non-obese, healthy adults in three age groups and measured resting metabolic rate. They then tested whether Elia's tissue-specific metabolic rates predicted the measured expenditure.

The rates from the chart above, about 13 kcal per kilogram per day for skeletal muscle, 200 for the liver and 440 for the heart and kidneys, fitted well in younger and middle-aged people, while in people over 50, according to the authors, Elia's rates were 3 percent too high.

What this means for you: one kilogram of muscle uses roughly 13 kcal a day at rest, not 100. The small, highly active organs contribute many times more per kilogram.

Wang Z, Ying Z, Bosy-Westphal A et al. Am J Clin Nutr. 2010;92(6):1369-1377. PMID: 20962155 · DOI: 10.3945/ajcn.2010.29885 [Validation study, n=131]

So why does muscle still count? Because there is a lot of it. In a whole-body MRI study by Janssen and colleagues in 468 people aged 18 to 88, skeletal muscle made up an average of 38.4 percent of body mass in men and 30.6 percent in women. A small value per kilogram, multiplied by a great many kilograms, adds up to a noticeable item.

And muscle carries more than resting expenditure. It is the tissue you move with, and so it carries items three and four. After meals, it takes up a large share of blood sugar. It has a say in whether stairs, carrying and getting up remain easy in older age. Why muscle can therefore be seen as an organ in its own right is explained in Strength training after 40. How insulin resistance can make weight loss even harder is covered in Insulin resistance and weight loss.

Meta-analysis, 18 studies pooled What training changes about resting metabolic rate

MacKenzie-Shalders and colleagues pooled studies in which people completed an exercise programme and resting metabolic rate was measured. People aged 65 and over, pregnant and breastfeeding women and postmenopausal women were excluded.

Exercise overall did not significantly increase resting metabolic rate (74.6 kcal per day), nor did endurance training (81.65 kcal per day). Strength training increased it compared with controls by 96.17 kcal per day (95 percent confidence interval 45.17 to 147.16). The methods were heterogeneous and the risk of bias was high.

What this means for you: in this analysis, strength training was the form of exercise with the clearest measurable effect on resting metabolic rate. The effect is moderate, and this analysis says nothing about older people or postmenopausal women, because exactly these groups were missing.

MacKenzie-Shalders K, Kelly JT, So D et al. J Sports Sci. 2020;38(14):1635-1649. PMID: 32397898 · DOI: 10.1080/02640414.2020.1754716 [Systematic Review and Meta-analysis]

And if you are no longer young? A meta-analysis by Peterson and colleagues in people aged 50 and over found a pooled increase in lean mass of 1.1 kg with strength training, with high heterogeneity between studies. Older participants gained less, but they did gain. Starting earlier appears to bring more, but starting later can still bring something.

The German S3 guideline on obesity takes this up in two places. If sarcopenic obesity, meaning a lot of fat with little muscle, is clinically suspected, body composition should be measured with a validated method such as BIA or DXA (recommendation grade B, low evidence). And the background text states that strength training should be recommended in the context of weight reduction, taking possible sarcopenic obesity into account.

Protein when you eat less

People who lose weight generally lose more than just fat. Part of the loss is fat-free mass, and with it resting metabolic rate falls. This is where the question of protein comes in.

Meta-analysis, 24 RCTs, n=1,063 A little more is preserved

Wycherley and colleagues pooled 24 randomised trials in which adults received an energy-reduced diet with the same fat content but more or less protein. The studies lasted a little over twelve weeks on average.

On the higher-protein diet, less fat-free mass was lost (0.43 kg difference) and resting energy expenditure fell less sharply (595.5 kJ per day difference). The authors described the effects as modest.

What this means for you: during a phase of eating less, adequate protein can help preserve a little more muscle and resting metabolic rate. That is not a turbo boost but damage limitation, and that is exactly where its value lies.

Wycherley TP, Moran LJ, Clifton PM et al. Am J Clin Nutr. 2012;96(6):1281-1298. PMID: 23097268 · DOI: 10.3945/ajcn.112.044321 [Meta-analysis, 24 RCTs]

I deliberately do not give gram amounts here, because requirements depend on age, kidney function, movement and life stage. How to put your requirements into context is explained in How much protein do you need, and why protein is so closely linked to feeling full in Satiety and protein.

Sleep has a say in what a diet costs

Sleep seems like a side issue in this topic. A small but careful study suggests otherwise.

RCT, crossover, n=10 Same diet, less sleep

Nedeltcheva and colleagues had 10 overweight adults go through a moderate calorie restriction twice for 14 days each, once with 8.5 and once with 5.5 hours of sleep opportunity.

The shorter sleep reduced the proportion of weight lost as fat by 55 percent (1.4 versus 0.6 kg of fat at 8.5 versus 5.5 hours) and increased the loss of fat-free mass by 60 percent (1.5 versus 2.4 kg). In addition, there was more hunger and signs of a stronger hormonal adaptation to the restriction.

What this means for you: short sleep could influence whether a diet costs you more fat or more muscle. Ten people and two weeks is not much, but the direction is clear.

Nedeltcheva AV, Kilkus JM, Imperial J et al. Ann Intern Med. 2010;153(7):435-441. PMID: 20921542 · DOI: 10.7326/0003-4819-153-7-201010050-00006 [RCT, Crossover, n=10]

What can support good sleep in everyday life is described in Putting sleep hygiene into practice and in the Sleep Guide.

GLP-1 injections and muscle, in brief

Whether GLP-1 medications slow the metabolism through muscle loss is covered in detail in GLP-1 injections and muscle loss, and how these medications work in the first place in GLP-1 injections: how GLP-1 works. Here are just three newer findings. These medications are prescription-only, and whether they are an option for you belongs in a medical consultation.

In a substudy of the large SURMOUNT-1 trial with whole-body DXA in 160 participants (Look and colleagues, 2025), the weight lost after 72 weeks consisted of about 75 percent fat and about 25 percent lean mass in both groups, on the medication just as on placebo. The substudy was funded by the manufacturer, which was involved in its design and analysis.

A network meta-analysis by Karakasis and colleagues of 22 randomised trials likewise found about 25 percent lean mass in the weight lost for GLP-1 receptor agonists. Relative lean mass, meaning relative to baseline, remained unchanged. The agents with the strongest effect on weight and fat mass were among the weakest at preserving lean mass.

The review by Neeland and colleagues adds two important footnotes. First, the proportion varies widely between studies, from 40 to 60 percent in some to about 15 percent or less in others. Second, lean mass is not the same as muscle. It also includes organs, bone and water. MRI data suggest that muscle quality may even improve, for example through less fat within the muscle. Older age and severe illness remain risk factors for sarcopenia, a pathological loss of muscle mass and strength.

Reframe

Muscle contributes to your basal metabolic rate, but it is not a blast furnace. If you build muscle only to burn calories in your sleep, the calculation will disappoint you.

Its value lies above all in strength, mobility, blood sugar and in the fact that in every phase with less energy it has a say in what you lose. Muscle is less a burner than a safeguard.

And now you know why preserving muscle, protein and sleep belong together, regardless of whether you lose weight with or without medication.

My metabolism is broken: what diets do to energy expenditure, and for how long

Perhaps you have stopped counting your diets. Each one worked, for a while. And after each one, the weight came back, sometimes with a surcharge. At some point the thought suggests itself that the body has lost something along the way. That the metabolism has fallen asleep or is broken.

The answer from research is uncomfortable in both directions. Yes, under energy deficiency the body saves more energy than weight loss alone explains. This is called adaptive thermogenesis. No, for most diets there is no evidence that this turns into a permanent defect. Both can be shown with four studies.

Cohort, follow-up, n=14 Six years after an extreme competition

Fothergill and colleagues, working with Hall, examined 14 participants from the television show The Biggest Loser at baseline, at the end of the 30-week competition and six years later, using DXA and indirect calorimetry.

By the end of the competition, they had lost an average of 58.3 kg, and resting metabolic rate was 610 kcal per day lower. After six years, 41.0 kg had been regained, but resting metabolic rate was still 704 kcal per day below baseline, and metabolic adaptation, meaning the part beyond body composition and age, was minus 499 kcal per day. Adaptation at the end of the competition did not predict weight regain. Those who had maintained more weight loss after six years simultaneously showed more slowing.

What this means for you: after extreme weight loss, the body can work measurably more economically for years. But these were 14 people in an extreme television format, and the adaptation did not explain the weight regain.

Fothergill E, Guo J, Howard L et al. Obesity (Silver Spring). 2016;24(8):1612-1619. PMID: 27136388 · DOI: 10.1002/oby.21538 [Cohort, n=14]

During the same competition, a research group led by Johannsen and Hall had already measured that resting metabolic rate had fallen by 504 kcal per day more in week 30 than the loss of mass explained. And this despite fat-free mass being comparatively well preserved: 83 percent of the loss was fat, 17 percent fat-free mass. Preserving muscle is therefore important, but it is no shield against every adaptation.

The counterweight

What remains after less extreme diets

Martins and colleagues followed 71 people with obesity through 8 weeks of dieting, 4 weeks of stabilisation and 9 months of maintenance. Adaptation was minus 92 kcal per day in week 9 and minus 38 kcal per day in week 13, after stabilisation. In the subgroup with data at all time points (n = 45), it was no longer significant after one year, at minus 7 kcal per day. The title of the paper calls adaptation an illusion. That is overstated. The data suggest rather that it is tied to the deficit and becomes smaller once weight is stable.

Redman and colleagues analysed 53 non-obese adults in the CALERIE study, 34 of whom spent two years on calorie restriction. Their expenditure over 24 hours or during sleep was about 80 to 120 kcal per day below what the weight loss would have predicted. The activity of the thyroid axis was significantly dampened.

Read together with Fothergill, both papers show: the adaptation is real, and its size depends heavily on the extent and the phase. An extreme television format is not your diet from last spring.

Why does the body save energy at all? From its point of view, a sustained deficit is a state of scarcity. Signals from adipose tissue such as leptin fall, hunger rises, and several systems throttle expenditure at the same time. How these hormones interact is explained in Leptin and insulin, and why a calorie deficit therefore rarely runs as linearly as it does on paper in Calorie deficit: why it is not enough and The calorie myth.

An old study, read with care

There is one study that is often misused in this context, so I describe it with caution. In 1992, Lichtman and colleagues examined ten people with obesity who said they did not lose weight despite eating little.

Clinical measurement study, n=10 Perception is hard, for everyone

Using doubly labelled water and calorimetry, the team measured expenditure and intake over 14 days and compared them with the participants' own reports.

Total expenditure and resting metabolic rate were within 5 percent of the expected values, and no measurably slowed metabolism was found. Reported intake was on average 47 percent lower than actual intake, and participants overestimated their activity by 51 percent.

For you, this does not mean that people with weight problems cheat. Estimating what you eat and how much you move is hard for everyone, regardless of weight. It is a small, old study, and it is not suitable as an accusation, only as an indication that feeling and measurement can diverge.

Lichtman SW, Pisarska K, Berman ER et al. N Engl J Med. 1992;327(27):1893-1898. PMID: 1454084 · DOI: 10.1056/NEJM199212313272701 [Clinical study, n=10]

That leaves the question many people ask: how can the metabolism be boosted again after a diet? The honest answer is quieter than the advertising. According to the data from Martins, the adaptation becomes smaller once weight remains stable. What can count in this phase, you already know from the last chapter: preserving and using muscle, enough protein, enough sleep, everyday movement. And not going straight into the next restriction.

Reframe

The body saves as long as it has to. That is protection, not a defect. An organism that holds back energy in times of scarcity is working the way it is built.

So your metabolism is not broken. It responds to what you have offered it over the past months and years, and it can respond to changes again.

And now you know why an even stricter diet is rarely the answer to the last diet.

After 40, after 50, menopause: what changes and what does not

Hardly any sentence is as widespread as this one: after 40, your metabolism falls asleep. Some guidebooks even state that basal metabolic rate during menopause is a third lower than at 25. If you are at this age right now and your body is changing, that sounds plausible.

The largest measurement to date paints a different picture.

Pooled database, doubly labelled water Energy expenditure across the lifespan

Pontzer and an international consortium analysed measurements of total energy expenditure with doubly labelled water in people aged 8 days to 95 years, 6,421 individuals according to the full text, and adjusted expenditure for fat-free mass and fat mass.

They found four life phases. Adjusted expenditure rose rapidly after birth to about 50 percent above adult values at around one year of age, then declined slowly until about age 20, remained stable in adulthood from 20 to 60, including during pregnancy, and only declined after that. According to the full text, the decline from about age 60 was 0.7 percent per year, and in people in their nineties adjusted expenditure was about 26 percent below that of middle adulthood.

What this means for you: the claim that metabolism falls asleep after 40 is not supported by these data. Relative to body composition, people at 55 use on average a similar amount of energy over the day as at 25. What often changes is body composition itself.

Pontzer H, Yamada Y, Sagayama H et al.; IAEA DLW Database Consortium. Science. 2021;373(6556):808-812. PMID: 34385400 · DOI: 10.1126/science.abe5017 [Cross-sectional, pooled database, n=6,421]

Two nuances belong here so that this study is not oversold. First, according to the full text, the statistical breakpoint for adjusted basal metabolic rate came earlier than for total expenditure, at 46.5 years instead of 63.0 years. However, the authors point out that there were few basal metabolic rate measurements between the ages of 45 and 65, which makes this value uncertain. Second, the study did not analyse menopause separately. It describes averages across many people, not your own course.

What actually shifts measurably with age is shown by the MRI study by Janssen and colleagues mentioned earlier. There, the relative proportion of muscle decreased from the third decade of life. A noticeable decrease in absolute muscle mass appeared towards the end of the fifth decade, mainly in the lower half of the body. The legs therefore appear to lose muscle earlier than the upper body. This is a cross-sectional study, not a longitudinal measurement, but the direction fits what many people over 45 notice on stairs and when getting up.

What menopause shifts

Many women experience during perimenopause that their body changes even though little has changed about what they eat. That is not imagination. But it is also not the metabolic collapse that some websites describe.

Prospective cohort, SWAN The scales do not show the remodelling

In the American SWAN study, Greendale and colleagues used repeated DXA measurements to follow how women's fat and lean mass change around the final menstrual period.

At the start of the transition, the rate of fat gain doubled and lean mass declined. This continued until about two years after the final menstrual period, after which both trajectories levelled off. Weight, by contrast, rose linearly before menopause, without acceleration during the transition.

What this means for you: during menopause, body composition can shift towards more fat and less lean mass, even if the scales rise at the same rate as before. This is exactly where preserving muscle and protein can come in.

Greendale GA, Sternfeld B, Huang M et al. JCI Insight. 2019;4(5):e124865. PMID: 30843880 · DOI: 10.1172/jci.insight.124865 [Cohort, prospective]
Prospective cohort, 4 years, calorimetry n=34 Less expenditure during sleep, less movement even earlier

Lovejoy and colleagues followed 156 initially premenopausal women for four years with annual measurements. In 34 of them, expenditure over 24 hours was determined in a metabolic chamber.

Body fat, weight and visceral fat rose significantly only in the women who had become postmenopausal by the fourth year. Their sleeping energy expenditure fell more than in the other women (minus 7.9 versus minus 5.3 percent), and fat oxidation fell by 32 percent. Physical activity had already declined two years before menopause.

What this means for you: menopause can indeed shift something about expenditure and fat distribution, and movement often declines even earlier. These are percentage changes from a small measurement group, not a third less basal metabolic rate.

Lovejoy JC, Champagne CM, de Jonge L et al. Int J Obes (Lond). 2008;32(6):949-958. PMID: 18332882 · DOI: 10.1038/ijo.2008.25 [Cohort, prospective, n=156]

And hormone therapy? It has its own good reasons during menopause, such as severe symptoms. As protection for muscle, however, it showed no significant effect in a meta-analysis by Javed and colleagues of 12 randomised trials in postmenopausal women: women on hormone therapy lost 0.06 kg less lean mass than controls, with low quality of evidence. This says nothing about whether hormone therapy makes sense for you. That decision belongs in a gynaecological consultation, and an ongoing therapy is not changed on your own.

You can find more on this life stage in Menopause: symptoms and phases, Perimenopause: when does it start, Iron deficiency during menopause and Intermittent fasting for women over 40.

Reframe

It is not your metabolism that grows old at 45. It is muscle mass, movement, sleep and, during menopause, fat distribution that can shift.

That is no small matter. But it is a different story from an engine that switches itself off, because each of these items remains open to influence.

And now you know why the year of birth in your passport says less about your expenditure than what has changed in your body and your everyday life.

When a slow metabolism is a symptom: thyroid, iron, energy deficiency, medication

So far, this has been about items that shift in almost everyone. Now it is about something else. Sometimes the feeling that the body is running on low is a symptom with a cause. Then a tea or a new training plan alone starts at the wrong end.

I know this picture well from my practice. Behind the sentence that someone's metabolism is slow, there are often several things at once: a long history of dieting, little protein, little everyday movement, short sleep, low iron stores or an underactive thyroid that has not yet been recognised. That is a clinical observation, not a study finding. But it is the reason why a thorough medical history comes first, not a supplement.

The thyroid

Thyroid hormones set, so to speak, the base temperature of the metabolism. If they are lacking, everything can slow down: pulse, digestion, thinking, heat production. That is why the thyroid comes first in this topic.

Guideline, expert consensus What the German obesity guideline says

In its 2024 version, the interdisciplinary S3 guideline on the prevention and treatment of obesity recommends: to check for overt hypothyroidism as a possible hormonal cause of obesity, TSH should be measured. This is an expert consensus with 94 percent agreement and refers to diagnostics in obesity, not to general screening.

The background text states that hypothyroidism occurs in about 5 percent of the population and that overt hypothyroidism is associated with more central obesity, while subclinical hypothyroidism is not necessarily associated with weight gain. Weight loss after starting treatment is partly due to water loss. And for L-thyroxine in subclinical hypothyroidism with TSH below 10 mU/l, the guideline group found no evidence that it lowers weight in people with overweight.

What this means for you: taking the thyroid seriously makes sense. Expecting a large change in weight from its treatment usually does not.

German Obesity Society (Deutsche Adipositas-Gesellschaft, DAG) e. V. et al. Interdisziplinäre S3-Leitlinie zur Prävention und Therapie der Adipositas (Interdisciplinary S3 guideline on the prevention and treatment of obesity). AWMF register no. 050-001, version 5.0, October 2024. Recommendation 3.14. [Guideline]
Retrospective cohort, n=101 After treating an underactive thyroid

Lee, Braverman and Pearce analysed the records of 101 adults with newly diagnosed primary hypothyroidism and a TSH of 10 mIU/l or higher and compared weight at diagnosis with weight at the point when TSH on levothyroxine first fell below 5 mIU/l.

After a median of 5 months, the median weight change was minus 0.1 kg, with a range from minus 20.6 to plus 7.7 kg. Only 52 percent lost any weight at all. Neither sex, age, TSH level nor baseline weight predicted who lost weight.

What this means for you: treating a diagnosed underactive thyroid is important for energy, the heart and well-being. For most people, the treatment is not a route to weight loss.

Lee SY, Braverman LE, Pearce EN. Endocr Pract. 2014;20(11):1122-1128. PMID: 24936556 · DOI: 10.4158/EP14072.OR [Cohort, retrospective, n=101]

A common cause of an underactive thyroid is autoimmune inflammation of the thyroid, Hashimoto's thyroiditis. Why the immune system attacks the thyroid is explained in Understanding Hashimoto's thyroiditis. Which thyroid values count and why TSH alone does not show everything is covered in Thyroid blood tests: which ones count.

Important

Thyroid hormones are not a metabolism booster

Because thyroid hormones can increase expenditure, the idea of using them for weight loss keeps coming up, even with a healthy thyroid and even in small doses. This is dangerous, and I explicitly do not recommend it.

The 2014 guideline of the American Thyroid Association recommends against treating obesity with levothyroxine in people with normal thyroid function (strong recommendation, moderate-quality evidence) and likewise against treating it with liothyronine, meaning T3 (strong recommendation, low-quality evidence). Among the reasons given are that weight loss with hormone administration is largely fluid, and that harmful effects on the heart and bones argue against it. The same guideline also advises against dietary supplements and over-the-counter products for the thyroid, explicitly naming a thyroid hormone metabolite marketed as a weight loss product.

A systematic review by Kaptein and colleagues found no consistent effects of T3 or T4 on weight loss, metabolic rate or heart rate in obesity under calorie restriction, but it did find subclinical hyperthyroidism induced by the hormones. And the US prescribing information for levothyroxine carries a boxed warning right at the top: not for the treatment of obesity or for weight loss. Doses within the range of daily hormone requirements are ineffective for this purpose in people with a healthy thyroid, and higher doses can cause serious or even life-threatening signs of toxicity.

And just as important: if you have been prescribed thyroid hormones, do not change the dose or how you take them on your own. This also applies if you hope to lose weight that way, or if you feel tired despite treatment. That belongs in a conversation with your treating doctor.

And what if you already have an underactive thyroid or Hashimoto's, or no longer have a thyroid? Then good adjustment of your treatment by your treating practice is the foundation, and everything else in this article applies in addition, not instead. If your values are good and the symptoms still persist, you can find guidance in Symptoms despite L-thyroxine and Normal values, symptoms anyway.

At this point, the guidelines and the functional perspective partly diverge. The guidelines see no effect of L-thyroxine on weight in subclinical hypothyroidism. Functional medicine additionally looks at the symptom picture, free hormones, the conversion of T4 to T3 and cofactors such as selenium, zinc and iron. That is a complementary perspective with a thinner evidence base, not an invitation to take hormones without a diagnosis. More on this in Functional hypothyroidism and Selenium, zinc, iron and vitamin D for the thyroid.

Iron

Feeling cold when others do not, and being tired even though you have slept: many women with iron deficiency know this. There is also a biochemical bridge to the thyroid: the enzyme the thyroid uses to build its hormones, thyroid peroxidase, needs haem and therefore iron. Zimmermann and Köhrle summarised this in a review. The data come mainly from regions with iodine deficiency, so this is mechanistically plausible but not documented in detail in humans in everyday life.

Controlled laboratory study, n=30 Iron deficiency anaemia and temperature regulation

Beard and colleagues placed 10 women with iron deficiency anaemia, 8 women with depleted iron stores without anaemia and 12 controls in a cool water bath and observed body temperature, oxygen consumption and thyroid hormones.

The women with anaemia cooled down more, had lower oxygen consumption and significantly lower T4 and T3 levels. The women with depleted stores without anaemia responded like the controls. After iron administration, the anaemia was no longer detectable, temperature regulation was better, and thyroid hormones were partly back within the range of the controls.

What this means for you: feeling cold and a sense of slowing down can have a measurable basis in iron deficiency anaemia. For iron deficiency without anaemia, this small study did not show that.

Beard JL, Borel MJ, Derr J. Am J Clin Nutr. 1990;52(5):813-819. PMID: 2239756 · DOI: 10.1093/ajcn/52.5.813 [Laboratory study in humans, n=30]

For iron deficiency without anaemia, the situation is more contested, and here both sides belong visibly side by side.

Two perspectives on the same data

Tiredness with low ferritin without anaemia

What studies show. In a randomised trial by Vaucher and colleagues with 198 menstruating women with fatigue, ferritin below 50 µg/l and normal haemoglobin, the fatigue score over 12 weeks fell by 47.7 percent on oral iron and by 28.8 percent on placebo. The difference was significant, so placebo also had a clear effect. A meta-analysis by Houston and colleagues of randomised trials in iron deficiency without anaemia found less self-reported fatigue with iron, but no better objectively measured physical capacity.

What the general practice guideline says. The DEGAM guideline on fatigue is cautious about mild iron deficiency without anaemia. It considers the effects of iron supplementation with ferritin below 50 µg/l to be probably placebo-related and sees a benefit mainly with considerably lower stores or low transferrin saturation. It warns against fixating on a solution that probably does not explain the fatigue.

What I see clinically. In my practice, I observe that people with exhaustion and low iron stores often feel better when the deficiency is carefully assessed and treated. When symptoms are present, I consider higher ferritin levels appropriate than those the guideline uses as its basis. That is a clinical position, not a guideline statement. I explain why I see it this way in Ferritin above 100 and Functional iron deficiency despite normal ferritin.

Important for the topic of metabolism: measurably lower energy expenditure has not been shown for iron deficiency without anaemia, but the feeling of exhaustion can improve. And iron is not a harmless dietary supplement to take on suspicion. It should only be taken after a confirmed deficiency and under medical supervision, because too much can cause harm of its own, and a deficiency can have a cause that needs to be clarified. More on the link between iron and energy in Iron deficiency, tiredness and exhaustion and Iron deficiency, thyroid and sleep.

Too little energy

Now comes a paradox that many people do not expect. Eating too little can lower your expenditure. This applies especially when a lot of movement is added.

Controlled laboratory study, n=27 When too little is left for the body

Loucks and Heath had 27 untrained women with regular cycles train under supervision for four days and, in four groups, set how much energy remained for the rest of the body after subtracting training.

Below a certain threshold of this energy availability, T3 fell by 16 percent and free T3 by 9 percent, and not gradually but abruptly. Reverse T3, an inactive form, rose by 22 percent in the group with the lowest availability.

What this means for you: if too little energy remains for what you do, the body can turn down the effect of thyroid hormones. A slow metabolism can then be the result of eating too little, not too much.

Loucks AB, Heath EM. Am J Physiol. 1994;266(3 Pt 2):R817-R823. PMID: 8160876 · DOI: 10.1152/ajpregu.1994.266.3.R817 [Laboratory study in humans, n=27]

In its 2023 consensus, the International Olympic Committee describes this state as Relative Energy Deficiency in Sport, REDs for short: a syndrome with consequences for health and performance in female athletes and explicitly also in male athletes when energy intake is too low relative to training expenditure. That the same principle can affect recreational athletes who train a lot and eat little is an obvious extrapolation, not a statement of the consensus itself.

Even without sport, persistently lower energy intake can make the body more economical. In the CALERIE study mentioned earlier, the activity of the thyroid axis fell alongside expenditure in people without obesity. That is adaptation, not thyroid disease. And it is explicitly not a reason for thyroid hormones.

If you train a lot, eat little and constantly feel cold, your periods stop or you are frequently injured, this belongs in a medical assessment. The answer then is not to become even stricter. I will come back to this in the last chapter.

Medication

Some people gain weight after starting a new treatment and wonder whether it is their fault. Sometimes it is the medication.

Meta-analysis, 257 RCTs, n=84,696 Medication and weight

Domecq and colleagues analysed randomised trials in which commonly prescribed medications were compared with placebo and changes in weight were measured, 54 drugs in total.

Individual drugs from the groups of antidepressants, antipsychotics, antiepileptics and diabetes medications showed weight gain compared with placebo. Other drugs were associated with weight loss. For many others, including blood pressure medications and antihistamines, the effect was not significant or the evidence was very low.

What this means for you: a medication can contribute to changes in weight. That is a good reason for a conversation with the prescribing doctor and never a reason to stop or reduce anything yourself.

Domecq JP, Prutsky G, Leppin A et al. J Clin Endocrinol Metab. 2015;100(2):363-370. PMID: 25590213 · DOI: 10.1210/jc.2014-3421 [Systematic Review and Meta-analysis, 257 RCTs]

On this point, the German S3 guideline on obesity recommends with recommendation grade B: for medications with a possible relevant weight gain, this should be taken into account when weighing benefits and harms, patients should be informed about it, and weight management as well as a possible switch where appropriate should be discussed together. In the background text, it names, among others, neuroleptics, lithium, valproic acid, tricyclic antidepressants, beta blockers, insulin, sulfonylureas, glitazones, glucocorticoids and progestins. The 2015 guideline of the Endocrine Society similarly states that the weight profile can be taken into account in the choice of medication where possible.

If you suspect that a medication is affecting your weight or your energy balance, talk to the prescribing doctor. Do not stop it on your own and do not change the dose. This applies to antidepressants, neuroleptics, antiepileptics, beta blockers, insulin, cortisone, hormone preparations and all other prescribed medications. With some of these medications, stopping abruptly can be dangerous, and the underlying condition for which they were prescribed counts at least as much in the weighing up as weight does.

Short sleep also belongs on this list, as the study by Nedeltcheva in the second chapter suggests.

Reframe

If you still feel persistently slowed down despite everything, that is not a sign of lack of discipline. It is a finding that deserves a question.

The question is not which remedy fires up the metabolism, but what is slowing it down. Thyroid, iron status, energy balance, sleep and medication are the first candidates.

And now you know why an assessment, rather than a supplement, can come first.

Getting your metabolism tested: which values make sense and why you should not interpret them alone

Can metabolism actually be measured? The question is justified, and the answer has two parts.

First: blood values do not measure your expenditure. They look for causes that can change it, such as an underactive thyroid, anaemia or inflammation. Second: resting metabolic rate itself is measured with indirect calorimetry via the respiratory gases, and body composition with methods such as BIA or DXA. For the latter, the German S3 guideline names a clear reason: clinical suspicion of sarcopenic obesity.

Guideline, recommendation grade A and consensus point The basic laboratory panel for unexplained fatigue

The DEGAM S3 guideline on fatigue for general practice specifies: in primarily unexplained fatigue, blood glucose, full blood count, erythrocyte sedimentation rate or CRP, transaminases or gamma-GT and TSH shall be measured (recommendation grade A). Further laboratory or instrument-based tests should only be carried out if previous findings are abnormal or there are specific indications (good clinical practice point, GCP).

The background text states that for women of childbearing age, ferritin can be measured in addition. And the guideline warns: tests without a clear question carry the risk of false positive findings.

What this means for you: there is a sensible, well-founded starting point. More values are not automatically better, they belong to a question.

German College of General Practitioners and Family Physicians (Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin, DEGAM). S3-Leitlinie Müdigkeit (S3 guideline on fatigue). AWMF register no. 053-002, as of 11/2022. Recommendations 5.3.1 and 5.3.2. [Guideline]

Why are there no reference ranges in a table here? Because they differ from laboratory to laboratory and from measurement method to measurement method. The German S3 guideline on obesity itself gives an example: the upper limit of the TSH reference range lies between 2.5 and 5.0 mU/l depending on the laboratory. A table from the internet next to your results can therefore easily lead you in the wrong direction.

And a single value says little without symptoms, medical history, medication and the course over time. Deriving a treatment from it therefore belongs in a conversation with a doctor, not in your own hands.

How I approach this in my practice

For me, it starts with a conversation: dieting history, sleep, everyday movement, menstrual cycle, medication, stress. Then comes basic diagnostics guided by the guidelines, and only then the question of whether extended diagnostics could provide further clues.

In functional medicine, I also look at cofactors that cells need for energy production, such as B vitamins, magnesium and iron. That is a complementary perspective with evidence of varying strength. More on this in Micronutrients as cofactors in energy metabolism and Whole blood micronutrient analysis.

I did not examine commercial tests that certify you a metabolic type for this article. I therefore neither recommend nor evaluate them. How genes and ancestry can help shape metabolism is covered in Genetics, metabolism and ancestry, and which blood values count when iron deficiency is suspected in Iron deficiency: which blood tests.

Reframe

A lab value is a question to your body, not a shopping list. It only becomes useful when someone reads it together with your story.

And now you know why the most sensible metabolism test begins with a conversation.

Fat burners, green tea, chilli, coffee, cold water, breakfast: the fact check

A glass of cold water in the morning, something spicy at lunch, green tea in the afternoon, plus a capsule from the drugstore. Each of these ideas has a measurable starting point. The question is how big it is.

All values are study data and not recommendations. Sources with DOI are listed in the source section below.
MythWhat was measuredSize of the effectAssessment
Green teaWeight loss over at least 12 weeksCochrane review (Jurgens 2012): outside Japan minus 0.04 kg, not significant; studies from Japan could not be pooled, range minus 0.2 to minus 3.5 kg in favour of green tea. Meta-analysis Hursel 2009: pooled minus 1.31 kg, habitual caffeine intake and ethnicity as possible moderatorssmall to clinically not meaningful
Green tea extract, high doseLiver valuesEFSA 2018: from 800 mg EGCG per day from dietary supplements, significantly elevated transaminases. USP review 2020: case reports of liver damage from 140 mg EGCG per day. EU Regulation 2022/2340: below 800 mg per daily portion, with warningssafety issue
Chilli, capsaicinEnergy expenditureMeta-analysis Zsiborás 2018: plus 58.56 kcal per day, no effect at a mean BMI below 25. Review Ludy 2012: small effectssmall
Coffee, caffeineResting metabolic rate, weightLaboratory study Dulloo 1989: 100 mg caffeine raised resting metabolic rate by 3 to 4 percent over 150 minutes. Weight data from a very heterogeneous meta-analysis (Tabrizi 2019)small in the short term, weight unclear
Cold waterExpenditure after drinkingBoschmann 2003: plus 30 percent after 500 ml of water. Brown 2006: no significant rise after water, water chilled to 3 degrees plus 4.5 percent over 60 minutesnot confirmed, small at most
Cold, brown fatActivity of brown adipose tissuevan Marken Lichtenbelt 2009: active in 23 of 24 men under mild cold. Yoneshiro 2013: after 6 weeks of daily cold, more brown fat activity and more cold-induced thermogenesismechanistically plausible, everyday relevance open
Many small meals24-hour expenditure, weightReview Bellisle 1997: no difference in 24-hour expenditure. RCT Cameron 2010: no advantage with the same energy intake. Meta-analysis Schoenfeld 2015: apparent advantage depended on a single studyno metabolic advantage
BreakfastResting metabolic rate, weightRCT Betts 2014: resting metabolic rate stable within 11 kcal per day, more activity thermogenesis with breakfast. Meta-analysis Sievert 2019: adding breakfast brought no weight loss advantagenot a metabolism starter
Ginger drinkThermogenesis after eatingPilot study Mansour 2012 with 10 men: no effect on resting metabolic rate, marginally significantly higher diet-induced thermogenesis, less hungerone small pilot study
Apple cider vinegarMetabolic values, weightSystematic review Launholt 2020 with 13 human and 12 animal studies: evidence insufficient. A widely shared study on apple cider vinegar was retracted in 2025thin
Lemon water, metabolism teasEnergy expenditure, weightNo robust human studies with a relevant endpoint foundtradition without a study basis

Water shows how a myth is born. The figure of 30 percent comes from a study of 14 healthy people whose authors merely extrapolated the effect of two litres a day. A more precise re-examination found no significant rise after normal water. Drinking remains important, but it is not a metabolism trick.

With coffee, the short-term rise is well measured. But caffeine can shorten sleep, and sleep, as you saw in the second chapter, is an item in its own right. More on this in Coffee, cortisol and adenosine. With brown fat, the physiology is fascinating, but the studies are small, and cold applications are not suitable for everyone. With cardiovascular disease, Raynaud's syndrome and during pregnancy, this should be discussed with a doctor beforehand. What cold can set in motion as a stimulus in the body is explained in Cold, the immune system and hormesis.

For breakfast: it does not start your basal metabolic rate, and skipping it is just as little a metabolism trick. If you are hungry in the morning, you are allowed to eat. How often you eat can follow your hunger, your daily routine and what agrees with you. And you can find a detailed assessment of metabolism regimens, detox teas and morning miracle drinks in Detox regimens under critical scrutiny.

Fat burners and metabolism capsules

Capsules to rev up the metabolism are available in pharmacies, drugstores and online. I do not name any here. The question is more fundamental: what do well-conducted studies show about dietary supplements for weight loss overall?

Systematic review, 315 RCTs Many studies, little difference

Batsis and colleagues searched five databases for randomised trials on dietary supplements and alternative therapies for weight loss and found 315 studies on 14 products and combinations.

Only 52 of them had a low risk of bias and sufficient data. Of these 52, only 16 showed a significant difference in weight between groups, ranging from 0.3 to 4.93 kg.

What this means for you: the majority of well-conducted studies found no difference. An older systematic review by Pittler and Ernst came to a similar conclusion: none of the products examined could be recommended for over-the-counter use. The only exception in terms of effect, ephedra and ephedrine-containing preparations, was at the same time associated with an increased risk of adverse events.

Batsis JA, Apolzan JW, Bagley PJ et al. Obesity (Silver Spring). 2021;29(7):1102-1113. PMID: 34159755 · DOI: 10.1002/oby.23110 [Systematic Review, 315 RCTs]

The German S3 guideline on obesity draws a clear conclusion from this. In the prevention chapter, it states as an expert consensus: people shall be advised against dietary supplements for weight control, homeopathic weight loss remedies and other non-evidence-based methods.

On top of that come risks that are not on any label. In US emergency departments, adverse effects of dietary supplements led to 23,005 visits per year according to an estimate by Geller and colleagues. Weight loss or energy products were involved in 71.8 percent of the supplement-related events with palpitations, chest pain or tachycardia. An analysis of the warning database of the US Food and Drug Administration by Tucker and colleagues found the undeclared appetite suppressant sibutramine in 269 of 317 adulterated weight loss products, or 84.9 percent. And the substance 2,4-dinitrophenol, which is sold online as a slimming agent, uncouples energy production in the mitochondria so strongly that, according to a review by Grundlingh and colleagues, there had been 62 published deaths up to that point.

Key takeaway

What fires up the metabolism strongly is often dangerous. What is considered safe works quietly: using your muscles, moving in everyday life, eating enough, sleeping well, clarifying causes.

Reframe

You are welcome to enjoy green tea, chilli and coffee. They are good foods, just not levers.

And if a product promises to noticeably speed up your metabolism, the more interesting question is not whether it works, but with what.

And now you know why there is no capsule here.

When the wish for a faster metabolism becomes a burden

This chapter is short, and it matters to me. For some people, the search for the right metabolism trick is not a hobby but a cycle. Eat even less, train even more, one more rule. And the body can respond with feeling cold, exhaustion and an expenditure that tends to fall rather than rise.

You have seen in this article why that can happen. Too little energy with a lot of movement can turn down the thyroid axis, as the study by Loucks shows and as the consensus of the International Olympic Committee describes for female and male athletes. More restriction is then not the solution for a slow metabolism, but can be part of its cause.

A second observation belongs here: a long dieting history and strict restriction are themselves considered risk factors for disordered eating. A frequently cited basis is a cohort study by Patton and colleagues that followed around 1,700 school students in the Australian state of Victoria, initially aged 14 to 15, for three years. Girls who dieted severely were 18 times more likely to develop an eating disorder (recorded as partial syndrome) than girls who did not diet, and those who dieted moderately were five times more likely. Psychological distress predicted an eating disorder independently of this. The authors named dieting the most important predictor of new eating disorders. These are data from adolescents, and they cannot be transferred one to one to adults.

This does not mean that every diet leads to an eating disorder, and nobody is to blame if it happens. It means that warning signs may be taken seriously before they grow.

Look closely

When support matters more than any metabolism tip

  • Thoughts about food, calories, weight or training take up a large part of your day.
  • You experience binge eating episodes, vomit after eating or take laxatives or diuretics to lose weight.
  • Your periods stop, you constantly feel cold, you are frequently injured or you feel ever weaker despite training.
  • People around you are worried about your eating or your weight.

Then a conversation with your GP is a good first step. Medical and psychotherapeutic support belong together in disordered eating, and neither should be postponed. More on this, without blame and with a view of body and mind, in Understanding eating disorders. If exhaustion and training are hard to reconcile, Exercise with chronic exhaustion can also help put things into context.

If you are in an acute crisis or have thoughts of harming yourself: in Germany, the Telefonseelsorge crisis line 0800 111 0 111 or 0800 111 0 222, around the clock and free of charge (these are German numbers). In acute danger, 112. Outside Germany, please use your local emergency number.

Reframe

Sometimes the bravest step for your metabolism is not the next act of giving something up, but the permission to eat enough, and the willingness to accept help.

What remains in the end

Energy is not a luxury. Energy is the freedom to get up in the morning, take the stairs, play with children or grandchildren and not negotiate with your own body every day. That is what this topic is about, far more than a number on the scales.

If you take three directions away from this article, let them be these:

  • Preserve and use your muscles. Not because they burn a lot while you sleep, but because they protect what you could lose in any phase with less energy.
  • Make everyday life more active. The trips around the home are the quietest and often the most flexible item of your expenditure.
  • Have causes assessed instead of buying capsules. Thyroid, iron status, energy balance, sleep and medication belong in medical hands, not in a shopping basket.

How all these building blocks around weight fit together can be found in the overview Understanding weight holistically and in the Weight Loss Guide.

If you would rather not just read about this but approach it with medical support: below this article you will find the option to book an appointment.

And now you know why your metabolism needs less of a push than a careful look.

Frequently asked questions about metabolism

Can you actually boost your metabolism?

Your basal metabolic rate itself barely, your daily energy expenditure yes. The biggest levers are fat-free mass, everyday movement, adequate protein and sleep, especially during phases of eating less. Teas, spices and cold water show small effects at most in studies. If you feel persistently slowed down, a medical assessment of thyroid, iron status, energy balance and medication makes more sense than any supplement.

How much energy does a kilogram of muscle use, and does strength training raise basal metabolic rate?

According to the tissue-specific values by Elia, which Wang and colleagues tested in 2010, one kilogram of skeletal muscle uses about 13 kcal per day at rest, not 100, as is often claimed. Muscle still counts, because it makes up a large share of body mass and supports movement, strength and blood sugar. In a meta-analysis, strength training raised resting metabolic rate compared with controls by 96.17 kcal per day, with a high risk of bias in the studies. Endurance training showed no significant effect there.

How can you tell if your metabolism is slow, and when is an illness behind it?

A slow metabolism cannot be reliably identified from symptoms alone, because tiredness, feeling cold or weight gain have many causes. Persistent sensitivity to cold, constipation, dry skin, swelling and a slow pulse can point to an underactive thyroid. Feeling cold and exhaustion also occur with iron deficiency anaemia, energy deficiency, lack of sleep or as a result of medication. If such symptoms last for weeks or your weight changes unintentionally, have it assessed by a doctor.

Can an underactive thyroid slow down your metabolism?

Yes, overt hypothyroidism can slow the metabolism. The German S3 guideline on obesity therefore recommends that TSH should be measured to check for overt hypothyroidism as a possible cause of obesity. After treatment begins, however, weight loss is usually small and partly water: in an analysis of 101 people, the median weight change after a median of 5 months was minus 0.1 kg. Treatment is important for energy and the heart, but for most people it is not a route to weight loss.

Can you lose weight with thyroid hormones?

Not with a healthy thyroid, and it is dangerous. The 2014 guideline of the American Thyroid Association explicitly recommends against treating obesity with either levothyroxine or T3 when thyroid function is normal. The US prescribing information for levothyroxine warns right at the top that higher doses can cause life-threatening signs of toxicity. If you have been prescribed thyroid hormones, do not change the dose or how you take them on your own, but discuss every question about this with your treating practice.

Can iron deficiency slow down your metabolism?

For iron deficiency with anaemia there are indications: in a small study, anaemic women cooled down more and had lower T4 and T3 levels, while women without anaemia did not. Without anaemia, lower energy expenditure has not been shown, but subjective tiredness can improve with iron. The DEGAM guideline for general practice is cautious about mild iron deficiency without anaemia, and clinically I see this somewhat differently. Iron should only be taken after a confirmed deficiency and under medical supervision.

Is your metabolism broken after many diets?

For most diets, lasting damage has not been shown. The body saves energy during a deficit, and after extreme weight loss, the adaptation in a study of 14 participants from the show The Biggest Loser was still minus 499 kcal per day after six years. After a shorter, less extreme diet, by contrast, the adaptation was considerably smaller after weight stabilisation and no longer significantly detectable after one year. Its size therefore depends heavily on the extent and the phase.

Does your metabolism slow down after 40 or 50?

According to the largest measurement to date by Pontzer and an international consortium, daily energy expenditure adjusted for fat-free mass and fat mass remains stable on average between the ages of 20 and 60 and only declines after that, by 0.7 percent per year according to the full text. For basal metabolic rate alone, the statistical breakpoint came earlier, at 46.5 years, although the data there are uncertain. What often changes is muscle mass and everyday movement. The claim that metabolism falls asleep after 40 is not supported by these data.

What changes in metabolism during menopause?

Above all, body composition. In the SWAN study, the rate of fat gain doubled at the start of the transition and lean mass declined, while weight continued to rise without acceleration. In a smaller cohort, sleeping energy expenditure fell more in women who became postmenopausal than in the others (minus 7.9 versus minus 5.3 percent), and physical activity had already declined beforehand. A drop in basal metabolic rate by a third cannot be derived from these data.

Can medications slow down your metabolism or lead to weight gain?

Yes, individual drugs from several groups can change weight, including certain antidepressants, antipsychotics, antiepileptics, insulin and some diabetes medications, glucocorticoids, beta blockers and progestins. If you suspect this, talk to the prescribing doctor. Do not stop the medication on your own and do not change the dose, because stopping abruptly can be dangerous.

Do you lose muscle on a GLP-1 injection, and does that slow your metabolism?

Part of the weight loss on GLP-1 medications is also lean mass, about a quarter both in a manufacturer-funded substudy and in a meta-analysis, similar to weight loss without medication. But lean mass is not the same as muscle. Preserving muscle through strength training, enough protein and sleep therefore makes particular sense in this situation, especially at an older age. Whether such a prescription-only medication is an option for you belongs in a medical consultation.

Do metabolism capsules, fat burners or pills do anything?

The evidence is weak. In a systematic review of 315 randomised trials, only 16 of 52 methodologically sound studies showed a significant difference in weight. In its prevention chapter, the German S3 guideline on obesity states as an expert consensus that people shall be advised against dietary supplements for weight control. On top of that come risks: racing heart and chest pain after weight loss and energy products, undeclared drugs in online products and, in extreme cases, life-threatening substances.

Do green tea, chilli, coffee, ginger or cold water boost your metabolism?

Measurably, but only a little. In the Cochrane review, green tea produced minus 0.04 kg outside Japan, capsaicin produced plus 58.56 kcal per day in a meta-analysis and no effect in studies with a mean BMI below 25, and caffeine produced a short-term rise of 3 to 4 percent in resting metabolic rate. The well-known figure of 30 percent after half a litre of water was not confirmed, and chilled water produced 4.5 percent over one hour. High-dose green tea extracts can strain the liver.

Which blood tests make sense if I suspect a slow metabolism?

For unexplained tiredness, the DEGAM guideline for general practice names a basic laboratory panel: blood glucose, full blood count, erythrocyte sedimentation rate or CRP, transaminases or gamma-GT and TSH, and for women of childbearing age, ferritin can be added. Further tests should only be carried out when there are specific indications. Reference ranges differ between laboratories, so the results belong in a medical assessment together with symptoms and medical history.

Where metabolism connects with the rest of the body

Your energy expenditure depends on muscles, hormones, iron, sleep and the history of your diets. Here are the paths that lead on from this article.

If you use or are considering a GLP-1 injection
GLP-1 injections and muscle loss

How much lean mass can be lost on GLP-1 and what protecting muscle looks like.

If eating less no longer seems to be enough
Calorie deficit: why it is not enough

Adaptive thermogenesis as a mechanism, explained in detail.

If you want to preserve muscle
Strength training after 40

Muscle as an organ for blood sugar, strength and healthy ageing.

If your thyroid values are normal and you still feel slow
Functional hypothyroidism

The complementary functional perspective, with its limits.

If you want your thyroid assessed
Thyroid blood tests: which ones count

Why TSH alone does not answer every question.

If you feel cold and tired
Iron deficiency, tiredness and exhaustion

Anaemia, empty stores and what both have to do with energy.

If you want to understand why the body pushes back
Leptin and insulin

The hormones behind hunger, satiety and saving energy.

If the delivery charges of food interest you
A calorie is not just a calorie

What the body does differently with protein, fat and carbohydrates.

If cravings and belly fat are part of the picture
Insulin resistance and weight loss

Why disturbed blood sugar regulation can make weight loss harder.

If you are going through menopause
Menopause: symptoms and phases

Hormonal changes, symptoms and ways to address them.

If eating has become a struggle
Understanding eating disorders

Body and mind considered together, without blame.

If you want the big picture
Understanding weight holistically

All the building blocks around weight at a glance.

SJ

Shukri Jarmoukli

Physician, Integrative Medicine · ViveCura Berlin

In my private practice, I work at the interface of conventional medicine, functional medicine and Clinical Psychoneuroimmunology. When it comes to weight and energy, I am less interested in the next trick than in the question of which item has shifted in a person and which cause may not yet have been looked at.

This article does not replace medical advice. It is explicitly not a guide to changing prescribed medications, and not a substitute for an assessment when red flags are present. It is meant to help you put promises into better perspective and ask good questions at your next appointment.

ViveCura, Privatpraxis Shukri Jarmoukli, Skalitzer Straße 137, 10999 Berlin

Scientific sources

63 verified sources, 59 of them with DOI and PMID. Four sources have no DOI: two German guidelines, an EU regulation and a US prescribing information document. All figures in the text are study data.

Energy expenditure and its items

  1. Pontzer H, Yamada Y, Sagayama H et al.; IAEA DLW Database Consortium. Daily energy expenditure through the human life course. Science. 2021;373(6556):808-812. PMID: 34385400 · DOI: 10.1126/science.abe5017 [Cross-sectional, pooled database, n=6,421]
  2. Johnstone AM, Murison SD, Duncan JS, Rance KA, Speakman JR. Factors influencing variation in basal metabolic rate include fat-free mass, fat mass, age, and circulating thyroxine but not sex, circulating leptin, or triiodothyronine. Am J Clin Nutr. 2005;82(5):941-8. PMID: 16280423 · DOI: 10.1093/ajcn/82.5.941 [Cross-sectional, n=150]
  3. Wang Z, Ying Z, Bosy-Westphal A, Zhang J, Schautz B, Later W, Heymsfield SB, Muller MJ. Specific metabolic rates of major organs and tissues across adulthood: evaluation by mechanistic model of resting energy expenditure. Am J Clin Nutr. 2010;92(6):1369-77. PMID: 20962155 · DOI: 10.3945/ajcn.2010.29885 [Validation study, n=131]
  4. Levine JA, Eberhardt NL, Jensen MD. Role of nonexercise activity thermogenesis in resistance to fat gain in humans. Science. 1999;283(5399):212-4. PMID: 9880251 · DOI: 10.1126/science.283.5399.212 [Controlled overfeeding study, n=16]
  5. Levine JA, Lanningham-Foster LM, McCrady SK, Krizan AC, Olson LR, Kane PH, Jensen MD, Clark MM. Interindividual variation in posture allocation: possible role in human obesity. Science. 2005;307(5709):584-6. PMID: 15681386 · DOI: 10.1126/science.1106561 [Observational study, n=20]
  6. Pontzer H, Durazo-Arvizu R, Dugas LR, Plange-Rhule J, Bovet P, Forrester TE, Lambert EV, Cooper RS, Schoeller DA, Luke A. Constrained Total Energy Expenditure and Metabolic Adaptation to Physical Activity in Adult Humans. Curr Biol. 2016;26(3):410-7. PMID: 26832439 · DOI: 10.1016/j.cub.2015.12.046 [Cross-sectional, 5 populations, n=332]
  7. Careau V, Halsey LG, Pontzer H et al.; IAEA DLW database group. Energy compensation and adiposity in humans. Curr Biol. 2021;31(20):4659-4666.e2. PMID: 34453886 · DOI: 10.1016/j.cub.2021.08.016 [Cross-sectional, pooled database, n=1,754]
  8. Lichtman SW, Pisarska K, Berman ER, Pestone M, Dowling H, Offenbacher E, Weisel H, Heshka S, Matthews DE, Heymsfield SB. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med. 1992;327(27):1893-8. PMID: 1454084 · DOI: 10.1056/NEJM199212313272701 [Clinical study, n=10 plus comparison group]

Diets, adaptive thermogenesis, energy deficiency

  1. Fothergill E, Guo J, Howard L, Kerns JC, Knuth ND, Brychta R, Chen KY, Skarulis MC, Walter M, Walter PJ, Hall KD. Persistent metabolic adaptation 6 years after "The Biggest Loser" competition. Obesity (Silver Spring). 2016;24(8):1612-9. PMID: 27136388 · DOI: 10.1002/oby.21538 [Cohort, follow-up, n=14]
  2. Johannsen DL, Knuth ND, Huizenga R, Rood JC, Ravussin E, Hall KD. Metabolic slowing with massive weight loss despite preservation of fat-free mass. J Clin Endocrinol Metab. 2012;97(7):2489-96. PMID: 22535969 · DOI: 10.1210/jc.2012-1444 [Cohort, intervention without control group, n=16]
  3. Martins C, Roekenes J, Salamati S, Gower BA, Hunter GR. Metabolic adaptation is an illusion, only present when participants are in negative energy balance. Am J Clin Nutr. 2020;112(5):1212-1218. PMID: 32844188 · DOI: 10.1093/ajcn/nqaa220 [Intervention study, two studies pooled, n=71]
  4. Redman LM, Smith SR, Burton JH, Martin CK, Il'yasova D, Ravussin E. Metabolic Slowing and Reduced Oxidative Damage with Sustained Caloric Restriction Support the Rate of Living and Oxidative Damage Theories of Aging. Cell Metab. 2018;27(4):805-815.e4. PMID: 29576535 · DOI: 10.1016/j.cmet.2018.02.019 [RCT, CALERIE, n=53]
  5. Loucks AB, Heath EM. Induction of low-T3 syndrome in exercising women occurs at a threshold of energy availability. Am J Physiol. 1994;266(3 Pt 2):R817-23. PMID: 8160876 · DOI: 10.1152/ajpregu.1994.266.3.R817 [Controlled laboratory study in humans, n=27]
  6. Mountjoy M, Ackerman KE, Bailey DM, Burke LM, Constantini N, Hackney AC et al. 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med. 2023;57(17):1073-1097. PMID: 37752011 · DOI: 10.1136/bjsports-2023-106994 [Guideline] [Consensus Guideline, IOC]

Muscle, protein, sleep, menopause, GLP-1

  1. Janssen I, Heymsfield SB, Wang ZM, Ross R. Skeletal muscle mass and distribution in 468 men and women aged 18-88 yr. J Appl Physiol (1985). 2000;89(1):81-8. PMID: 10904038 · DOI: 10.1152/jappl.2000.89.1.81 [Cross-sectional, MRI, n=468]
  2. Peterson MD, Sen A, Gordon PM. Influence of resistance exercise on lean body mass in aging adults: a meta-analysis. Med Sci Sports Exerc. 2011;43(2):249-58. PMID: 20543750 · DOI: 10.1249/MSS.0b013e3181eb6265 [Meta-analysis, 49 studies, n=1,328]
  3. MacKenzie-Shalders K, Kelly JT, So D, Coffey VG, Byrne NM. The effect of exercise interventions on resting metabolic rate: A systematic review and meta-analysis. J Sports Sci. 2020;38(14):1635-1649. PMID: 32397898 · DOI: 10.1080/02640414.2020.1754716 [Systematic Review and Meta-analysis]
  4. Wycherley TP, Moran LJ, Clifton PM, Noakes M, Brinkworth GD. Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012;96(6):1281-98. PMID: 23097268 · DOI: 10.3945/ajcn.112.044321 [Meta-analysis, 24 RCTs, n=1,063]
  5. Nedeltcheva AV, Kilkus JM, Imperial J, Schoeller DA, Penev PD. Insufficient sleep undermines dietary efforts to reduce adiposity. Ann Intern Med. 2010;153(7):435-41. PMID: 20921542 · DOI: 10.7326/0003-4819-153-7-201010050-00006 [RCT, Crossover, n=10]
  6. Lovejoy JC, Champagne CM, de Jonge L, Xie H, Smith SR. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008;32(6):949-58. PMID: 18332882 · DOI: 10.1038/ijo.2008.25 [Cohort, prospective, n=156]
  7. Greendale GA, Sternfeld B, Huang M, Han W, Karvonen-Gutierrez C, Ruppert K et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019;4(5):e124865. PMID: 30843880 · DOI: 10.1172/jci.insight.124865 [Cohort, prospective, SWAN]
  8. Javed AA, Mayhew AJ, Shea AK, Raina P. Association Between Hormone Therapy and Muscle Mass in Postmenopausal Women: A Systematic Review and Meta-analysis. JAMA Netw Open. 2019;2(8):e1910154. PMID: 31461147 · DOI: 10.1001/jamanetworkopen.2019.10154 [Meta-analysis, 12 RCTs, n=4,474]
  9. Neeland IJ, Linge J, Birkenfeld AL. Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies. Diabetes Obes Metab. 2024;26 Suppl 4:16-27. PMID: 38937282 · DOI: 10.1111/dom.15728 [Review]
  10. Look M, Dunn JP, Kushner RF, Cao D, Harris C, Gibble TH et al. Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight. Diabetes Obes Metab. 2025;27(5):2720-2729. PMID: 39996356 · DOI: 10.1111/dom.16275 [RCT substudy, DXA, n=160, manufacturer-funded]
  11. Karakasis P, Patoulias D, Fragakis N, Mantzoros CS. Effect of glucagon-like peptide-1 receptor agonists and co-agonists on body composition: Systematic review and network meta-analysis. Metabolism. 2025;164:156113. PMID: 39719170 · DOI: 10.1016/j.metabol.2024.156113 [Systematic Review, network meta-analysis, 22 RCTs]

Thyroid, iron, medication

  1. Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS et al.; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid. 2014;24(12):1670-751. PMID: 25266247 · DOI: 10.1089/thy.2014.0028 [Guideline] [Consensus Guideline, ATA]
  2. Kaptein EM, Beale E, Chan LS. Thyroid hormone therapy for obesity and nonthyroidal illnesses: a systematic review. J Clin Endocrinol Metab. 2009;94(10):3663-75. PMID: 19737920 · DOI: 10.1210/jc.2009-0899 [Systematic Review]
  3. Lee SY, Braverman LE, Pearce EN. Changes in body weight after treatment of primary hypothyroidism with levothyroxine. Endocr Pract. 2014;20(11):1122-8. PMID: 24936556 · DOI: 10.4158/EP14072.OR [Cohort, retrospective, n=101]
  4. Zimmermann MB, Kohrle J. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid. 2002;12(10):867-78. PMID: 12487769 · DOI: 10.1089/105072502761016494 [Mechanism Review]
  5. AbbVie Inc. Synthroid (levothyroxine sodium) tablets, US prescribing information with boxed warning "Not for treatment of obesity or for weight loss". Label version of 20 February 2024, retrieved via openFDA on 16 September 2026. No DOI. [Prescribing information]
  6. Beard JL, Borel MJ, Derr J. Impaired thermoregulation and thyroid function in iron-deficiency anemia. Am J Clin Nutr. 1990;52(5):813-9. PMID: 2239756 · DOI: 10.1093/ajcn/52.5.813 [Controlled laboratory study in humans, n=30]
  7. Vaucher P, Druais PL, Waldvogel S, Favrat B. Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial. CMAJ. 2012;184(11):1247-54. PMID: 22777991 · DOI: 10.1503/cmaj.110950 [RCT, placebo-controlled, n=198]
  8. Houston BL, Hurrie D, Graham J, Perija B, Rimmer E, Rabbani R et al. Efficacy of iron supplementation on fatigue and physical capacity in non-anaemic iron-deficient adults: a systematic review of randomised controlled trials. BMJ Open. 2018;8(4):e019240. PMID: 29626044 · DOI: 10.1136/bmjopen-2017-019240 [Systematic Review and Meta-analysis, 18 RCTs]
  9. German College of General Practitioners and Family Physicians (Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin, DEGAM). S3-Leitlinie Müdigkeit (S3 guideline on fatigue). AWMF register no. 053-002, as of 11/2022. No DOI. [Guideline]
  10. Domecq JP, Prutsky G, Leppin A, Sonbol MB, Altayar O, Undavalli C et al. Clinical review: Drugs commonly associated with weight change: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2015;100(2):363-70. PMID: 25590213 · DOI: 10.1210/jc.2014-3421 [Systematic Review and Meta-analysis, 257 RCTs]
  11. Apovian CM, Aronne LJ, Bessesen DH, McDonnell ME, Murad MH, Pagotto U et al.; Endocrine Society. Pharmacological management of obesity: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2015;100(2):342-62. PMID: 25590212 · DOI: 10.1210/jc.2014-3415 [Guideline] [Consensus Guideline, GRADE]
  12. German Obesity Society (Deutsche Adipositas-Gesellschaft, DAG) e. V. et al. Interdisziplinäre S3-Leitlinie zur Prävention und Therapie der Adipositas (Interdisciplinary S3 guideline on the prevention and treatment of obesity). AWMF register no. 050-001, version 5.0, October 2024. Recommendations 3.4, 3.14, 4.20, 4.22, 5.21. No DOI. [Guideline]

Fact check: tea, spices, water, meals, home remedies

  1. Jurgens TM, Whelan AM, Killian L, Doucette S, Kirk S, Foy E. Green tea for weight loss and weight maintenance in overweight or obese adults. Cochrane Database Syst Rev. 2012;12(12):CD008650. PMID: 23235664 · DOI: 10.1002/14651858.CD008650.pub2 [Systematic Review, Cochrane, 14 RCTs on weight loss]
  2. Hursel R, Viechtbauer W, Westerterp-Plantenga MS. The effects of green tea on weight loss and weight maintenance: a meta-analysis. Int J Obes (Lond). 2009;33(9):956-61. PMID: 19597519 · DOI: 10.1038/ijo.2009.135 [Meta-analysis, 11 studies]
  3. EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS); Younes M, Aggett P, Aguilar F et al. Scientific opinion on the safety of green tea catechins. EFSA J. 2018;16(4):e05239. PMID: 32625874 · DOI: 10.2903/j.efsa.2018.5239 [Authority document, EFSA]
  4. Oketch-Rabah HA, Roe AL, Rider CV et al. United States Pharmacopeia (USP) comprehensive review of the hepatotoxicity of green tea extracts. Toxicol Rep. 2020;7:386-402. PMID: 32140423 · DOI: 10.1016/j.toxrep.2020.02.008 [Review, safety assessment]
  5. Commission Regulation (EU) 2022/2340 of 30 November 2022 (amending Annex III to Regulation (EC) No 1925/2006 as regards green tea extracts containing (-)-epigallocatechin-3-gallate). EUR-Lex, CELEX 32022R2340. No DOI. [Legal regulation]
  6. Ludy MJ, Moore GE, Mattes RD. The effects of capsaicin and capsiate on energy balance: critical review and meta-analyses of studies in humans. Chem Senses. 2012;37(2):103-21. PMID: 22038945 · DOI: 10.1093/chemse/bjr100 [Review with meta-analyses]
  7. Zsiboras C, Matics R, Hegyi P, Balasko M, Petervari E, Szabo I et al. Capsaicin and capsiate could be appropriate agents for treatment of obesity: A meta-analysis of human studies. Crit Rev Food Sci Nutr. 2018;58(9):1419-1427. PMID: 28001433 · DOI: 10.1080/10408398.2016.1262324 [Meta-analysis, 9 studies]
  8. Dulloo AG, Geissler CA, Horton T, Collins A, Miller DS. Normal caffeine consumption: influence on thermogenesis and daily energy expenditure in lean and postobese human volunteers. Am J Clin Nutr. 1989;49(1):44-50. PMID: 2912010 · DOI: 10.1093/ajcn/49.1.44 [Controlled laboratory study, metabolic chamber]
  9. Tabrizi R, Saneei P, Lankarani KB, Akbari M, Kolahdooz F, Esmaillzadeh A et al. The effects of caffeine intake on weight loss: a systematic review and dos-response meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2019;59(16):2688-2696. PMID: 30335479 · DOI: 10.1080/10408398.2018.1507996 [Systematic Review and Meta-analysis, 13 RCTs]
  10. Boschmann M, Steiniger J, Hille U, Tank J, Adams F, Sharma AM et al. Water-induced thermogenesis. J Clin Endocrinol Metab. 2003;88(12):6015-9. PMID: 14671205 · DOI: 10.1210/jc.2003-030780 [Laboratory study in humans, n=14]
  11. Brown CM, Dulloo AG, Montani JP. Water-induced thermogenesis reconsidered: the effects of osmolality and water temperature on energy expenditure after drinking. J Clin Endocrinol Metab. 2006;91(9):3598-602. PMID: 16822824 · DOI: 10.1210/jc.2006-0407 [Randomised crossover laboratory study]
  12. van Marken Lichtenbelt WD, Vanhommerig JW, Smulders NM, Drossaerts JM, Kemerink GJ, Bouvy ND et al. Cold-activated brown adipose tissue in healthy men. N Engl J Med. 2009;360(15):1500-8. PMID: 19357405 · DOI: 10.1056/NEJMoa0808718 [Clinical study, PET-CT, n=24]
  13. Yoneshiro T, Aita S, Matsushita M, Kayahara T, Kameya T, Kawai Y et al. Recruited brown adipose tissue as an antiobesity agent in humans. J Clin Invest. 2013;123(8):3404-8. PMID: 23867622 · DOI: 10.1172/JCI67803 [RCT according to PubMed, small intervention study]
  14. Bellisle F, McDevitt R, Prentice AM. Meal frequency and energy balance. Br J Nutr. 1997;77 Suppl 1:S57-70. PMID: 9155494 · DOI: 10.1079/bjn19970104 [Review]
  15. Cameron JD, Cyr MJ, Doucet E. Increased meal frequency does not promote greater weight loss in subjects who were prescribed an 8-week equi-energetic energy-restricted diet. Br J Nutr. 2010;103(8):1098-101. PMID: 19943985 · DOI: 10.1017/S0007114509992984 [RCT, n=16]
  16. Schoenfeld BJ, Aragon AA, Krieger JW. Effects of meal frequency on weight loss and body composition: a meta-analysis. Nutr Rev. 2015;73(2):69-82. PMID: 26024494 · DOI: 10.1093/nutrit/nuu017 [Meta-analysis, 15 studies]
  17. Betts JA, Richardson JD, Chowdhury EA, Holman GD, Tsintzas K, Thompson D. The causal role of breakfast in energy balance and health: a randomized controlled trial in lean adults. Am J Clin Nutr. 2014;100(2):539-47. PMID: 24898233 · DOI: 10.3945/ajcn.114.083402 [RCT, n=33]
  18. Sievert K, Hussain SM, Page MJ, Wang Y, Hughes HJ, Malek M et al. Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials. BMJ. 2019;364:l42. PMID: 30700403 · DOI: 10.1136/bmj.l42 [Systematic Review and Meta-analysis, 13 RCTs]
  19. Mansour MS, Ni YM, Roberts AL, Kelleman M, Roychoudhury A, St-Onge MP. Ginger consumption enhances the thermic effect of food and promotes feelings of satiety without affecting metabolic and hormonal parameters in overweight men: a pilot study. Metabolism. 2012;61(10):1347-52. PMID: 22538118 · DOI: 10.1016/j.metabol.2012.03.016 [RCT, Crossover, pilot study, n=10]
  20. Launholt TL, Kristiansen CB, Hjorth P. Safety and side effects of apple vinegar intake and its effect on metabolic parameters and body weight: a systematic review. Eur J Nutr. 2020;59(6):2273-2289. PMID: 32170375 · DOI: 10.1007/s00394-020-02214-3 [Systematic Review, 13 human and 12 animal studies] contains animal data

Fat burners and dietary supplements for weight loss

  1. Pittler MH, Ernst E. Dietary supplements for body-weight reduction: a systematic review. Am J Clin Nutr. 2004;79(4):529-36. PMID: 15051593 · DOI: 10.1093/ajcn/79.4.529 [Systematic Review]
  2. Batsis JA, Apolzan JW, Bagley PJ, Blunt HB, Divan V, Gill S et al. A Systematic Review of Dietary Supplements and Alternative Therapies for Weight Loss. Obesity (Silver Spring). 2021;29(7):1102-1113. PMID: 34159755 · DOI: 10.1002/oby.23110 [Systematic Review, 315 RCTs]
  3. Geller AI, Shehab N, Weidle NJ, Lovegrove MC, Wolpert BJ, Timbo BB et al. Emergency Department Visits for Adverse Events Related to Dietary Supplements. N Engl J Med. 2015;373(16):1531-40. PMID: 26465986 · DOI: 10.1056/NEJMsa1504267 [Real-world surveillance, 63 emergency departments]
  4. Tucker J, Fischer T, Upjohn L, Mazzera D, Kumar M. Unapproved Pharmaceutical Ingredients Included in Dietary Supplements Associated With US Food and Drug Administration Warnings. JAMA Netw Open. 2018;1(6):e183337. PMID: 30646238 · DOI: 10.1001/jamanetworkopen.2018.3337 [Real-world analysis, FDA database]
  5. Grundlingh J, Dargan PI, El-Zanfaly M, Wood DM. 2,4-dinitrophenol (DNP): a weight loss agent with significant acute toxicity and risk of death. J Med Toxicol. 2011;7(3):205-12. PMID: 21739343 · DOI: 10.1007/s13181-011-0162-6 [Review with case series]

Disordered eating

  1. Patton GC, Selzer R, Coffey C, Carlin JB, Wolfe R. Onset of adolescent eating disorders: population based cohort study over 3 years. BMJ. 1999;318(7186):765-8. PMID: 10082698 · DOI: 10.1136/bmj.318.7186.765 [Cohort, prospective, adolescents, n=1,699]
Transparency on the evidence: where the data are thin
  1. Levels of evidence. Well documented: fat-free mass as the main factor in basal metabolic rate, stable adjusted expenditure between 20 and 60, energy compensation, no weight loss effect of thyroid hormones with a healthy thyroid. Mechanistically plausible, thin in humans: brown fat, iron and the thyroid, capsaicin, ginger. Tradition without a study basis: lemon water, metabolism teas.
  2. Adaptive thermogenesis. The large figures come from two small studies in an extreme television format (n = 14 and n = 16). Their transferability to typical diets is limited, and the size of the adaptation remains disputed.
  3. Conflicts of interest. According to the full text, the SURMOUNT-1 substudy was funded by the manufacturer, which was involved in design, analysis and the manuscript. PubMed lists a correction to this paper whose content was not accessible at the time of research.
  4. Retracted study. A widely cited randomised trial on apple cider vinegar in adolescents and young adults was retracted in 2025. It is not used as evidence here. The review on apple cider vinegar includes animal studies, which are not used as human findings in the text.
  5. Gaps in the study populations. The meta-analysis on training and resting metabolic rate excluded people aged 65 and over and postmenopausal women. Pontzer's lifespan data did not analyse menopause separately. The menopause calorimetry is based on 34 women. The cohort on dieting and eating disorders included adolescents in Australia in the 1990s.
  6. Iron. The statements on ferritin targets from my practice are clinical observation, not a guideline statement. The DEGAM guideline is more cautious about iron deficiency without anaemia, and both positions are presented in the text.
  7. Not examined. Individual fat burner ingredients, commercial metabolic type tests and metabolism regimens were not researched individually and are therefore neither recommended nor evaluated. The emergency department and product data come from the USA.
  8. What is deliberately not included here. No calorie or weight targets, no training volumes, no dosages of dietary supplements, iron or medication, no product names and no advice to stop, reduce or replace a prescribed medication. No paragraph implies that medical or psychotherapeutic treatment should be postponed.

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