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Is the idea of a set-point settled medical/scientific fact, or still a disputed theory?



It's still a theory. We definitely don't know the underlying mechanism(s) of action, and it's likely there's more hidden complexity there.

But rapid weight gain after weight loss (until you arrive somewhere near your old weight) is at least a well observed experimental effect. About 80% of people who lose weight, through any means, will revert back to their old weight.

Source:

https://www.ncbi.nlm.nih.gov/books/NBK592402/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673773/


i lost about 30 lbs a couple of years ago, white knuckling my way through starving myself on a medically supervised diet. within two months of going off the diet, i was back at the exact weight i started at, to the pound, and haven’t varied >2lbs since, no matter what i eat. consider me convinced on the setpoint theory.


There are lots of physiological parameters with set-points, such as body temperature. The problem for weight gain/loss is that instead of one set-point for body weight itself, you have maybe 5-10 set and operating points that are indirectly related to body weight, but not direct measurements of it. They don't all have to be "working right" to keep you healthy, but if too many become disordered at once, you're gonna have a problem.


Set-point theory is pretty much settled medical fact. The mechanism involves leptin, and you can easily see processes that defend bodyweight change in both directions. Though it will more aggressively defend weight loss than weight gain.

In addition prey animals will defend against weight gain more aggressively than non-prey animals. Which makes sense from an evolutionary standpoint. If a lion gets fat he doesn't have nearly as much to worry about than if a gazelle gets fat.


A lion may also have to endure long periods of no food.




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